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Exam 11 > Derm > Flashcards

Derm Flashcards

1
Q

What are 5 factors that determine percutaneous absorption

A 
stratum corneum thickness + integrity of barrier function
drug partition coefficient 
drug diffusion coefficient
drug concentration
superficial dermal vascular plexus
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2
Q

From most to least, what are the areas of skin with drug penetration

A

mucous membrane-> scrotum-> eyelids-> face-> chest/back-> upper arms/legs-> lower arms/legs-> dorsa hands and feet-> palmar + plantar skin-> nails

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3
Q

____ is the strongest vehicle due to highest optimal partition coefficient to transfer drug to stratum corner lipids. ___ is the weakest

A

ointment, solution

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4
Q

Diseased skin variables that affect percutaneous absorption

A

inflamed skin (increase), ulceration, addition skin med, occlusion of med, age of pt

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5
Q

What are adverse effects of topical medicine?

A

irritant and allergic contact dermatitis

toxicity related to systemic absorption (eg cataracts)

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6
Q

MOA of topical corticosteroids

A

anti-inflammatory, immunosuppressive, anti prolific, vasoconstrictive
mediated by intracellular glucocorticoid receptor-> modulate gene transcription

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7
Q

low potency topical corticosteroids should be used on ____ areas

A

face and intertriginous

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8
Q

Potent corticosteroids should be used for ____ and ____

A

hyper keratitis or lichenified dermatoses or involvement of palms and soles

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9
Q

3 diseases that are highly responsive to topical corticosteorids

A

inverse psoriasis, seborrheic dermatitis, nummular eczema

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10
Q

Using topical corticosteroids could affect the ______ axis and cause

A

hypothalamic-pituitary-adrenal axis-> striae, bruising, allergic contact dermatitis, depigmentation, worse infection, rebound phenomenon

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11
Q

special guidelines should be used for topical steroid use in ____ or ____

A

certain body areas or certain populations (children or elderly)

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12
Q

MOA of topical calcineurin inhibitors

A

inhibits antigen induced activation of T cells

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13
Q

What are topical calcineurin inhibitors used for

A

atopic dermatitis

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14
Q

AEs of topical calcineurin inhibitors

A

burning and stinging at application site

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15
Q

MOA of topical crisaborole

A

topical phosphodiesterase 4 inhibitor -> decrease inflammatory cytokines-> increase intracellular cAMP

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16
Q

Indications for topical crisaborole

A

mild to moderate atopic dermatitis

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17
Q

MOA of calcipotriene

A

vitamin D analog-> inhibit epidermal proliferation + epidermal differentiation + anti-inflammatory

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18
Q

Calcipotriene is effective in ____ but ____ may occur if you use too much. ____ (AE) can be see when used on face or intertriginous area

A

psoriasis, hypercalcemia

cutaneous irritation

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19
Q

MOA of imiquimod

A

agonist of TLR7 and 8-> proinflammatory

enhances innate and adaptive immune fxn (against antiviral, anti tumor, antiangiogenic, vaccine adjuvant)

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20
Q

What is topical imiquimod used for?

A

anogenital warts, superficiale BCC

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21
Q

MOA of topical retinoids

A

analogs of vitA-> regulate gene transcription-> cell growth, differentiation, morphogenesis + inhibit tumor

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22
Q

6 uses of topical retinoids

A

acne, psoriasis, cutaneous T cell lymphoma, KS, melanoma, photo aged skin

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23
Q

Topical antibiotics are prescribed to manage mild/moderate _____ or adjective with ___

A

acne vulgaris/cosacea

oral agents

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24
Q

Some superficial infections (impetigo) can be treated with just topical antibiotics and don’t need _____

A

oral antibiotics. reduces side effects

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25
8 antibiotics used for topical things
bacitracin, polymyxin B, muirocin, neomycin, erythromycin, clindamycin, metronidazole, azelaic acid
26
Topical anti fungal classes (4)
imidazole, allylamines, benzylamines, polyenes
27
Ciclopirox olamine is a topical antifungal with ____
broad spectrum activity
28
Combination agents (anti fungal and steroids) have a higher rate of ____
treatment failure
29
Imidazole impede synthesis of fungal cell wall thorugh ____
lanosterol 14 α-demethylase (lanosterol->ergosterol)
30
Imidazole are used for
dermatophytoses, pityriasis versicolor, candidiasis, seborrheic dermatitis, onychomycosis
31
Allylamines and benzylamines MOA
inhibit squalene epoxidase-> inhibit squalene to squalene oxide-> impeded synthesis of ergosterol
32
Allylamines and benzylamines are used for
dermatophytoses (tinea pedis/tinea manum, tinea cruris/corporis/faciei), pityriasis vericolor
33
Nystatin binds irreversibly to membrane _____ in candida
sterols
34
nystatin is used to treat ____
mucocutaneous candidasis
35
Ciclopirox olamine is indicated for:
dermatophytoses and onychomycosis, candidiasis, pityriasis, versicolor, seborrheic dermatitis, saprophyte infection (cutaneous)
36
Ciclopirox interrupts active transport of cell precursors like ____
trivalent cations
37
Acyclovir and penciclovir are used for
HSV1 and 2
38
Two cholinesterase inhibitors used for lice and scabies
malathion (not scabies) | lindane (scabies)
39
MOA of permethrin
inhibits nerve cell Na ion influx
40
Permethrin use
lice and scabies-> clothing as insect repellant
41
What are topical and intralesional cytotoxic agents used for
skin cancers, inflammatory + infectious dermatologic conditions
42
5-fluorouracil MOA and indications
block DNA synthesis by inhibiting thymidylate synthetase | actinic keratoses + superficial BCC
43
Mechlorethamine (nitrogen mustard) MOA and indications
alkylating activity + immune stimulation | mycosis fungoides stage 1A, B
44
Vinblastine MOA and indications
anti mitotic agent, distrust microtubule->block cell division in metaphase KS
45
Bleomycin MOA and indications
disrupt DNA synthesis + scission of DNA strands | viral warts, hemangiomas, keloids, hypertrophic scars
46
Podophyllin MOA and indications
Bind tubular, disrupt cellular cytoskeleton | anogentical warts, facial angiofibromas
47
Three agents used as washes, how they work and what they are used for
``` benzoyl peroxide (microbial molecules, acne) hydrogen peroxide (microbial-> clean wounds, suppurating ulcers/local infxn) Chlorhexidine (bind to neg charged back cell walls-> alter osmotic equlirbrium. keratitis + ototoxic) ```
48
Doxepin MOA
histamin antagonism-> interfere with neurons-> drowsiness | break itch scratch cycle
49
Menthol MOA
counter-irritant. cooling is from interaction with cold receptors or nerve fibers
50
Pramoxine hydrochloride MOA
local anesthesia
51
Topical minoxidil (Rogaine) indications
hair loss. | reverse process of miniaturization of terminal scalp hairs associated with alopecia. not permanent
52
Bimatoprost mOA and indications
PGE analog ophthalmic solution for hypotrichosis of eyelashes
53
Eflornithine indications
reduce facial hair growth in 30% women twice daily for 6 months
54
Hydroquinone MOA and indications
inhibit tyrosinase-> block dopa to melanin-> decrease pigmentation
55
Monobenzyl ether of hydroquinone MOA and indications
depigment skin from vitiligo | melanocyte necrosis
56
_____ wavelength is the one responsible for erythema and sunburn
Ultraviolet B 280-320nm
57
___ range is associated with skin aging and cancer
Ultraviolet A 320-400nm
58
SPF is the ratio of ___ to ___. Its a measure of ___
minimal erythema dose with sunscreen to minimal dose without. effectiveness in absorbing UV
59
What does broad spectrum sunscreen mean?
protection against skin cancer and early skin aging as well as sunburn
60
Hidradenitis suppurativa stages:
Hurley stages I: single lesion without sinus tract formation II: more than 1 lesions/area, limited tunneling III: multiple lesions, extensive sinus tract formation
61
Ointments can be used with ____
irritated or broken skin
62
Calcipotriene is sun ___
sensitizing
63
why are steroid incorporated with antifungals
help with the itchy
64
onychomycosis is a
nail infection

Exam 11 (5 decks)

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