DERM Pharm

Question 1

4 variables for cutaneous absorption of topical medications?

Answer 1

Regional, concentration gradient, dosing schedule, vehicles/occlusion

Question 2

How do we best describe topical creams and what are they best to treat?

Answer 2

Half water/half oil with emulsifier and absorb very well

Better than ointments for oozing/wet skin conditions

Question 3

Characterize a topical ointment and what situation is it best used in?

Answer 3

More oil than water mixture and are not well absorbed

Best used on dry skin since they trap moisture and provide more absorption of the active ingredient in the medicine

Question 4

How long should we wash our hands for, what is the soap of choice and what can be better than soap, but what is the catch?

Answer 4

15-30 seconds
Plain soap
Alcohol based disinfection, but doesn’t cover c diff so soap.

Question 5

What is the beneficial effect of the following moisturizer components?
Emollients?
Humectants?
Horny substance?

Answer 5

Forms oily layer to trap water in
Draws water into the outer layer of skin
Gets dead cells to fall off and helps skin retain water

Question 6

MOA of PABA for sun protection?
MOA for benzophenones?
MOA of Dibenzoylmethanes?

Answer 6

Absorb UVB range
Same but less effective that PABA
UVA range, particularly useful for drug induced photosensitivity

Question 7

MOA of minoxidil and clinical use?

Answer 7

Vasodilates due to opening potassium channels. Promotes hair growth by increasing the anlagen/growth phase, shortening the telogen/rest phase and enlarging follicles.

Male and female pattern baldness

Question 8

MOA of finasteride and effect and clinical application?

Answer 8

Oral inhibitor of DHT which increases hair count

Male and female pattern baldness

Question 9

What is first line treatment for female pattern baldness and what 3 drugs are second line treatment?

Answer 9

Minoxidil

Anti androgens like spironolactone, finasteride and flutamide

Question 10

What is alopecia areata and what are two ways we can treat it?

Answer 10

Immune mediated hair loss
Corticosteroids
Topical immunotherapy like DPCP that causes contact dermatitis that grows hair back

Question 11

Two ways to treat BCC or SCC of the skin?

Answer 11

Surgical removal/Oblation

Topical meds like imiquimod and 5 fluorouracil

Question 12

MOA of vismodegib and sonidegib and clinical application?

Answer 12

Sonic hedgehog blockers

Advanced BCC

Question 13

What is conventional chemo for melanoma?

What drug do we use if the melanoma if from a BRAF mutation?

Answer 13

Dacarbazine

Vemurafenib (MAP kinase blocker)

Question 14

4 major ways to treat actinic keratosis?

Answer 14

Liquid nitrogen cryotherapy
Surgical therapy
Pharmacotherapy
Photodynamic red light therapy

Question 15

Topical 5 fluoro MOA, clinical use and 1 big time adverse effect?

Answer 15

Thymidylate synthetase blocker, basically blocks the synthesis of DNA
Actinic keratosis
Inflammatory response that destroys the lesions

Question 16

MOA of imiquimod and clinical use?

Answer 16

Upregualtes the immune system by stimulating cytokines

AK

Question 17

MOA of ingenol mebutate and clinical use?

Answer 17

Destroy cell membrane and mitochondria and then neutrophil destruction of tumor cells

AK

Question 18

Two other meds to take for AK besides the anti tumor stuff?

Answer 18

Topical diclofenac (NSAID) and retinoids

Question 19

How do we characterize actinic keratosis?

Answer 19

Raised areas of heavily sun exposed skin