Chapter 39: Common Skin Conditions Flashcards
1
Q
Which drugs can cause the skin & secretions to turn brown
A
o Entacapone
o Levodopa
o Methyldopa
2
Q
Which drugs can cause the skin & secretions to turn brown/black/green
A
iron
3
Q
Which drug can cause the skin & secretions to turn brown/yellow
A
Nitrofurantoin
think of a nitro cold brew at starbucks that’s brown with yellowish foam on top
4
Q
Which drug can cause the skin & secretions to turn orange/yellow
A
Sulfasalazine
5
Q
Which drug can cause the skin & secretions to turn yellow-green
A
Propofol
6
Q
Which drugs can cause the skin & secretions to turn red-orange
A
Phenazopyridine
Rifampin
7
Q
Which drug can cause the skin & secretions to turn red
A
Anthracyclines
8
Q
Which drugs can cause the skin & secretions to turn blue
A
Methylene blue
Mitoxantrone
9
Q
Which drugs can cause the skin & secretions to turn blue-gray
A
o Amiodarone
10
Q
____ are the primary determinant of acne along with presence of the bacteria (Cutibacterium acnes) and fatty acids (sebum) present in oil (sebaceous glands)
A
Androgens
11
Q
Retinoids are ____ derivatives
A
vitamin A
12
Q
How do retinoids work for acne?
A
Reduce adherence of keratinocytes in the oil gland
13
Q
First-line for mild acne
A
Topicals: Benzoyl Peroxide and/or retinoid
14
Q
First-line for moderate acne
A
Topicals: combination*
Or
PO antibiotic + BPO + topical retinoid (+ topical antibiotic)
15
Q
First-line for severe acne
A
Topicals: combination* + PO antibiotic
Or
Oral: isotretinoin
16
Q
Tretinoin brand names
A
Atralin, Renova, Retin-A, Retin-A Micro
17
Q
Adapalene brand name
A
Differin
18
Q
How long do topical retinoids take to work
A
4-12 weeks
may worsen acne initially
19
Q
T/F: Topical retinoids should be avoided in pregnancy
A
True
20
Q
Which topical retinoid has a slower release and therefore causes less skin irritaiton
A
Retin-A-Micro
21
Q
Which topical retinoid is CI in pregnancy
A
Tazarotene
others should just be avoided, not CI
22
Q
Dapsone gel should be avoided in:
A
G6PD deficiency
23
Q
Isotretinoin brand names
A
Absorica, Amnesteem
24
Q
Boxed warning for isotretinoin
A
Birth defects (2 forms of BC are required [cannot use a POP])
25
Warnings of isotretinoin
dry eyes/irritation, dry skin, chapped lips
26
Females on isotretinoin cannot get pregnant during which times
Cannot get pregnant for 1 month before, during, or 1 month after drug is stopped
(remember: 1 looks like the letter I for isotretinoin)
27
Minocycline brand names
Minocin, Solodyn
28
XR Minocycline should only be used in patients > __ years
12 years
29
Counseling for minocycline
can cause photosensitivity, fetal harm, discoloration in teeth in children
30
Docosantol brand name
Abreeva
31
cold sores are caused by
HSV-1 mostly
32
Which Rx drug is used for cold sores?
Acyclovir topical cream/ointment (Zovirax)
33
acyclovir brand name
Zovirax
34
How should you apply Abreva cream
apply 5x daily at first sign of outbreak; continue until healed
35
How should you apply Zovirax cream
apply 5x daily for 4 days
36
natural product used for cold sores
lysine
37
OTC and Rx used for dandruff
OTC: ketoconazole 1%, selenium sulfide, pyrithione zinc, coal tar shampoos
Rx: ketoconazole 2%
38
ketoconazole brand name
Nizoral
39
selenium sulfide brand name
Selsun
40
Pyrithione zinc brand name
Head and Shoulders
41
Coal tar shampoos brand name
T/Gel
42
Drugs that can cause alopecia
chemotherapeutics, valproate, spironolactone, heparin
43
What vitamin deficiencies can cause hair loss
Zinc and Vitamin D deficiency
44
Finasteride brand name for alopecia treatment
Propecia
45
Minoxidil topical brand name
Rogaine
46
Propecia is CI in
pregnancy
47
do not use bimatoprost with what other eye drops?
prostaglandin analogs used for glaucoma
48
bimatroprost counseling point
apply nightly to skin on upper eyelid base, NOT to the lower lid
49
OTC drugs that can be used for eczema
Aquaphor, Eucerin
50
What rx drugs should be used first in eczema before using topical calcineurin inhibitors, topical PDE4i, and MABs
topical steroids
51
Do not use Elidel and Protopic (topical calcineurin inhibitors) in children < ___ years of age
2
52
Topical calcineurin inhibitors are associated with ___ and should only be used as second-line drugs for short-term in eczema
lymphoma and skin cancer
53
hyperhidrosis treatment
OTC: antiperspirants
Rx: glycopyrronium topical (anticholinergic)
54
What are the following:
1. tinea pedis
2. tinea cruris
3. tinea corporis
4. tinea capitis
1. athlete's foot
2. jock itch
3. ringworm
4. ringworm on the scalp
55
Terbinafine brand name
Lamisil AT cream, gel, or spray
56
Butenafine brand name
Lotrimin Ultra cream
57
Clotrimazole brand name
Lotrimin AF cream
58
Miconazole brand name
Lotrimin AF
59
Tolnaftate brand name
Tinactin
60
betamethasone/clotrimazole brand name
Lotrisone
61
Which 2 OTC drugs are highly effective for fungal treatments of the skin
Terbinifine and butenafine
| think of a TB test on the skin
62
apply medicine ___-___ inches beyond the rash
1-2 inches
63
Topical antifungals should be used for at least _____ weeks, even if it appears healed
2-4 weeks
64
What is onychomycosis?
fungal infection of the nail
65
____ is essential for diagnosis of toenail and fingernail infections
20% KOH smear
66
Treatment of onychomycosis
usually topical not potent enough
oral treatments -- terbinafine, itraconazole (off-label fluconazole, possaconazole)
67
Which oral drugs are approved for toenail and fingernail infections
Itraconazole and terbinifine (Lamisil)
68
Itraconazole (Sporanox) has a boxed warning for
Heart failure
69
pH > ___ indicates the presence of bacterial vaginosis or trichomoniasis infection
4.5
70
Treatments for vaginal fungal infection
OTC: clotrimazole, miconazole (Monistat 3)
Rx: butonazole (Gynazole-1), fluconazole (Diflucan)
71
Miconazole brand name for vaginal fungal infections
Monistat 3 (OTC)
72
Butoconazole brand name for vaginal fungal infections
Gynazole-1 (Rx)
73
Fluconazole dosing for vaginal fungal infection
150 mg PO x 1
74
When should a patient be referred for a vaginal fungal infection
complicated infection, pregnancy
Could give 7-10 days treatment as well and then refer
75
Diaper rash prevention
```
Petrolatum ointment (A & D Ointment)
+ zinc oxide (a desiccant) - (Desitin)
```
76
brand name of petrolatum/zinc oxide
Desitin
77
If yeast is thought to be involved in a diaper rash, patient can use ___
nystatin (or clotrimazole, miconazole)
78
treatment for hemorrhoids
increase dietary fiber
Preparation H - vasoconstrictor
hydrocortisone (Anusol-HC, Preparation H)
witch hazel
79
Preparation H contains which drug
phenylephrine (topical)
80
Which drugs can be used for pinworms
OTC: Pyrantel pamoate
Rx: albendazole, mebendazole
81
What is the "tape" test in pinworm infection?
before voiding or defecating, take piece of tape around anus to see if eggs stick - look at under microscope
82
Mebendazole and albendazole used for pinworms cause
HA, nausea and hepatotoxicity
83
What drugs are given with systemic worm infections to help with the toxicity
steroids and Antiepileptic drugs
84
When treating pinworms with albendazole, it must be taken with ____ to increase absorption
a high-fat meal
*think of fat Albert - ALBEndazole & high-fat meal*
85
Primary treatment for scabies (mites) is _____ (OTC) in a cream formulation and the Rx drug _____
permethrin (Elemite)
| Ivermectin (Stromectol)
86
Malathion lotion 0.5% (Ovide) for lice causes ____ and is ____
skin irritation; flammable
87
Lindane shampoo 1% is no longer recommended for lice due to ____
neurotoxicity
88
what is used to treat scabies?
5% permethrin cream
89
what is used to treat lice?
Nix 1% lotion
topical ivermectin (Sklice)
90
After each lice treatment, check the hair and use a nit comb to remove nits and lice every _-_ days
2-3
91
Why is lindane no longer recommended?
neurotoxicity
| reserved for refractory cases
92
DOC for lice & when should treatment be repeated
permethrin (Nix) or pyrethrin/piperonyl butoxide (Rid)
| Repeat treatment on day 9
93
For burns, _______ can be used topically to reduce infection risk and promote healing
Silver sulfadiazine (Silvadene; SSD)
94
Primary treatment for skin irritation is topical steroids. OTC hydrocortisone comes in 2 strengths: _____; all other strengths are Rx
0.5% and 1%
95
Potency of vehicles from highest to weakest:
Ointments > creams > lotions > solutions > gels > sprays
96
How often should sunscreen be reapplied
every 2 hours & after swimming
97
How to calculate Time to Burn
TTB (with sunscreen in min) = SPF x TTB (without sunscreen)
Example: if someone normally burns in 10 min and they use SPF of 5, then it would extend their time they would burn to 50 min (5x10)
98
Very high potency topical steroids
* Clobetasol propoionate 0.05% Lotion/Shampoo/Spray (Clobex), Cream/Ointment (Temovate), Foam (Olux)
* Fluocinonide 0.1% Cream (Vanos)
99
High potency topical steroids
* Betamethasone dipropionate 0.05% Cream (Diprolene AF)
* Fluocinonide 0.05% Ointment
* Mometasone furoate 0.1% Ointment
100
High-Medium potency topical steroids
Fluocinonide 0.05% Cream
101
Medium potency topical steroids
* Mometasone furoate 0.1% Cream
* Triamcinolone acetonide 0.1% Cream, Spray (Kenalog)
102
Lowest potency topical steroids
Hydrocortisone Cream: 0.5%, 1% (Cortaid, Cortisone, Cortizone-10)
103
Propecia dose for alopecia
1 mg daily at least 3 months to see effect
104
Topical tacrolimus (Protopic) and pimecrolimus (Elidel) should not be used in children < __ years
2
105
Antifungals should be applied _-_ inches beyond the rash
1-2
106
Fungal infection of the foot
tinea pedis
107
Fungal infection of the genitals, inner thighs, and buttocks
Tinea cruris
108
Circular, red, flat sores that are itchy
tinea corporis (ringworm)
109
Terbinafine has a risk of
hepatotoxicity
110
Mupirocin (Bactroban) is an antibiotic cream/ointment that has very good __ and __ coverage & can be used for _____ colonization
Staph & strep
| nasal MRSA colonization
111
Ointments (__% oil and __% water such as Aquaphor) should be used for skin protection over a minor burn to hold in moisture & reduce scarring risk
80% oil
| 20% water
112
Hydroxyzine brand name
Vistaril
113
Hydroxyzine is used for
general urticaria (hives)
114
Hydroxyzine common side effects
sedation and dry mouth
115
Sunscreen labeling can no longer use "waterproof" or "sweatproof." They can claim to be "water resistant" but only for __-__ min
40-80
