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Pharmacology > Derm > Flashcards

Derm Flashcards

1
Q

Lotions MOA

A

Mostly water

Evaporation gives cooling action

Vasoconstriction decreases inflammation

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2
Q

Gels

A

semi-solid colloidal solutions and suspensions

contain alcohol

enhance absorption thru skin

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3
Q

Creams

A

oil in water: mix with serous discharge, washable

water in oil: vehicle for fat-soluble substances

do not mix with serous dischages

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4
Q

ointments

A

water-soluble: improve penetration of drugs, PEG

emulsifying: mix with water and exudate

non-emulsifying: occlusive dressing, enhance hydration

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5
Q

atopic dermatitis tx

A

reduce contact and exposure

emollients

topical steroids (try not to use)

systemic antihistamines

antibiotics

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6
Q

soap substitues

A

cetaphile–less drying an dirritating

cleansing and moisturizing formulas–OTC

expensive

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7
Q

emollients

A

soften skin and reduce itching; trap moisture

best: oils–petroleum jelly
moderate: creams

use after bathing and dry times

agents: vanicream, eucerin, lubriderm, moisturel, curel, neutrogena, vegetable shortening, vaseline, urea creams, oils

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8
Q

emollients: alpha-hydroxy acid

A

creams are excellent for relieving dryness, but can sting and sometimes aggravate eczema

useful for maintenance when no longer inflamed

forces epidermal cells to produce keratin that is softer, more flexible and less likely to crack

preps: glycolic acid, lactic acid, urea

use 1x/d

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9
Q

Emollients: Oils

A

Bath oil or mineral oil lotions in lukewarm water

Add to tub 15 minutes into bath

Bath oil preps: alpha-keri, aveeno bath, jeri-bath

Colloidal oatmeal (Aveeno) reduces itching

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10
Q

Corticosteroids

A

Topical steroids very effective

Ointments for dry or lichenified skin

Creams for weeping skin or body foldsOnce under control, intermittent use may prevent relapse

Systemic may bring rapid control but may precipitate rebound

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11
Q

Antibiotics

A

atopic eczema frequently secondarily colonized with a bacteria (up to 30%)

Use oral antibiotics in recalcitrant or widespread cases

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12
Q

Antihistamines

A

Oral can reduce urticaria and itch

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13
Q

Alt medications for eczema

A

Licorice, calendula, echinacea, golden seal, nettle, oats

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14
Q

Diaper dermatitis

A

Irritant dermatits

Cutaneous candidiasis infection (c. albicans)

risks: areas where warmth and moisture lead to maceration of skin or mucous membranes
tx: topical antifungal agens: nystatin, miconazole or clotrimatzole; topical corticosteroids

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15
Q

Pimecrolimus (Elidel) and Tacrolimus (Protopic)

A

Inhibit inflammatory cytokine release

Minimal systemic immunosuppression

indicated for atopic dermatitis and contact dermatitis

alt to corticosteroids

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16
Q

Imiquimod (Aldara)

A

Immunomodulator

Tx of external genital and perianal warts and actinic keratitis

stimulates peripheral mononuclear cells to release interferon alpha and stimulate macrophages to produce interleukins and TNF-alpha

17
Q

Parasitic skin infections

A

Pediculosis: Lice. 2-4mm. Female lay 100s of nits. Vectors of other diseases: typhus, recurrent fever. tx: chemical killing, clean linens/clothes, comb out, tx social contacts

pediculocides: lindance (not in cali): hepatotoxic and neurotoxic. Permethrin (Nix)
scabies: mite infestation transmitted by close-prolonged contact. epidermal curved or linear ridges, follicular papules, pruritus palms. excoriated erythematous papules, pustules, crusted lesions. tx: topical sulfur preps, crotamiton, permethrin, launder. no disinfectant.

18
Q

acne

A

comedones (keratin plugs in sebaceious duct opening), papules, pustules, nodules, cysts, scars

propionibacterium acnes, staphylococcus spp., angrogenic stimulation of sebaceious gland

tx: kertaolytics: benzoyl peroxide, slenium sulfide, retic A, accutane oral (isotretinoin); antibacterial: topical erythromycin, clindamycin or azelaic acid. oral tetracycline or erythromycin

19
Q

rosacea

A

azelaic acid

metronidazole

20
Q

psoriasis

A

hyperproliferative disorder

thickened skin plaques

inflammatory infiltrate in the dermis

comorbidities: autoiummune, CV, metabolic sx, malignancies, mood disorders, smoking, alcohol
tx: topical: keratolytics: coal tar, salicylic acid. corticosteroids (potent)
systemic: corticosteroids (prednisone), methotrexate (neutropenia), hydroxyurea, cyclosporine (decreases infiltration of inflammatory cells), infliximab (remicade)

21
Q

tx of psoriasis

A

mild: topical (kertolytic, corticosteroids); phototherapy

mild psoriatic arthritis: NSAIDs, intra-articular injections of corticosteroids

Moderate to severe psoriasis and PsA: DMARDs: methotrexate, cyclosporine, gold (can cause renal dysfunction), antimalarials; systemic corticosteroids, biologics (NOT during an active infection)

22
Q

criteria for using biologics

A

18yo or older

moderate to severe PsA AND:at least one comorbiditiy, inadequate control with DMARDs alone, failed other therapies

NO active infection

Normal liver function

23
Q

Biologics

A

T-cell inhibitors: alefacept, efalizumab

TNF inhibitors: etanercept, adalimumab, infliximab

24
Q

Glucocorticoids

A

mild, moderate (triamcinolone), potent (desonide), very potent (mometasone).

only use mild on face (1% hydrocortisone, no higher)

25
Q

sunscreens

A

filter UVA and UVB

Mild: <10

Moderate: 10-15

Strong: >15 sunscreens

26
Q

hair loss

A

minoxidil (rogaine): vasodilation, effect not predictable or permanent

finasteride (propecia): increases levels of testosterone and decreases the rate of death of follicles. side effects are high and its not shown to be very effective

27
Q

fungal skin infections: topical tx

A

Clotrimazole

Miconazole

Terbinafine

Ketoconazole

Tolnaftate

Nystatin

28
Q

fungal skin infections systemic tx

A

Ketoconazole

Iatraconazole

Terbinafine

Griseofulvin

Look at LFTs prior to initition of drug and once a month

29
Q
A

Pharmacology (10 decks)

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