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M2F > Derm Pharm 1 > Flashcards

Derm Pharm 1 Flashcards

1
Q

choice of proper vehicle

A
  • acute infl- drying preparations (tinctures, wet dressings, lotions)
  • chronic infl- lubricating preparations (creams, ointments)
  • drying preparations- scalp and hairy areas
  • lubricating agents- intertriginous areas
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2
Q

topical antibacterial preparations

A
  • Bacitracin, gramicidin
  • mupirocin
  • retapamulin
  • polymyxin B sulfate
  • neomycin, gentamicin
  • topical abx in acne
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3
Q

Bacitracin, gramicidin- moa

A
  • inhibits cell wall syn (bacitracin)
  • inc permeability of cell wall (gramicidin)
  • active against gram+ organisms
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4
Q

mupirocin- moa

A
  • inhibits prot syntesis
  • gram+ aerobic bacteria, including MRS
  • tx impetigo caused by S aureus and group A B-hemolytic streptococci
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5
Q

retapamulin- moa

A
  • binds to ribosomal 50S subunit and inhibits normal bacterial prot biosyn
  • group A B-hemolytic streptococci and S aureus
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6
Q

Polymyxin B sulfate- moa

A
  • inc perm of cell wall membrane
  • gram-neg organisms (P aeruginosa, E coli, enterobacter, klebsiella)
  • high levels- neurotoxicity, nephrotoxicity (rare)j
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7
Q

Neomycin and gentamicin- moa

A
  • irreversibly binds 30S subunit and inhibits prot syn
  • gram-neg organisms
  • excreted in urine- renal failure may cause nephrotoxicity, neurotoxicity, ototoxicity
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8
Q

topical abx in acne

A
  • clindamycin
  • erythromycin
  • metronidazole
  • sodium sulfacetamide
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9
Q

Clindamycin- moa

A
  • inhibits pro syn by reversibly binding to 50S ribosomal subunit
  • serious infections due to S aureus
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10
Q

Erythromycin- moa

A
  • inhibits prot syn- reversibly binds to 50S

- complications- abx resistance in staphylococci- discontinue topical tx and begin systemic abx tx

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11
Q

metronidazole- moa

A
  • inhibit nucleic acid syn; anti-infl effects
  • tx acne rosacea
  • no in pregnancy or nursing
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12
Q

sodium sulfacetamide- moa

A
  • inhibits P acnes- competitive inhibition of p-aminobenzoic acid utilization and inhibits bacterial folic acid syn
  • contraindicated in pts w sensitivity to sulfonamides
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13
Q

Topical antifungal agents

A
  • azoles
  • ciclopirox olamine
  • allylamines
  • butenafine
  • tolnaftate
  • nystatin and amphotericin B
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14
Q

azoles- moa

A
  • inhibit syn of ergosterol by inhibiting fungal cytochrome P450s
  • tinea corporis, pedis, cruris, versicolor; cutaneous candidiasis
  • clotrimazole and miconazole- prototype for Candidiasis
  • often used with corticosteroid- more rapid sx improvement
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15
Q

Ciclopirox olamine- moa

A
  • inhibits uptake of precursors of macromolecular syn
  • topical dermatomycosis, candidiasis, tinea versicolor; onychomycosis
  • poor efficacy
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16
Q

Allylamines- moa

A

Terbinafine, naftifine

  • inhibits squalene epoxidase (key enzyme in ergosterol biosyn)
  • tinea corporis, cruris, pedis
17
Q

Butenafine- moa

A

-similar to allylamines

18
Q

Tolnaftate- moa

A
  • cutaneous mycoses; but ineffective against candida
  • tinea pedis, cruris, corporis
  • unknown moa
19
Q

Nystatin and amphotericin B- moa

A
  • binds to ergosterol in fungal cell memb and alters memb permeability- loss of K and other cell constituents
  • Nystatin topical uses- used for oral candidiasis
  • Amphotericin B- used IV; infusion related toxicity and cumulative organ toxicity (kidney in almost all pts)- “Ampho-terrible”
20
Q

Oral antifungal agents

A
  • azoles
  • griseofulvin
  • terbinafine
21
Q

Oral antifungal agents- azoles

A
  • vaginal, urinary, oropharyngeal candida infections
  • itraconazole and fluconazole- prototype
  • many drug-drug interactions
22
Q

Oral antifungal agents- griseofulvin- moa

A
  • inhibits fungal cell mitosis and binds to human keratin, making it resistant to fungal invasion
  • tx dermatophyte infections; but not candida
  • induces hepatic CYPs
23
Q

Antiviral agents- topical

A
  • Acyclovir, valacyclovir, penciclovir, famciclovir

- docosanol

24
Q

Acyclovir, valacyclovir, penciclovir, famciclovir- moa

A
  • converted to active triphosphate metabolites and inhibit viral DNA syn and viral replication
  • oral- herpes labialis
  • topical- recurrent orolabial HSV infection in immunocompromised pts
25
Q

Docosanol- moa

A
  • inhibits fusion b/w plasma memb and HSV envelope, preventing viral entry and replication
  • orolabial herpes
26
Q

Antiviral agents- sytemic

A

-acyclovir, famciclovir, valacyclovir- can be used for HSV and VZV infections

27
Q

Immunomodulators

A
  • imiquimod
  • tacrolimus
  • pimecrolimus
28
Q

Imiquimod- moa

A
  • external genital and perianal warts, actinic keratoses on face and scalp, primary BCCs on trunk, neck, and extremities
  • moa- unknown
29
Q

tacrolimus and pimecrolimus- moa

A
  • tx atopic dermatitis (second-line)
  • inhibits T-lymphocyte act and prevents release of infl cytokines from mast cells
  • long-term safety is not esta- dont use in immunocompromised or < 2 yo
30
Q

Acne preparations

A
  • retinoids
  • benzoyl peroxide
  • azelaic acid
  • brimonidine
31
Q

Retinoids- topical

A
  • Tretinoin
  • Adapalene
  • Tazarotene
32
Q

Tretinoin

A
  • moa unknown
  • SEs- erythema, mild peeling, dryness; avoid sun exposure (inc photosensitivity rxns)
  • initially may aggravate acne
33
Q

Adapalene

A
  • less irritating than tretinoin

- mild/moderate acne vulgaris

34
Q

Tazarotene

A
  • psoriasis, photoaging, acne

- teratogenic

35
Q

Retinoids- oral

A

Isotretinoin (Accutane)

  • reduces sebaceous gland size and reduces sebum production
  • tx unmanageable severe cystic acne, psoriasis, cutaneous malignant neoplasms
  • teratogen
36
Q

Benzoyl peroxide- moa

A
  • releases free-radical oxygen which oxidizes bacterial proteins in the sebaceous follicles- dec the # of anaerobic bacteria and dec irritating-type free fa’s
  • antimicrobial activity against P acnes
37
Q

Azelaic acid- moa

A

-antimicrobial against P acnes and in vitro inhibitory effects on the conversion to T to DHT

38
Q

Brimonidine- moa

A
  • alpha-2 adrenergic agonist- dec erythema via direct vasoconstriction
  • only for > 18 yo

M2F (15 decks)

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