Chapter 39: Common Skin Conditions Flashcards
Which drugs can cause the skin & secretions to turn brown
o Entacapone
o Levodopa
o Methyldopa
Which drug can cause the skin & secretions to turn brown/yellow
Nitrofurantoin
think of a nitro cold brew at starbucks that’s brown with yellowish foam on top
Which drug can cause the skin & secretions to turn orange/yellow
Sulfasalazine
Which drug can cause the skin & secretions to turn yellow-green
Propofol
Which drugs can cause the skin & secretions to turn red-orange
Phenazopyridine
Rifampin
Which drug can cause the skin & secretions to turn red
Anthracyclines
Which drugs can cause the skin & secretions to turn blue
Methylene blue
Mitoxantrone
Which drugs can cause the skin & secretions to turn blue-gray
o Amiodarone
______ are the primary determinant of acne along with presence of the bacteria, Cutibacterium acnes and fatty acids (sebum) present in oil (sebaceous glands)
Androgens
Retinoids are _____ derivatives
vitamin A
How do retinoids work?
Reduce adherence of keratinocytes in the oil gland
First-line for mild acne
Topicals: Benzoyl Peroxide and/or retinoid
First-line for moderate acne
Topicals: combination*
Or
PO antibiotic + BPO + topical retinoid (+ topical antibiotic)
First-line for severe acne
Topicals: combination* + PO antibiotic
Or
Oral: isotretinoin
Tretinoin brand names
Atralin
Renova
Retin-A
Retin-A Micro
Adapalene brand name
Differin
How long do topical retinoids take to work
4-12 weeks
T/F: Topical retinoids should be avoided in pregnancy
True
Which topical retinoid has a slower release and therefore causes less skin irritaiton
Retin-A-Micro
Which topical retinoid is CI in pregnancy
Tazarotene
Dapsone gel should be avoided in:
G6PD deficiency
Isotretinoin brand names
Absorica, Amnesteem
Boxed warning for isotretinoin
Birth defects (2 forms of BC are required [cannot use a POP])
Warnings of isotretinoin
dry eyes/irritation
dry skin
chapped lips
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)
Minocycline brand names
Minocin
Solodyn
Minocycline should only be used in patients > __ years
12 years
Counseling for minocycline
can cause photosensitivity, fetal harm, discoloration in teeth in children
Docosantol brand name
Abreeva
Which Rx drug is used for cold sores?
Acyclovir topical cream/ointment (Zovirax)
How should you apply Abreva cream
apply 5x daily at first sign of outbreak; continue until healed
How should you apply Zovirax cream
apply 5x daily for 4 days
Drugs that can cause alopecia
chemotherapeutics
valproate
spironolactone
heparin
What vitamin deficiencies can cause hair loss
Zinc and Vitamin D deficiency
Finasteride brand name for alopecia treatment
Propecia
Minoxidil topical brand name
Rogaine
Propecia is CI in
pregnancy
OTC drugs that can be used for eczema
Aquaphor, Eucerin
What rx drugs should be used first in eczema before using topical calcineurin inhibitors, topical PDE4i, and MABs
topical steroids
Do not use Elidel and Protopic (topical calcineurin inhibitors) in children < ___ years of age
2
Topical calcineurin inhibitors are associated with ___ and should only be used as second-line drugs for short-term in eczema
lymphoma and skin cancer
Terbinafine brand name
Lamisil AT cream, gel, or spray
Butenafine brand name
Lotrimin Ultra cream
Miconazole brand name
Lotrimin AF
tolnaftate brand name
Tinactin
Which 2 OTC drugs are highly effective for fungal treatments of the skin
terbinifine
butenafine
think of a TB test on the skin
Topical antifungals should be used for at least _____ weeks, even if it appears healed
2-4 weeks
____ is essential for diagnosis of toenail and fingernail infections
20% KOH smear
Which oral drugs are approved for toenail and fingernail infections
Itraconazole
and
terbinifine (Lamisil)
Itraconazole (Sporanox) has a boxed warning for
Heart failure
pH > ___ indicates the presence of bacterial vaginosis or trichomoniasis infection
4.5
Clotrimazole brand name for vaginal fungal infections
Gyne-Lotrimin (OTC)
Miconazole brand name for vaginal fungal infections
Monistat 3 (OTC)
Butoconazole brand name for vaginal fungal infections
Gynazole-1 (Rx)
Fluconazole dosing for vaginal fungal infection
150 mg PO x 1
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
Diaper rash prevention
Petrolatum ointment (A & D Ointment) \+ zinc oxide (a desiccant) - (Desitin)
If yeast is thought to be involved in a diaper rash, patient can use ___
nystatin
Preparation H contains which drug
phenylepherine (topical)
Which drug is used for pinworms
Pyrantel pamoate (OTC)
Mebendazole and albendazole used for pinworms cause
HA
nausea
hepatotoxicity
What drugs are given with systemic worm infections to help with the toxicity
steroids and AEDs
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
Primary treatment for scabies (mites) is _____ (OTC) in a cream formulation and the Rx drug _____
permethrin (Elemite)
Ivermectin (Stromectol)
Malathion lotion 0.5% (Ovide) for lice causes ____ and is ____
skin irritation; flammable
Lindane shampoo 1% is no longer recommended for lice due to ____
neurotoxicity
After each lice treatment, check the hair and use a nit comb to remove nits and lice every - days
2-3
DOC for lice & when should treatment be repeated
permethrin (Nix) or pyrethrin/piperonyl butoxide (Rid)
Repeat treatment on day 9
For burns, _______ can be used topically to reduce infection risk and promote healing
Silver sulfadiazine (Silvadene; SSD)
Primary treatment for skin irritation is topical steroids.
OTC hydrocortisone comes in 2 strengths: _____; all other strengths are Rx
0.5% and 1%
Potency of vehicles from highest to weakest:
Ointments>creams > lotions > solutions > gels > sprays
How often should sunscreen be reapplied
every 2 hours & after swimming
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)
Very high potency topical steroids
- Clobetasol propoionate 0.05% Lotion/Shampoo/Spray (Clobex), Cream/Ointment (Temovate), Foam (Olux)
- Fluocinonide 0.1% Cream (Vanos)
High potency topical steroids
- Betamethasone dipropionate 0.05% Cream (Diprolene AF)
- Fluocinonide 0.05% Ointment
- Mometasone furoate 0.1% Ointment
High-Medium potency topical steroids
Fluocinonide 0.05% Cream
Medium potency topical steroids
- Mometasone furoate 0.1% Cream
* Triamcinolone acetonide 0.1% Cream, Spray (Kenalog)
Lowest potency topical steroids
Hydrocortisone Cream: 0.5%, 1% (Cortaid, Cortisone, Cortizone-10)
Ketoconazole 2% Rx shampoo for dandruff brand name
Nizoral
Propecia dose for alopecia
1 mg daily at least 3 months to see effect
Topical tacrolimus (Protopic) and pimecrolimus (Elidel) should not be used in children < __ years
2
Antifungals should be applied - inches beyond the rash
1-2
Fungal infection of the foot
tinea pedis
Fungal infection of the genitals, inner thighs, and buttocks
Tinea cruris
Circular, red, flat sores that are itchy
tinea corporis (ringworm)
Terbinafine has a risk of
hepatotoxicity
Mupirocin (Bactroban) is an antibiotic cream/ointment that has very good __ and __ coverage & can be used for _____ colonization
Staph & strep
nasal MRSA colonization
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
Hydroxyzine brand name
Vistaril
Hydroxyzine is used for
general urticaria (hives)
Hydroxyzine common side effects
sedation
dry mouth
Sunscreen labeling can no longer use “waterproof” or “sweatproof.” They can claim to be “water resistant” but only for __-__ min
40-80
