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SG - Pharm 4 > Derm 3 > Flashcards

Derm 3 Flashcards

1
Q

Topical antifungal treatments require __ to ___ weeks of therapy

A

4 - 6

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2
Q

What are the 4 topical antifungals?

A
  • Clotrimazole
  • Miconazole
  • Ketoconazole
  • Nystatin
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3
Q
A
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4
Q

What are the 3 Fungicides?

A
  • Tolnaftate
  • Naftifine
  • Terbinafine
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5
Q

What antifungal has a greater response but is expensive? $$$

A

Fungicides

  • Tolnaftate
  • Naftifine
  • Terbinafine
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6
Q

What are the 2 oral dissolving Oral Antifungals?

A
  • Clotrimazole
  • Miconazole
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7
Q

What is the oral suspension Oral Antifungal?

A

Nystatin

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8
Q

What are the 2 IV Antifungals?

A
  • Amphotericin B
  • Fluconazole
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9
Q

Azoles that are available for systemic use can be classified into what 2 groups?

A
  • Triazoles
    • fluconazole
    • itraconazole
  • Imidazoles
    • clotrimazole
    • ketokonazole
    • miconazole
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10
Q

What is the MOA of Azoles?

(Triazoles: fluconazole, itraconazole)

(Imidazoles: clotrimazole, ketoconazole, miconazole)

A

Interfere w/ fungal cytochrome P450 activity, decreasing ergosterol synthesis & inhibiting cell membrane formation

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11
Q
A
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12
Q

MOA of what antifungal agent?

  • Binds to sterols in fungal cell membrane, changing the cell wall permeability allowing for leakage of cellular contents
A

Nystatin

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13
Q

Which antifungal?

  • For stratum corneum, mucosa, cornea by dermatophytes & Candida sp. infections
  • Not for subcutaneous, nail or hair infections
  • Paronychial and intertriginous candidiasis applied three or four times daily
  • Also treats seborrheic dermatitis (ketoconazole)
  • Once- or twice-daily application
  • clearing of dermatophyte infections in 2-3 weeks
A

Topical Imidazoles

  • Clotrimazole
  • Ketoconazole
  • Miconazole
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14
Q

Which antifungal?

  • Topical ____ - cutaneous and mucosal candida
  • Not effective against dermatophytes
  • Oral candidiasis (thrush) - 5 mL (infants, 2 mL) oral suspension in the mouth (Swish and Swallow) four times daily for 7-10 days
  • Oral troches four times daily for 7-10 days
  • Vulvo-vaginal candidiasis - 1 vaginal tablet BID x 14 days, then Q HS for an additional 14-21 days
A

Nystatin

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15
Q

Atopic Dermatitis / Pruritis is also called what?

A

Eczema

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16
Q

What drugs?

  • Inhibit T-lymphocyte activation and prevent degranulation of mast cells by antigen IgE complexes
A

Immunomodulators

  • Calcineurin inhibitors
    • Tacrolimus
    • Pimecrolimus
17
Q

What is used to tx:

  • Atopic dermatitis
  • Off label for other autoimmune dermatologic disorders such as: Vitiligo & alopecia areata

*Neither medication should be used w/ ____.

A

Immunomodulators

  • Calcineurin inhibitors
    • Tacrolimus
    • Pimecrolimus

*Occlusive dressings

18
Q

Which medication?

**Box Warning**

  • Rare cases of malignancy (e.g., skin and lymphoma)
  • Continuous long-term use in any age group should be avoided
  • Application limited to areas of involvement with atopic dermatitis
  • NOT indicated for use in children less than 2 years of age
A

Immunomodulators

  • Calcineurin Inhibitors
    • Tacrolimus
    • Pimecrolimus
19
Q

General Tx of ____.

  • If underlying cause known, treat that first
  • Cool skin - light clothes on the body and bedding
  • Air conditioning, humidifier
  • Avoid topical products with fragrances, alcohol, wool, alkaline soap, and potential allergens
  • Tepid shower before bed or cool compresses - Limit bathing to once per day with a non-soap, low pH cleanser (Cera-Ve, Cetaphil, Aveeno, Dove)
  • NO orange or green soaps and NO Ivory
A

Pruritis

20
Q

General tx of Pruritis

  • Within __ mins after bathing, apply ___ liberally and __ other times in the day
  • Emollients can be _____ and compounded w/ 1% menthol, 10% urea to increase their effectiveness
  • Topical steroids with inflammatory conditions
  • Topical _____ 4x/day -causes burning sensation that decreases compliance
  • Topical _____ 3-4x/day - can cause anticholinergic effects
A
  • 3 / emollient cream ointment (Cetaphil) / 2
  • Refrigerated
  • Capsaicin
  • Doxepin
21
Q

Which antipruritic agent?

  • Potent H1- and H2-receptor antagonist properties
  • May result in significant drowsiness in patients
  • Topical use is contraindicated in urinary retention or narrow angle glaucoma
A

Topical doxepin 5% cream (Zonalon)

22
Q

What drugs are these?

  • Permethrin
  • Lindane (Hexachlorocyclohexane)
  • Crotamiton
  • Sulfur
  • Spinosad
  • Malathion
  • Ivermectin
A

Ectoparasiticides

23
Q

Most common ADEs of what therapy?

  • conjunctivitis
  • ocular hyperemia
  • eye irritation
  • dandruff
  • dry skin
  • skin burning sensation
A

Sklice (ivermectin 0.5% lotion)

(tx for head lice)

24
Q

What are the 5 prescription lice products?

A
  • Benzyl alcohol
  • Malathion
  • Spinosad
  • Ivermectin (Skilice)
  • Lindane

(MILBS)

25
Q

Which prescription lice product?

  • Age: 6 months+
  • Dosage: 4-48 oz
  • Time of app: 10 mins, repeat in 7 days
A
  • Benzyl alcohol
26
Q

Which prescription lice product?

Age: safety not shown <6 yrs

Dosage: 2 oz bottle: apply enough to wet hair & scalp

Time of app: 8-12 hrs, repeat in 7-9 days if lice persist

A

Malathion

27
Q

Which prescription lice product?

Age: 4 yrs+

Dosage: up to 120 mL (1 bottle)

Time of app: 10 mins, repeat in 7 days if lice persist

A

Spinosad

28
Q

Which prescription lice product?

Age: 6 months+

Dosage: Up to 120 mL (4 oz tube)

Time of app: 10 mins, tube for single use, consult HCP prior to re-treatment

A

Ivermectin (Sklice Lotion)

29
Q

Which prescription lice product?

Age: use w/ caution in those <110 lbs

Dosage: 1-2 oz

Time of app: 4 mins, DO NOT re-treat

A

Lindane

30
Q

Which Ectoparasiticide?

  • Is toxic to Pediculus humanus, Pthirus pubis, and Sarcoptes scabiei

•Residual drug persists up to 10 days following application

  • 1% cream rinse pediculosis
  • 5% cream for scabies

•Single application applied to the body from the neck down, left on for 8-12 hours, and then washed off

A

Permethrin

31
Q

Which Ectoparasiticide?

  • is available as a shampoo or lotion
  • 10% of a dose is absorbed
  • Concentrated in fatty tissues, including the brain
  • Potentially neurotoxic and can lead to seizures
  • For pediculosis capitis or pubis
A

Lindane

32
Q

Tx of which Ectoparasiticide?

What is this treating?

•30 mL of shampoo applied to dry hair on the scalp or genital area for 4 minutes and then rinsed off

A

Lindane: to tx Pediculosis capitis or Pediculosis pubis

33
Q

Tx of which Ectoparasiticide?

What is this treating?

•Single application applied to the entire body from the neck down, left on for 8-12 hours, and then washed off

A

Lindane: tx of scabies

34
Q

Which ectoparasiticide?

  • available as a cream or lotion
  • Scabicide with some antipruritic properties
  • Two applications applied from the chin down at 24-hour intervals, with a cleansing bath 48 hrs. after the last application
A

Crotamiton

35
Q

Which Ectoparasiticide?

•remains a possible alternative drug for use in infants and pregnant women.

  • 5% precipitated ____ in petrolatum (compounded)
  • Two applications applied from the chin down at 24-hour intervals, with a cleansing bath 48 hrs. after the last application
A

Sulfur

SG - Pharm 4 (16 decks)

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