Derm Pharm Flashcards
1
Q
Variables that affect rate of cutaneous absorption
A
region, concentration gradient, dosing schedule, vehicles/occlusion
2
Q
Cream
A
half water/half oil with an emulsifier; spreads easily and well absorbed, best for oozing or wet skin conditions
3
Q
Ointments
A
20% water, 80% oil; feel greasy and stay on surface of skin; best for dry skin because they trap moisture, allowing for more complete absorption of active ingredient
4
Q
Single most important measure to reduce transmission of microorganisms to other areas of the body or patients
A
hand hygiene
5
Q
Alcohol-based hand disinfectants are not effective against what bacteria?
A
C. difficile
6
Q
Emolients
A
form an oily layer on top of skin that traps water in the skin
7
Q
Common emolients
A
petrolatum, lanolin, mineral oil, and dimethicone
8
Q
Humectants
A
draw water into the outer layer of the skin
9
Q
Common humectants
A
glycerin, lecithin, propylene glycol
10
Q
Horny substance softeners
A
loosen bonds between top layer of cells; helps dead skin cells fall off and skin retain water
11
Q
Common horny substance softeners
A
urea, alpha hydroxy acids
12
Q
Moisturizers for normal skin
A
water-based moisturizer that has a light, nongreasy feel
13
Q
Moisturizes for dry skin
A
heavier, oil-based moisturizer that contains ingredients to keep skin dry
14
Q
Moisturizers for oily skin
A
water-based product labeled “noncomedogenic”
15
Q
Moisturizers for sensitive skin
A
sooth ingredients free of fragrances or dyes
16
Q
Moisturizers for mature skin
A
oil-based moisturizer that contains petrolatum as the base to keep skin hydrated plus antioxidants
17
Q
UVB radiation
A
280-320 nm, causes erythema/sunburn and skin aging and photocarcinogenesis
18
Q
UVA radiation
A
320-400 nm, causes skin aging and cancer
19
Q
Sunscreens
A
chemical compounds that absorb UV light
20
Q
Sunscreen ingredients active in UVB range
A
PABA (p-aminobenzoic acid) and benzophenones
21
Q
Sunscreen ingredients active in UVA range
A
dibenzoylmethanes
22
Q
Sunshades
A
opaque materials that reflect light
23
Q
Sun protection factor
A
ratio of minimal erythema dose without sunscreen to minimal erythema dose with sunscreen
24
Q
Clorhexidine
A
broad-spectrum antimicrobial agent widely used due to general efficacy on skin and low irritability
25
Prions resistant to antiseptics and disinfectants
CJD
26
Protozoan resistant to antiseptics and disinfectants
cryptosporidium
27
Spores resistant to antiseptics and disinfectants
Bacillus ssp., C. difficile
28
Role of biofilms in abx reistance
limited penetration, abx neutralization
29
Is the use of antiseptic wash solutions necessary for wounds?
No, have minimal action against bacteria and may impede wound healing
30
Is the use of antibiotic therapy necessary for wounds?
Should only be used for wounds that appear clinically infected, no evidence that prophylactic use helps
31
How is glycemic control related to wound outcomes?
poor glycemic control is associated with worse outcomes
32
Typical reason for inadequate oxygenation of a wound
local vasoconstriction due to sympathetic overactivity
33
How does the removal of dead tissue and debris promote wound healing?
limits protease production and conserving local resources needed for healing
34
Role of low-pressure irrigation with normal saline for wound debridment
should be routine, flushes bacteria and removes loose material
35
Becaplermin
platelet derived growth factor that promotes cell proliferation and angiogenesis, black box warning for malignancy
36
General principles of wound dressing
wounds should be kept moist and not exposed to air, wounds can be exposed to their own fluid and improve healing
37
Wound dressing for debridement stage
hydrogel
38
Wound dressing for granulation stage
foam and low-adherence dressings
39
Wound dressing for epithelialization stage
hydrocolloid and low-adherence dressings
40
Bacitracin
abx that inhibits bacterial cell wall synthesis, active against G+ organisms, anaerobic cocci, neisseriae, tetanus bacilli, diphtheria bacilli; may cause contact dermatitis
41
Neomycin
binds to 30s subunit, active against G- organisms, can causes allergic contact dermatitis
42
Polymixin B
peptide abx that binds to phospholipids to alter permeability of membrane, effective against G-
43
Topical imidazoles
block ergosterol synthesis
44
Use for miconazole
vulvovaginal candidiasis
45
Use for clotrimazole
vulvovaginal candidiasis
46
Use for efinaconazole
onychomycosis
47
Use for ketoconazole
seborrheic dermatitis
48
AE of topical imidazoles
stinging, pruritis, erythema, local irritation
49
Ciclopirox
broad=spec topical antimycotic agent that disrupts macromolecular synthesis; active against dermatophytes, Candida, and Malassezia
50
Terbinafine
allylamine that selectively inhibits squalene epoxidase, a key enzyme for ergosterol synthesis; less active against yeasts
51
Tolnaftate
distorts hyphae and stunts growth; effective against various dermatophyte and Malassezia infections, not Candida
52
Nystatin
alters membrane permeability, topical treatment used for candida infections (swallowed or cutaneous)
53
Amphotericin B
alters membrane permeability, topical treatment for candida infections
54
Acyclovir
Inhibitory activity against HSV 1 and 2, used for herpes labialis
55
Nonpharmacologic interventions for pruritus
skin moisturization, cool environment, avoidance of irritants, stress reduction
56
Potency of topical steroid treatment
Use low-potency on face, genitals, skin folds; use high potency elsewhere and titrate down
57
Capsaicin
used for chronic pain and pruritis, activation of TRPV1 stimulates neurons to release and deplete neuropeptides to induce lasting desensitizations
58
Salicylic acid
COX inhibitor, found in many skin-care products; causes epidermal cells to shed more readily, keratolytic effects
59
Systemic therapies for pruritis
antihistamines, antidepressants, anticonvulsants
60
Brimonidine
alpha 2 adrenergic agonist, topical gel causes vasoconstriction
61
Oxymetazoline
mixes alpha 1 and alpha 2 adrenergic agonist, cream causes vasoconstriction
62
Malathion
topical organophosphate cholinesterase inhibitor used to kill ectoparasites
63
Permethrin
topical agent that binds to insect Na channels
64
Ivermectin
administered orally, binds to glutamate-gated Cl- channels in invertebrates hyperpolarizes nerve and muscles
65
lindane
topical agent that disrupts GABAergic transmission in insects
66
First drug choice for comedonal acne
Topical retinoid
67
First drug choice for mixed and papular/postural acne
topical retinoid and topical antimicrobial
68
First drug choice for nodular acne
oral abx, topical retinoid, BPO
69
First drug choice for severe nodular/conglobate acne
oral isotretinoin
70
Most common topical retinoid
Tretinoin
71
Common topical antimicrobials
benzoyl peroxide, clindamycin, erythromycin
72
Azealic acid
dicarboxylic acid, involved in plant defense response to an infection; kills acne bacteria and decreases production of keratin
73
Common oral abx used for acne
tetracycline, doxycycline, minocycline, erythromycin, azithromycin, TMP-SMX
74
Hormonal agents used for acne
oral contraceptives, spironolactone
75
AE tretinoin
local skin irritation, dryness, flaking, sun sensitivity
76
AE benzoyl peroxide
local skin irritation
77
AE clindamycin
pseudomembranous colitis
78
AE tetracycline
photosensitivity, GI distress
79
AE doxycycline
photosensitivity, GI distress
80
AE minocycline
dizziness, drug-induced lupus, skin discoloration
81
AE erythroycin
GI distress
82
AE azithromycin
GI distress
83
TMP-SMX
Stevens-Johnson syndrome, toxic epidermal necrolysis
84
Retinoid MOA
Increased transcription RARE ? , reduced follicular occlusion and microcomedone formation
85
Home skin care recommendations
synthetic detergent cleanser with warm water twice daily, antimicrobial soaps not recommended; water-based lotions, cosmetics and hair products
86
Initial topical therapies for psoriasis
emollients, corticosteroids
87
Topical therapies for psoriasis
topical vitamin D analogs, tar, tazarotene, anthralin, salt water bath
88
UV light therapy for psoriasis
UVB radiation to point of erythema 3x per week; PUVA penetrates deeper into the skin without causing sunburn
89
Systemic therapies of psoriasis
methotrexate, apremilast, retinoids, systemic calcineurin inhibitors, biologic agents
90
Apremilast
PDE4 inhibitor used for psoriasis, increases cAMP, decreases inflammatory mediators
91
Ustekinumab
IL-12 and IL-23 mAb for psoriasis
92
Secukinumab and Ixekuzumab
IL-17A mAb
93
Clinical applications apremilast
moderate to severe plaque psoriasis, active psoriatic arthritis
94
Administration of apremilast
orally
95
AE apremilast
severe diarrhea, nausea, and vomiting; HA, depression, suicide
96
Clinical applications ustekinumab
plaque psoriasis, Crohn disease, psoriatic arthritis
97
Administration of ustekinumab
subQ
98
AE ustekinumab
increases risk for infections and squamous cell carcinoma
99
Clinical applications secukinumab
ankylosing spondylitis, plaque psoriasis, psoriatic arthritis
100
Administration of secukinumab
subQ
101
AE secukinumab
increases risk for infection
102
Treatment options for actinic keratosis
liquid nitrogen cryotherapy, surgical therapy, 5-fluorouracil, immiquiod, red light therapy, dermabrasion, chemical peels
103
Topical 5-fluorouracil
inhibits thymidylate synthetase, enzyme in DNA synthesis; causes inflammation and dectruction of lesions
104
Skin progression for topical 5-fluorouracil
erythema through blistering, necrosis with erosion, re-epithelialization
105
Treatment of basal cell or squamous cell carcinoma
surgical removal/ablation, topical medications, vismodegib
106
Treatment of melanoma
surgical excision, dacarbazine with carmustine and tamoxifen OR cisplastin and vinblastine; vemurafenib
107
Minoxidil
vasodilation, K channel opening; promotes hair growth by increasing duration of growth phase, shortening rest phase, enlarging miniaturized follicles
108
Fenasteride
Oral inhibitor of DHT (dihydrotestosterone), increases hair count
109
Treatment of alopecia in men
minoxidil, fenasteride, surgery
110
Treatment of alopecia in women
minoxidil, spironolactone, finasteride, flutamide
111
Management of alopecia areata
chronic, relapsing immune-mediated inflammatory disorder affecting hair follicles resulting in non-scarring hair loss; treat with corticosteroids, topical immunotherapy
