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Pharmacology Test 1 > Derm Drugs > Flashcards

Derm Drugs Flashcards

1
Q

Clotrimazole (Lotrimin) cream

Clotrimazole + Betamethasone (Lotrisone) cream

Zinc oxide, petrolatum, + miconazole 0.25% (Vusion) cream

A

Fungicide

Fungal Diaper Rash

Rash caused by yeast

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2
Q

Diaper Rash

A

Yeast: most common cause – Mostly due to candida albicans species

Bacterial: 2nd most common cause - Mostly due to Staph. aureus, group A Strep. pyogenes

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3
Q

Nystatin (Mycolog) powder, cream, oint

Nystatin + Triamcinolone (Mycolog II) cream, oint

A

Fungal Diaper Rash

Rash caused by yeast

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4
Q

Mupirocin (Bactroban) cream, ointment

A

Effective against gram-positive bacteria

Bacterial Diaper Rash

Treats Strep or Staph

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5
Q

Bacitracin OTC

A

Disrupts both gram positive and gram negative bacteria by interfering with cell wall peptidoglycan synthesis

Bacterial Diaper Rash

Treats Strep or Staph

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6
Q

β-Lactam Antibiotics

A

Penicillins
Cephalosporins

Inhibit cell wall biosynthesis in bacterial organism

Bacterial Diaper Rash
Staphylococcus

PO administration

PO + topical combination is most effective

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7
Q

“Butt” Paste

A

Zinc oxide
Aquaphor
A&D oint

Petrolatum
Cholestramine (Questran) sugar freE(Binds to uric acid, keeps ph normal)

Treatment of diaper rash

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8
Q

Bentoquatam

A

Barrier Products for Poison Ivy, Oak, Sumac

Prevents oils from plants reacting with the skin

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9
Q

Zanfel OTC wash

A

Barrier Products for Poison Ivy, Oak, Sumac

Prevents oils from plants reacting with the skin

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10
Q

Colloidal oatmeal Aveeno

A

Anti-itch Soaks

Emolient that softens and moisturizes the skin to decrease itching and flaking

Poison ivy, Oak, Sumac

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11
Q

Aluminum acetate (Burrow’s solution)

A

Anti-itch Dressings

Moist/wet dressings, reduce itch, mild astringent

Poison Ivy, Oak, and Sumac

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12
Q

Calamine

Calamine + Pramoxine (Caladryl)

A

Local Anesthetics

Poison Ivy, Oak, and Sumac

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13
Q

Diphenhydramine (Benadryl)

A

Antihistamines

Anti-itch

Poison Ivy, Oak, and Sumac

25-50mg PO qid prn

Eczema (reduce itch

ADR: sedation, dry mouth

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14
Q

Camphor + Menthol

A

“Cooling Agent”

Herbal remedy

Poison Ivy, Oak, and Sumac

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15
Q

Poisons – Ivy, Oak, Sumac

A

Rhus Dermatitis – delayed hypersensitivity rxn occurring 12 – 72 hrs after exposure

Urushiol – chemical secreted by bruised plants

Primary exposure – direct contact to bruised portion of plant that exudes urushiol

Secondary exposure – contact with exposed pets, contaminated clothing, smoke from burning plants

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16
Q

Prednisone

Methylprednisolone (Medrol Dose Pack)

A 
Steroids
Oral glucocorticosteroids (anti-inflammatory)

Poison Ivy, Oak, and Sumac

ADR: Adrenal Suppression

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17
Q

Cleanse: Cetaphil (BID)
Exfoliate
Astringent (close pores)
Medication (PRN

A

General Acne Treatment

Acne
P. acnes bacteria

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18
Q

Benzoyl Peroxide

(Benzac, Benzagel, Clearasil, Stridex) 2.5%-10%

A

Desqamation - increased turnover of epithelial cells, promotes healing
May be bacteriostatic or bacteriocida

ADR: drying, peeling, stinging, bleach clothing or linens

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19
Q

Salicylic Acid (Clearisil Pads) 0.5%-2%

A

Nitrogen Binding Agent -

Keratolytics-
Helps remove upper layer of dead cells

ADR: drying, peeling

Also used in higher concentrations for wart removal

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20
Q

Tretinoin(D)

Tazarotene(X)

A

Topical Retinoids (Vitamin A Derviatives)

Increases epithelial cell proliferation
Reduces comedo formation

P. acnes bacteria

Chronic Psoriasis (Tazaratene)

Rosacea

Actinic Keratosis

ADR: erythema, dryness, peeling, scaling, itching, crusting, photosensitivity, pigmentation changes (bleaching)

Avoid sun - use SPF 30-45

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21
Q

Adapalene (Differin) gel 1% (Class C)

Azelaic acid (Azelex) (C)

A

Retinoid-like compound
Binds to different retinoid type receptors

P.Acnes

ADR: similar to other retinoids, local skin irritation

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22
Q

Erythromycin(B)

Erythromycin + Benzoyl Peroxide(C)

Sodium Sulfacetamide(C)

Clindamycin(B)

A

Topical Antibiotics

Antimicrobial activity against causative organism

Acne
P. acnes bacteria

Rosacea

Eczema (if skin infected

ADR: burning, stinging, drying, peeling, erythema

Dose: 2-6 times a day

  • Metronidazole is the treatment of choice for Rosacea, it is also an antiprotozoal agent
  • *Azelaic Acid may be as good as Metronidazole
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23
Q

Tetracyclines

 - Doxycycline (D)
 - Minocycline(D)
A

Oral Antibiotics

Antimicrobial activity against causative organism

Acne
P. acnes bacteria

Rosacea

Eczema (if skin infected)

Precaution: May increase risk of antibiotic resistance with chronic use

ADR: nausea, vomitting, diarrhea, vertigo (minocycline), contraceptive failure of birth control pills)

*Tetracyclines are most commonly used to treat Rosacea

Eye problems: Doxycycline, Minocyclin, Tetracycline

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24
Q

Macrolides

- Erythromycin(B)

A

Oral Antibiotics

Antimicrobial activity against causative organism

Acne
P. acnes bacteria

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25
Q

Isotretinoin (Accutane) (Class X)

A

Oral Retinoid

Reduce sebaceous gland size, regulates cell proliferation and differentiation

P. acnes bacteria

Rosacea

ADR: dryness, itching of the skin + mucous membrane, headache, hyperlipidemia, alopecia, myalgia, photosensitivity

iPledge - informed consent that patient can not get pregnant

26
Q

Estrogen

Estrogen + Progesterone combo

A

Oral Contraceptives

ncreased estrogen helps counterbalance the high testosterone levels which cause acne

Acne
P. acnes bacteria

PMS-like symptoms, bloating, weight gain (inconclusive)

27
Q

Aquaphor
Cold cream
Lac-hydrin
Eucerin

A

Non-Medicated Topicals

Sooth irritation

Psoriasis

28
Q

Topical Corticosteroids

A

Anti-inflammatory
Antipruritic
Vasoconstrictor
Immunosuppressive

Chronic Psoriasis - start with high potency then pulse treatment

Rosacea

Eczema
Halogenated/fluorinated not to be used on face, perineum, mucous membranes

Non-fluorinated can be used on face, eyelids, perineum, mucous membranes

ADR: adrenal suppression, thinning, tearing, bruising, acne, hypopigmentation, infection, contact dermatitis

29
Q

Coal Tar (Zetar, Neutragena T) (Class C) oint, lotion, soap, shampoo

A

Coal Tar (OTC)

Used alone or with low potency steroids

Chronic Psoriasis

Eczema

Non-compliance problems because cosmetically unappealing (stains clothes, bedding, hair)

ADR: folliculitis, photosensitivity, irritation, scaling, itching, inflammation

30
Q

Psoriasis

A

No cure for psoriasis

Treatment can be defined as acute or chronic

Factors influencing treatment selection
Age of patient
Type of psoriasis
Site and extent of involvement
Previous treatment
Coexisting diseases
Treatment goals include:
Reduce severity
Palliative treatment
31
Q

Treatment of Acute Psoriasis

A

Treat the severely erythematous lesions

Goal is to soothe irritation, use non-medicated topicals
Aquaphor
Cold cream
Lac-hydrin
Eucerin

May also use topical steroids

32
Q

Treatment of Chronic Psoriasis

A

Topical Corticosteroids

Coal Tar

Psoralens

Retinoids

miscellaneous agents
Antimetabolites
Immunosuppressant
Topical Immune Modulators
Phototherapy
IV Immune Modulators
Keratolytics
Calciprotriene 
Anthralin
33
Q

Methoxsalen(C)

A

Psoralens
Chronic Psoriasis
ADR: pruritis, dry skin, loss of pigmentation, nausea, blistering, painful erythema

Follow with UVA light after 2 hours of treatment -> “PUVA”

34
Q

Etretinate (Tegison) PO (Class X)

Acitretin (Soriatane) PO (Class X)

A

Oral Retinoids

Normalizes expression of keratin
Suppresses chemotaxis
Decreases stratum corneum cohesiveness

Chronic Psoriasis

Actinic Keratosis

ADR: liver function test abnormalities, alopecia, exfoliation, hyperlipidemia, myalgia, arthralgia

35
Q

Methotrexate PO (Class D)

A

Antimetabolites

Chemotherapy

Chronic Psoriasis

36
Q

Cyclosporine A (Neoral) PO (Class C)

Sirolimus (Rapamune) PO (Class C)

A

Immunosuppressants

Usually used for organ transplant

Chronic Psoriasis

Eczema (only for resistant eczema)

37
Q

Tacrolimus (Protopic) (Class C)

Pimecrolimus (Elidel) (Class C)

A

Topical Immune Modulators

Chronic Psoriasis

Eczema

38
Q

Keratolytics

A

Misc. Psoriasis Treatment Agents

Softens keratin layer

of skin

39
Q

Calciprotriene (Dovonex) (Class C)

A

Misc. Psoriasis Treatment Agents

Effects equal to Class I or Class III steroids

40
Q

Anthralin (Drithrocreme) (Class C)

A

Misc. Psoriasis

Use for short-term treatment (1 hour on then wash off)
Side Effects: staining, irritation of uninvolved skin, permanent brown color staining Treatment Agents

41
Q

Rosacea Treatment

A

Topicals – Creams, lotions, oint and gels
Antibiotics
Azelaic acid
Sulfur lotions
Benzoyl peroxide – limited data on effectiveness

Oral antiobiotics

Glycolic acid
Topical tretinoin (Retin-A)
Isotretinoin (Accutane)

42
Q

Rosacea (Eye Problems)

A

Doxycycline - PO
Minocycline - PO
Tetracycline - PO

43
Q

Eczema

A

Most common symptoms
Dry, red, extremely itchy patches on skin
Occurs on any part of body
Usually appears during infancy

44
Q

Eczema Prevention

A 
Moisturize
Avoid rapid temperature changes
Reduce stress
Avoid scratchy materials (wool)
Avoid harsh soaps, detergents
Avoid triggers – allergens
Be aware for foods that cause outbreak and avoid them
45
Q

Eczema Treatment

A

Prevent scratching
Creams and lotions to moisturize

Cold compresses
Relieve itch

Topical Corticosteroids - OTC or Rx
Anti-inflammatory

Topical and PO antibiotics
Only if infected skin

Oral Antihistamines – OTC or Rx
Reduce itch

46
Q

Actinic Keratoses

A

Early beginning of skin cancer

Common lesions of epidermis

Caused by long sun exposure (most common)

Appear approx 40-50yo – chronic sun exposure

FL, southern CA – teens to 20’s

Increased risk in fair skin individuals

Definition – cutaneous dysplasia of epidermis

47
Q

Melanoma

A

Skin CA in melanocytes
Melanin – cells produce brown pigmentation

Potentially lethal skin CA

48
Q

5-Fluorouracil (Efudex, Fluoroplex) (Class X)

A

Topical Chemotherapy

Actinic Keratosis

49
Q

Permethrin (B)

A

Treatment of choice for all ectoparasites

pediculicide, scabicide

Topical lotion for lice: Wash hair w/ shampoo, towel dry. Saturate hair and scalp with lotion or crème rinse, leave on for 10 minutes then rinse. Remove remaining nits. May repeat in in 9 days x 2 more times if lice or nits still present. (total = 3 doses) Cure rate 90-97%

Cream for scabies: Wash and scrub body. Apply cream from head to toe, leave on for 8-14 hours before washing off with water. Cure rate 90%

50
Q

Malathion

A

pediculicide, scabicide.

Organophosphate cholinesterase inhibitor

Directions for use for lice: Apply to dry hair and leave on for 8-12 hours. Then shampoo hair. Repeat in 7-9 days if necessary

51
Q

Lindane

A

pediculicide, scabicide. Can be absorbed and concentrate in fatty tissues, especially the brain

Precautions – 2nd or 3rd line. CNS and hematological toxicity. Do not use in premature infants or in pts with known seizure disorders.

52
Q

Crotamiton

A

not fully understood,

may also have some antipruritic properties.

2nd or 3rd line agent

Directions for use for scabies: Apply to body in two applications (24 hours apart). Take a cleansing bath 48 hours after last application.

53
Q

Ivermectin PO

A

MOA – antihelminthic agent

Precautions: Mazzoti reaction in pts with onchocerciasis (allergic and inflammatory response due to the death of the microfilariae – often affects eyes)

Dose: 200mcg/kg x 1 dose

54
Q

gramicidin

A

Topical Antibacterial Preparation

Mostly gram + coverage. Available in combo w/ neomycin, polymyxin, bacitracin and nystatin

55
Q

mupirocin

A

Topical Antibacterial Preparation

Effective against MRSA. Preferred agent for impetigo and to eliminate nasal carriage of S. aureus.

56
Q

Polymyxin B

A

Topical Antibacterial Preparation

Mostly gram – coverage. Available as combo product

57
Q

neomycin/gentamcin

A

Topical Antibacterial Preparation

Topical aminoglycosides w/ gram – coverage, incl pseudomonas. Neomycin available in combo products, gentamicin in combo or alone

58
Q

Doxepin hydrochloride

A

Miscellaneous Topical Agent

Topical antipruritic used to treat pruritus associated with atopic dermatitis or lichen simplex chronicus

MOA - blocks H1 and H2 receptors

ADRs - local burning and stinging, sedation, anticholinergic side effects

59
Q

Pramoxine

A

Miscellaneous Topical Agent

Topical anesthetic available alone or in combo with hydrocortisone. Used to provide temporary relief form pruritus associated with mild eczematous dermatoses and hemorrhoids (for external use only)

ADRs - local burning and stinging

60
Q

Drug-induced photosensitivity

A

benzocaine (Americaine)

coal tar

hexachlorophene (PHisoHex)

isotretinoin (Accutane)

methoxsalen (Uvadex, Oxsoralen)

tacrolimus (Prograf, Protopic)

tazarotene (Tazorac)

retinoin (Retin-A)

Sunscreen agents: PABA, cinnamates, benzyphenones

Pharmacology Test 1 (5 decks)

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