- good cosmetic appearance/high pt acceptance

- Non greasy - good for hairy areas - high pt acceptance

Derm Flashcards by Blade Joneson

Ointment Properties:

Advantages

Hydrates
Removes Scales
Greatest bioavailability of active ingredient

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Ointment Properties:

Disadvantages

Greasy

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Ointment Properties:

Preferred Area of Use

smooth skin w/ short or sparse hair

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4 main properties of Ointments

occlusive
Humectant
Emollient
Protective

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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

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What does humectant mean? (in terms of ointments)

causes water to be retained b/c of hygroscopic properties (aka attracts water)

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what does emollient mean? (in terms of ointments)

softens skin/soothes irritation

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4 classes of Ointments

hydrocarbon
absorption
water-removable
water-soluble

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Creams/Lotions are ointment bases of the ____________ class

water removable

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T or F: Creams are more hydrating than ointments

FALSE

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Advantage of a Cream

good cosmetic appearance/high pt acceptance

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Lotions/Solns/Sprays can be easy applied to ________ areas/_______

hairy; scalp

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Disadvantages of Lotions/Solns/Sprays

DRYING; Lower bioavailability

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Advantages of Gels

Non greasy
good for hairy areas
high pt acceptance

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Disadvantages of Gels

drying

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Oleganious Bases:

absorb water - yes or no?

No! (they do NOT absorb water)

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Oleganious Bases:

water washable - yes or no?

No! (they are NOT water washable)

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Examples of Oleganious Bases

WHITE PETROLATUM

vaseline/plastibase

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Absorption Bases:

absorb water - yes or no?

Yes! (like several times its weight in water)

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Absorption Bases:

water washable - yes or no?

Nope

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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