Derm Flashcards
Five components of successful use of topical therapies
Correct diagnosis Type of lesion being treated Medication Vehicle (the base in which the active medication is delivered) Method used to apply the medication
Absorb moisture, decrease friction, and help cover wide areas easily
Powders
Act as emollients
Occlusive properties – often enhance drug penetration
Oils
Evaporate, provide a cooling, soothing sensation, while aiding exudative lesions to dry
Liquids
Smooth nonhair skin, thick, hyerpkeratotic leasions options
ointment+++
cream++
foam++
Hairy areas
solution+++
Foam+++
palms soles
Ointment+++
Cream++
Foam++
Infected Areas
Solution+++
Foam++
Lotion++
Between skin folds; moist, mascreated lesions
Cream
Lotion
Solution
Foam
all ++
Water suspended in oil
oinment
Ointments do what
Excellent lubrication, facilitates heat retentions, decreases transepidermal water loss, provides enhanced medical absorption, semi- occlulsive.
Ointments generally most are
potent vehicles (due to occlusive effectds)
Oinments are what and are not what
greasy and not useful in hair areas
Oinment use
Apply two to three times per day to dry, lichenified lesions, particularly after moisturizing the skin
Semi-solid emulsions of oil in 20 to 50% water and can be washed off with water
Creams
Creams are
Cosmetically appealing vehicles for delivering topical medications
Same medication – cream formulations are usually
stronger than lotions, but less potent than ointments.
Lotions are the least
potent topical tehrapies
lotions are useful in
hairy areas, conditions were large areas have to be treated
Lotions are Pwder in
Powder-in-water (shake container before application)
Lotions do what
evaporate
lotions provide a
colling and drying effect
lotions are useful in treating
treating moist dermatoses and/or pruritis.
Solutions contain
Contain water or non-aqueous (such as alcohol or propylene glycol)
Solutions bath
Bath soaks and open wet dressings provide coolness and aid in drying exudative lesions by means of evaporation
Solutions vasoconstictions results in
in decreased local blood flow and reduction in local edema
Wet Dressings permit
Permit the cleansing of exudate while maintaining drainage in infected lesions (e.g., ulcers)
Wet Dressings should be changed
Should be changed every 6 hours for 2 to 3 days before judging their effectiveness
Wet Dressings - closed
Closed wet dressings polyurethane plastic (e.g., Saran Wrap), which allows heat to be retained, prevents evaporation, and causes maceration
Gels are
Oil-in-water emulsion with alcohol in the base
Gels dry in a
Dry in a thin, greaseless, non-staining film
Gels combine
Combine best therapeutic advantage of ointments with the best cosmetic advantages of cream
Gels transparent
Transparent, colorless, semi-solid emulsions that liquefy on contact with the skin
Gels hair
Hair-bearing areas, treating acne
Foams pressurized
Pressurized collections of gaseous bubbles in a matrix of liquid film
Foams spread
Spread readily, easier to apply than other preparations, particularly for inflamed skin, scalp dermatoses
Foams more cosmetically
More cosmetically acceptable (which can lead to high compliance)
Topical Corticosteroids induce
Induce an inflammatory response in the skin by a variety of mechanisms
Topical Corticosteroids anti-
Anti-mitotic activity – scaling dermatoses
Topical Corticosteroids cutanious
Cutaneous vasoconstriction
Topical Corticosteroids divided into
Divided into seven groups (group one = super-high potency, group seven = least potent)
Topical Corticosteroids betetr
absorbed through areas of inflammation and desquamation than normal skin, more readily through the thin stratum corneum of infants than the skin of adults
Seven groups of corticosteroids
Group 1 (super-high potency Group 2 (high potency) Group 3 (high potency) Group 4 (medium potency) Group 5 (lower-mid potency group 5) Group 6 (low potency) Group 7 (least potent)
Regional Differences in Percutaneous Absorption
Sole of foot – 0.14 percent Palm – 0.83 percent Forearm – 1 percent Scalp – 3.5 percent Forehead – 6 percent Mandible – 13 percent Genitalia – 42 percent
Corticosteroid Selection can depend
Can depend on what is being treated
Corticosteroid Selection start
Start with lowest potency
Corticosteroid Selection use
Use shortest time possible
Corticosteroid Selection super high
Super high potency corticosteroids - severe dermatoses overnonfacial/nonintertriginousareas(psoriasis)
Corticosteroid Selection medium to
Medium to high potency - mild to moderatenonfacial/nonintertriginousdermatoses.
Corticosteroid Selection eyelid and
Eyelid and genital dermatoses - low-potency topical corticosteroids for limited time periods.
Corticosteroid Selection low to mediam
Low to medium strength - large areas are treated because of the likelihood of systemic absorption
