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Pharmacology > Derm > Flashcards

Derm Flashcards

1
Q

what are 5 clinical uses of topical corticosteroids?

A

atopic dermatitis
seborrheic dermatitis
allergic and nonallergic dermatitis
eczema
psoriasis

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2
Q

what are the MOA of topical steroids?

A

inhibition of phospholipase A2
decreases leukocytes and cytokines
antimitotic- reduces cell turnover
vasoconstrictive properties

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3
Q

low potency topical steroids are indicated for what areas and what populations?

A

face and intertriginous areas in any pop.
infants, children, and elderly

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4
Q

what strength are these topical steroids?
hydrocortisone
hydrocortisone acetate
triamcinolone acetonide (0.025%)

A

low potency

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5
Q

medium potency topical steroids are indicated for use in what population/ areas?

A

adults for the majority of areas

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6
Q

what strength are these topical steroids?
hydrocortisone valerate
mometasone furoate
betamethasone valerate
triamcinolone acetonide (0.1%)

A

medium potency

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7
Q

when are topical high potency steroids indicated?

A

palms and soles
adults with thick plaques not resopnding to low potency

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8
Q

what type of strength are these topical steroids?
fluocinonide
betamethasone dipropionate (0.05%) cream
triamcinolone acetonide (0.5%)

A

high potency

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9
Q

what type of strength of topical steroid are these?
betamethasone dipropionate (0.05%) ointment
clobetasol propionate (0.05%)

A

very high potency

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10
Q

does normal or inflamed skin have more absorption?

A

inflamed skin

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11
Q

are ointments or creams better for topical steroid penetration?

A

typically ointments

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12
Q

what are some ADRs of topical steroids?

A

tachyphylaxis (tolerance)
skin atrophy
rosacea, dermatitis, acne
secondary skin infection

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13
Q

what are systemic ADRs of topical steroid use?

A

iatrogenic cushing’s disease (buffalo hump, moon face)
PUD
myopathy, cataracts, glaucoma

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14
Q

this type of vehicle for topical steroids should be used for thick, lichenified lesions

A

ointment

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15
Q

this type of vehicle for topical steroids should be used for acute and subacute dermatoses and can be used on moist skin and intertriginous areas

A

creams

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16
Q

these vehicles for topical steroids should be used where a non-oil vehicle is needed

A

solutions
gels
sprays

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17
Q

these medications are indicated for mild non-inflammatory acne vulgaris

A

topical retinoid or salicylic acid QHS
if no improvement in 2-3mo, add topical abx

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18
Q

this tx is indicated for mild inflammatory acne vulgaris

A

benzoyl peroxide in AM, may use with abx
if no improvement in 2-3mo, add oral abx

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19
Q

this tx is indicated for moderate non-inflammatory acne vulgaris

A

topical retinoid QHS
if no improvement in 2-3mo, add topical abx

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20
Q

this tx is indicated for moderate inflammatory acne vulgaris

A

topical retinoid QHS
topical abx w/ benzoyl peroxide AM
oral abx

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21
Q

this tx is indicated in hormone related acne vulgaris in non-pregnant females

A

oral contraceptive
topical retinoid QHS
inflammatory- oral abx w/ benzoyl peroxide

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22
Q

this tx is indicated for severe cystic or nodulocystic acne vulgaris

A

derm referral
oral abx + topical retinoid

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23
Q

what is the clinical use of topical salicylic acid?

A

mild noninflammatory acne

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24
Q

what is the MOA of salicylic acid?

A

keratolytic agent
softens tissue
may dissolve protein that keep stratum corneum together
>6% destructive and used for corn/ wart removal

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25
Q

ADRs of salicylic acid

A

skin irritation
photosensitivity
allergic rxn (cross sensitivity with aspirin)

26
Q

is salicylic acid more or less effective than topical retinoids?

A

less effective

27
Q

what is the clinical use of topical retinoids?

A

mild to severe non-inflammatory and inflammatory acne

28
Q

what are 3 examples of topical retinoids?

A

tretinoin- Retin-A
adapalene- Differin
tazarotene- Tazorac

29
Q

what is the MOA of retinoids?

A

keratolytic agents
derivative of vitamin A
opens up closed comedones

30
Q

ADRs of topical retinoids

A

skin irritation
photosensitivity
teratogenicity (causes fetal abnormalities)

31
Q

clinical use of benzoyl peroxide includes what?

A

mild to moderate inflammatory acne
adjunct with topical or oral abx
rosacea

32
Q

MOA of topical benzoyl peroxide

A

lipophilic oxidizing agent- releases free radicals (oxidizes bacterial proteins)

peeling and comedolytic effects

33
Q

ADRs of benzoyl peroxide

A

bleaching agent
skin irritation (2% just as effective as 10%)
allergic contact dermatitis
inactivation of topical retinoids

34
Q

clinical uses of topical azelaic acid

A

post-inflammatory hyperpigmentation
rosacea
alternative to topical abx or benzoyl peroxide

35
Q

MOA of topical azelaic acid

A

antimicrobial activity against P. acnes
mild anti-inflammatory properties
inhibits effect of conversion of testosterone to dihydrotestosterone

36
Q

ADRs of topical azelaic acid

A

skin irritation
hypopigmentation
hypertrichosis

37
Q

topical abx may be used in combo with corticosteroids for what 3 instances?

A

secondarily infected dermatosis
diaper dermatitis
otitis externa

38
Q

this antimicrobial agent can be used in nares to decrease staph, is poorly absorbed, and can be used as ointment alone or in combo with polymyxin B

A

bacitracin

39
Q

what type of bacterial does bacitracin target

A

G+: strep, pneumo, staph
most anaerobes: neisseriae, tetanus, diptheria bacilli

40
Q

what type of bacteria does polymyxin B sulfate target?

A

G- : pseud, e coli, enterobacter, kleb
resistant: most proteus and serratia

41
Q

this antimicrobial agent should be avoided in pts with sulfa allergies and can be used alone or in combo

A

polymyxin B sulfate

42
Q

what type of bacteria does neomycin target?

A

G- : e coli, proteus, kleb, entero

43
Q

this antimicrobial agent is an aminoglycoside and should be avoided if possible (25% have allergic rxn) and is usually used in combo

A

neomycin

44
Q

this antimicrobial agent targets G+ bacteria including MRSA

A

mupirocin

45
Q

this abx is a tx for impetigo and usually is in a polyethylene glycol vehicle

A

mupirocin

46
Q

what type of bacteria does clindamycin target?

A

p. acnes

47
Q

this abx is used for mild to moderate inflammatory acne, lotion and gel is better than the foam, and can be used solo or in combo

A

clindamycin

48
Q

this abx is used for mild to moderate inflammatory acne and the water-based gel is less irritating

A

erythromycin

49
Q

this medication is used to tx rosacea and some rat studies show some carcinogenic effects so it should be avoided in pregnant women

A

metronidazole

50
Q

this topical antifungal can be used as vaginal cream or suppositories for vulvovaginal candidiasis

A

miconazole (monistat)

51
Q

this topical antifungal can be used as vaginal cream or tablets

A

clotrimazole (lotrimin)

52
Q

this topical antifungal can be used:
cream- dermatophytosis and candidiasis
shampoo- foam for seborrheic dermatitis

A

ketoconazole (nizoral)

53
Q

this topical antifungal targets c. albicans and is used for thrush, diaper rash, and vaginitis

A

nystatin

54
Q

what are 3 clinical uses of imiquimod (aldara) which is a topical immunomodulator?

A

genital and perianal warts
actinic keratoses on face and scalp
basal cell carcinoma on trunk, neck, and extremities

55
Q

how to apply imiquimod for warts

A

apply 3x a week and wait 6-10 hrs before washing off

56
Q

how to apply imiquimod for actinic keratoses

A

apply 2x a week and wash off 8 hrs later

57
Q

what are 2 common ectoparasiticides?

A

permethrin
ivermectin

58
Q

tx for pityriasis/ tinea versicolor

A

selenium sulfide (selsun blue)

59
Q

tx for nipple irritation due to breastfeeding

A

lanolin

60
Q

tx for nipple fissures

A

mupirocin
betamethason
clotrimazole

Pharmacology (9 decks)

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