Derm Flashcards
Ointment Properties:
Advantages
Hydrates
Removes Scales
Greatest bioavailability of active ingredient
Ointment Properties:
Disadvantages
Greasy
Ointment Properties:
Preferred Area of Use
smooth skin w/ short or sparse hair
4 main properties of Ointments
- occlusive
- Humectant
- Emollient
- Protective
What does occlusive mean? (in terms of ointments)
promoting retention of water in the skin
creates hydrophobic barrier that prevents moisture in the skin from evaporating
What does humectant mean? (in terms of ointments)
causes water to be retained b/c of hygroscopic properties (aka attracts water)
what does emollient mean? (in terms of ointments)
softens skin/soothes irritation
4 classes of Ointments
- hydrocarbon
- absorption
- water-removable
- water-soluble
Creams/Lotions are ointment bases of the ____________ class
water removable
T or F: Creams are more hydrating than ointments
FALSE
Advantage of a Cream
- good cosmetic appearance/high pt acceptance
Lotions/Solns/Sprays can be easy applied to ________ areas/_______
hairy; scalp
Disadvantages of Lotions/Solns/Sprays
DRYING; Lower bioavailability
Advantages of Gels
- Non greasy
- good for hairy areas
- high pt acceptance
Disadvantages of Gels
drying
Oleganious Bases:
absorb water - yes or no?
No! (they do NOT absorb water)
Oleganious Bases:
water washable - yes or no?
No! (they are NOT water washable)
Examples of Oleganious Bases
WHITE PETROLATUM
vaseline/plastibase
Absorption Bases:
absorb water - yes or no?
Yes! (like several times its weight in water)
Absorption Bases:
water washable - yes or no?
Nope
Water in Oil or Oil in Water Emulsion Bases
- which one IS WATER WASHABLE
Oil in water…
Which kind of base has “minimal therapeutic effect” - and then why would we even use it?
Water soluble base (Ex: polyethylene glycol ointment)
we can use it for DRUG DELIVERY
3 main drug induced skin disorders
- photosensitivity
- hypersensitivity/allergic rxn
- Toxic Rxns (SKS, TEN, or Erythema Multiforme)
How to treat Adverse Drug Rxns (4 things)
1 - stop the drug..
2 - systemic antihistamines
3 - Systemic or topical corticosteroids
4 - Soothing baths or soaks
To prevent a photosensitivity reaction - use sunscreen/clothing - what SPF tho?
SPF 30 or greater!
If you did a bad job prevent a photosensitivity reaction - how should it be treated
- systemic analgesics
- Systemic antihistamines for itching
- Prevent infection/Moisturizers
- Cooling creams/gels aka ALOE
Underlying Mechanism behind drug induced skin disorders
drug protein complex leads to T cell activation –> dermis –> cytokines released
Common Drugs Assoc. w/ SJS/TEN
- Abx (sulfonamides, cephalosproins, penicllins, fluoroquinolones)
- ANTICONVULSANTS
- Allopurinol
- NSAIDs
Features of SJS/TEN
- Usually occurs within the first ________ of treatment
- will have flu-like symptoms
- involvement of ________ membranes
- widespread ________ & _______
4 weeks; mucous; blisters; lesions
How to treat SJS/TEN: stop \_\_\_\_\_\_\_\_ IV \_\_\_\_\_\_ pain control nasal \_\_\_\_\_\_\_ wound care/anesthetics/antiseptics
offending agent; fluids/nutrition; saline (to keep membranes moist)
Refer or Treat?
Cellulitis
refer - deep infection
how to treat cellulitis
antibiotics (oral normally, IV if severe)
Refer or Treat?
Impetigo
Refer to PCP
how to treat Impetigo
topical or oral abx
impetgio is a __________ skin infection
topical staph
List the agents that can be used to stop itching
- menthol/camphor
- pramoxine
- aluminum acetate
- hydrocortisone
Sig/Directions for Topical Corticosteroids
apply BID - QID 3 - 14 days
Corticosteroids are graded on strength:
Grades I - VII
(which one is stronger)
Grade I
Side effects of topical corticosteroids
- thinning of skin
- dilated blood vessels
- bruising
- skin color changes
Should you put high potency topical corticosteroids on the face
hell nah
Do not use super potent topical corticosteroids on the skin for > ______
2 weeks
Topical calcineurin inhibitor MOA:
blocks pro-inflammatory cytokine genes
Where can topical calcineurin inhibitor be used
anywhere
Topical calcineurin inhibitors are considered ____ line tx
2nd
Topical calcineurin inhibitor are for _________ use only
intermittent
what is the first biologic indicated for mod-severe AD
Dupilumab/Dupixent
what is statis dermatitis
itchy skin that occurs from poor circulation - - will see some aching, swelling, and discomfort
how to treat statis dermatitis
topical corticosteroids or emollients
seborrhic dermatitis - what is it
erythema w/ greasy and yellow scaling - usually by hairline/scalp/nose/neck
is itchy
Seborrhic dermatitis in infants is called _________
cradle cap
how to treat craddle cap
- baby oil to soften
- baby shampoo
Treatment options for seborrhic dermatitis
medicated shampoo - selenium, ketoconazole, and pyrithione zinc
try OTC 1st – should remove scales
then try topical corticosteroids
