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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
Isotretinoin (Accutane) (Class X)
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
Estrogen | Estrogen + Progesterone combo
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
Aquaphor Cold cream Lac-hydrin Eucerin
Non-Medicated Topicals Sooth irritation Psoriasis
28
Topical Corticosteroids
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
Coal Tar (Zetar, Neutragena T) (Class C) oint, lotion, soap, shampoo
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
Psoriasis
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
Treatment of Acute Psoriasis
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
Treatment of Chronic Psoriasis
Topical Corticosteroids Coal Tar Psoralens Retinoids ``` miscellaneous agents Antimetabolites Immunosuppressant Topical Immune Modulators Phototherapy IV Immune Modulators Keratolytics Calciprotriene Anthralin ```
33
Methoxsalen(C)
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
Etretinate (Tegison) PO (Class X) Acitretin (Soriatane) PO (Class X)
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
Methotrexate PO (Class D)
Antimetabolites Chemotherapy Chronic Psoriasis
36
Cyclosporine A (Neoral) PO (Class C) Sirolimus (Rapamune) PO (Class C)
Immunosuppressants Usually used for organ transplant Chronic Psoriasis Eczema (only for resistant eczema)
37
Tacrolimus (Protopic) (Class C) Pimecrolimus (Elidel) (Class C)
Topical Immune Modulators Chronic Psoriasis Eczema
38
Keratolytics
Misc. Psoriasis Treatment Agents Softens keratin layer of skin
39
Calciprotriene (Dovonex) (Class C)
Misc. Psoriasis Treatment Agents Effects equal to Class I or Class III steroids
40
Anthralin (Drithrocreme) (Class C)
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
Rosacea Treatment
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
Rosacea (Eye Problems)
Doxycycline - PO Minocycline - PO Tetracycline - PO
43
Eczema
Most common symptoms Dry, red, extremely itchy patches on skin Occurs on any part of body Usually appears during infancy
44
Eczema Prevention
``` 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
Eczema Treatment
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
Actinic Keratoses
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
Melanoma
Skin CA in melanocytes Melanin – cells produce brown pigmentation Potentially lethal skin CA
48
5-Fluorouracil (Efudex, Fluoroplex) (Class X)
Topical Chemotherapy Actinic Keratosis
49
Permethrin (B)
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
Malathion
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
Lindane
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
Crotamiton
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
Ivermectin PO
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
gramicidin
Topical Antibacterial Preparation Mostly gram + coverage. Available in combo w/ neomycin, polymyxin, bacitracin and nystatin
55
mupirocin
Topical Antibacterial Preparation Effective against MRSA. Preferred agent for impetigo and to eliminate nasal carriage of S. aureus.
56
Polymyxin B
Topical Antibacterial Preparation Mostly gram – coverage. Available as combo product
57
neomycin/gentamcin
Topical Antibacterial Preparation Topical aminoglycosides w/ gram – coverage, incl pseudomonas. Neomycin available in combo products, gentamicin in combo or alone
58
Doxepin hydrochloride
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
Pramoxine
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
Drug-induced photosensitivity
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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