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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
Q

8 antibiotics used for topical things

A

bacitracin, polymyxin B, muirocin, neomycin, erythromycin, clindamycin, metronidazole, azelaic acid

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26
Q

Topical anti fungal classes (4)

A

imidazole, allylamines, benzylamines, polyenes

27
Q

Ciclopirox olamine is a topical antifungal with ____

A

broad spectrum activity

28
Q

Combination agents (anti fungal and steroids) have a higher rate of ____

A

treatment failure

29
Q

Imidazole impede synthesis of fungal cell wall thorugh ____

A

lanosterol 14 α-demethylase (lanosterol->ergosterol)

30
Q

Imidazole are used for

A

dermatophytoses, pityriasis versicolor, candidiasis, seborrheic dermatitis, onychomycosis

31
Q

Allylamines and benzylamines MOA

A

inhibit squalene epoxidase-> inhibit squalene to squalene oxide-> impeded synthesis of ergosterol

32
Q

Allylamines and benzylamines are used for

A

dermatophytoses (tinea pedis/tinea manum, tinea cruris/corporis/faciei), pityriasis vericolor

33
Q

Nystatin binds irreversibly to membrane _____ in candida

A

sterols

34
Q

nystatin is used to treat ____

A

mucocutaneous candidasis

35
Q

Ciclopirox olamine is indicated for:

A

dermatophytoses and onychomycosis, candidiasis, pityriasis, versicolor, seborrheic dermatitis, saprophyte infection (cutaneous)

36
Q

Ciclopirox interrupts active transport of cell precursors like ____

A

trivalent cations

37
Q

Acyclovir and penciclovir are used for

A

HSV1 and 2

38
Q

Two cholinesterase inhibitors used for lice and scabies

A

malathion (not scabies)

lindane (scabies)

39
Q

MOA of permethrin

A

inhibits nerve cell Na ion influx

40
Q

Permethrin use

A

lice and scabies-> clothing as insect repellant

41
Q

What are topical and intralesional cytotoxic agents used for

A

skin cancers, inflammatory + infectious dermatologic conditions

42
Q

5-fluorouracil MOA and indications

A

block DNA synthesis by inhibiting thymidylate synthetase

actinic keratoses + superficial BCC

43
Q

Mechlorethamine (nitrogen mustard) MOA and indications

A

alkylating activity + immune stimulation

mycosis fungoides stage 1A, B

44
Q

Vinblastine MOA and indications

A

anti mitotic agent, distrust microtubule->block cell division in metaphase
KS

45
Q

Bleomycin MOA and indications

A

disrupt DNA synthesis + scission of DNA strands

viral warts, hemangiomas, keloids, hypertrophic scars

46
Q

Podophyllin MOA and indications

A

Bind tubular, disrupt cellular cytoskeleton

anogentical warts, facial angiofibromas

47
Q

Three agents used as washes, how they work and what they are used for

A 
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
Q

Doxepin MOA

A

histamin antagonism-> interfere with neurons-> drowsiness

break itch scratch cycle

49
Q

Menthol MOA

A

counter-irritant. cooling is from interaction with cold receptors or nerve fibers

50
Q

Pramoxine hydrochloride MOA

A

local anesthesia

51
Q

Topical minoxidil (Rogaine) indications

A

hair loss.

reverse process of miniaturization of terminal scalp hairs associated with alopecia. not permanent

52
Q

Bimatoprost mOA and indications

A

PGE analog ophthalmic solution for hypotrichosis of eyelashes

53
Q

Eflornithine indications

A

reduce facial hair growth in 30% women twice daily for 6 months

54
Q

Hydroquinone MOA and indications

A

inhibit tyrosinase-> block dopa to melanin-> decrease pigmentation

55
Q

Monobenzyl ether of hydroquinone MOA and indications

A

depigment skin from vitiligo

melanocyte necrosis

56
Q

_____ wavelength is the one responsible for erythema and sunburn

A

Ultraviolet B 280-320nm

57
Q

___ range is associated with skin aging and cancer

A

Ultraviolet A 320-400nm

58
Q

SPF is the ratio of ___ to ___. Its a measure of ___

A

minimal erythema dose with sunscreen to minimal dose without.
effectiveness in absorbing UV

59
Q

What does broad spectrum sunscreen mean?

A

protection against skin cancer and early skin aging as well as sunburn

60
Q

Hidradenitis suppurativa stages:

A

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
Q

Ointments can be used with ____

A

irritated or broken skin

62
Q

Calcipotriene is sun ___

A

sensitizing

63
Q

why are steroid incorporated with antifungals

A

help with the itchy

64
Q

onychomycosis is a

A

nail infection

Exam 11 (5 decks)

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