Common Drugs used in Derm

Question 1

Griseofulvin

Answer 1

1st line for scalp infections
8 weeks of therapy for tinea capitis
MOA:Fungistatic (inhibits fungal cell division)
Binds to human keratin making it resistant to fungal invasion
Administration:
Taken with a fatty meal helps to increase absorption

Question 2

Contraindications and precautions with the administration of griseofulvin

Answer 2

Liver failure
Porphyria
Pregnancy category X
Use with caution if history of penicillin allergy as potential for cross reactivity
Breast feeding not recommended

Question 3

Terbinafine (Lamisil)

Answer 3

1st line for nail infections
Systemic allylamine antifungal
MOA
Creates ergesterol deficiency within the fungal cell wall leading to cell death
Multiple drug interactions including metoprolol and tramadol

Question 4

Itraconazole (Sporanox) for onychomycosis contraindications

Answer 4

Ventricular dysfunction
Pregnancy
CHF
Black box warning: Negative inotropic effects have been observed following intravenous administration. Discontinue or reassess use if signs or symptoms of heart failure (HF) occur during treatment

Question 5

5-Alpha-Reducatase inhibitor: Finasteride (Propecia)

Answer 5

First line therapy for the treatment of androgenic alopecia in men
MOA: inhibits the conversion of testosterone to dihydrotestosterone
Same as Proscar (but lower dose)
Used for treatment of benign prostatic hypertrophy
Baseline PSA needed

Question 6

Cephalexin (Keflex)

Answer 6

Derm indications: skin and skin structure infections…good for walled off abscess (cellulitis)
Distribution: Widely distributed to all body tissues except does not penetrate the CSF very well
Covers Staph and Strep

Question 7

Mupirocin (Bactroban)

Answer 7

Indications: Impetigo due to S. aureus and S. pyogenes
Treatment of secondarily infected skin lesions due to Staph or Strep
Intranasal: Used to eradicate nasal colonization of MRSA

Question 8

Tetracyclines

Answer 8

Doxycycline, Minocycline
MOA: Inhibition of protein synthesis by binding with the 30S ribosomal subunit
SE: All cause photosensitivity
All are pregnancy category D and not generally used in kids (esp.

Question 9

Doxycycline dermatologic indications

Answer 9

Ticborne rickettsial infections
Acne
Rosacea

Question 10

Clindamycin

Answer 10

Avoid oral for treatment of acne due to risk of C. difficile colitis

Question 11

Retinoic Acid Derivative: Isotrentinoin (Accutane)

Answer 11

Treatment of severe, recalcitrant, nodular acne
Acne with many inflammatory nodules (greater than 5 mm) that is unresponsive to conventional therapy, including systemic antibiotics
The only acne medication that can permanently alter the natural course of the disorder

Question 12

Isotrentinoin (Accutane) MOA

Answer 12

Shrinks sebaceous glands

Decreases sebum production

Question 13

Topical calcineurin inhibitors

Answer 13

Tacrolimus (Protopic)
Pimecrolimus (Elidel)
BBX: Topical calcineurin inhibitors have been associated with rare cases of malignancy (including skin and lymphoma)
Used in: Atopic Dermatitis, Lichen Planus, Vitiligo, Psoriasis