Derm Pharmaco/management Flashcards
1st choice antibiotic for treatment of cellulitis. PO and IV. Full prescription.
(Simple cellulitis, likely infected with Strep or Staph. Aureus.
Cefadroxil 500-1000 mg PO BID x 5 to 10 days.
Cefazolin 1000-2000 mg IV TID x 5 to 10 days
1- 1st choice Antibiotic for cellulitis from Animal bite.
(Same as 1st choice Tx Antibiotic for cellulitis of Sinusal or simple periorbital origin.)
2- This is also the 2nd choice for what other type of cellulitis?
1- Amoxicillin/Clavulanate 875/125 mg PO BID for 7 to 10 days.
2- Cellulitis of dental origin
1st choice anitibiotic for cellulitis of dental origin?
Amoxicillin 500 mg PO TID for 5 to 10 days.
1st choice antibiotic for Cellulitis with suspicion of MRSA?
Doxycycline 100 mg PO BID x 5 to 10 days.
Treatment for
1- isolated
2- Diffuse Actinic Keratosis
1- 2 cycles of liquid nitrogen.
2- Topical fluorouracil (antineoplastic agent)(Efudex cream) BID 5/7 x 2 to 4 weeks,
Pharmacological approach for Atopic dermatitis for.
1- Body
2- Face
1- Moderate to strong cordiocosteroid BID x4-6 weeks
2- low potency corticosteroid on face BID x2-4 weeks.
Which class of corticosteroid will you use for more sensitive areas, including face?
Class 7 (least potent) and 6 (low potentcy).
What classes are considered moderate strength corticosteroids (numbers)?
4 (medium potency) and 5 (lower-mid potency)
Which classes are considered high potencycorticosteroids?
2 and 3
Which class is considered super-high potentcy? (Corticosteroids)
1
Which classes do you use in children for:
1- at risk zones (name the areas)
2- Rest of body/no risk zones
1- Low potentcy Class 6. (Face, neck, under the diaper, folds)
2- class 4 (medium potency) or 5. (Lower-mid potency)
After how many weeks of topical corticosteroid use to you start to worry about side effects?
4 to 6 weeks.
Name side effects of topical corticosteroids (8)
1-Atrophy
2- stretch marks
3- acne
4- periorifice dermatitis
5- Exacerbation of cutaneous fungus infections
6- Delays in healing
7- contact allergic dermatitis
8- Glaucoma / cataracts
After initiation of treatmetn for Actinic keratosis, when do you reassess?
What do you do if the lesion
1- is gone
2- persists
In 4 months.
1- FU q 2years.
2- Derm consult.
Psoriasis:
1- Tx for nails, palmoplantar and body
2- Tx for Face and folds
3- Tx for hair/scalp
1- Class 2 and 3 (High potency). Dovobet Gel (Nails HS, Palmoplantar HS, Body DIE)
2- Desonide cream dIE (Class 6 Low potency)
3- Shampoo containing salicyc acid 3x/week OR Dovobet gel (class 2 and 3, high potency) 3x week HS.
How long after psoriasis tx do you FU with patient?
6 months after tx start.
Atopic dermatitis treatment for adults.
1- Pharmacology Body
2- Pharmacolgy Face
3- Non pharmacology
4- 2 options for pruritis
5- add on if no response
1- Medium to high potency corticosteroid BID x 4-8 weeks
2- Low potency corticosteroid BID x 2-4 weeks
3- Emollient BID regularly
4- 1st (drowsiness) or 2nd (non drowsy) generation antihistamine
5- Topical calcineurin inhibitor. 2-3x per week to daily.
Atopic dermatitis in children
1- Pharamcology body
2- Pharmacology face
3- non pharmaceutical
4- for pruritis
5- Severe cases or recurrence
1- Class 4-5 corticosteroid (medium to lower-mid potency) BID x 4-8 weeks
2- Class 6-7 (Low potency to least potent) BID x 2-4 weeks
3- Emollient BID regularly
4- 1st generation antihistamine TID according to weight.
5- Topical Calcineurin ihibitor 2-3x/week to daily
Contra indications to Topical calcineurin inhibitor (2)
1- Pregnant
2- Breastfeeding
Atopic dermatitis infection treatment:
1- mild
2- severe (adults and children)
1- Topical antibiotic ointment.
2- cefadroxil 500-1000 mg PO BID x 5 to 10 days for adults.
OR cefadroxil 30mg/kg/day PO divided BID.
Counseling for atopic dermatitis (6)
1- Hydrate skin +++
2- Use fragrance free soap and detergent.
3- Short showers
4- Avoir extreme temperatures
5- ER if fever.
6- Do not use corticosteroids longer than indicated.
Ddx for atopic dermatitis (6)
1- Seborrheic dermatitis
2- Rosacea
3- Psoriasis
4- Lupus
5- Uritcaria
6- Contact dermatitis
Signs of infection atopic dermatitis (2)
1- Fever, chills
2- Yellow crusts
Important history taking for acne. (7)
1- Age of onset
2- Use of medication
3- Family history
4- Psychologic impact (suicidal ideation or depressive symptoms)
5- What has been tried so far?
6- link with menstrual cycle? Hyperandrogenism signs
7- Sudden onset?
Important history taking for acne. (7)
1- Age of onset
2- Use of medication
3- Family history
4- Psychologic impact (suicidal ideation or depressive symptoms)
5- What has been tried so far?
6- link with menstrual cycle? Hyperandrogenism signs
7- Sudden onset?
Treatment for Comedones
Topical retinoid HS and reevaluate in 2-3 months.
If tx for comedones 1- (name tx for comedones) is ineffective. 2- What do you do?
OR
Tx for mild inflammatory papules and pustules (1 and 2)
3- When to reevaluate?
1- Topical retinoid was ineffective
2- add benzyol peroxyde HS
3- 2 to 3 months
Two options for moderate inflammatory papules and pustules.
1- with nodules
2- without nodules
1- Topical retinoid + benzoyl peroxide + Topical antibiotic
2- Topical retinoird + Benzoyl peroxide + oral antibiotic
Whats the oral antibiotic for acne
Doxycyclin 100mg PO DIE or BID x 3-6 months.
If a female with acne, when do you add oral contraception?
.
After 6 months of Topical tx, before trying oral antibiotic
Systemic retinoid (oral isotretinoin) contra-indications. (7)
1- less than 12 years old
2- Breasfeeding
3- Pregnancy
4- Renal/hepatic insufficiency
5- uncontrolled dyslipidemia
6- uncontrolled depression
7- inflammatory bowel
8-more….
Systemic retinoid blood work to start. (5)
Creat, ALT, HbA1C, lipids, Beta-Hcg
Woman taking systemic retinoid MUST be on:
Contraceptives
Counselling for patient or systemic retinoid. (4)
1- Emollient on lips and hand
2- No anitibiotics
3- No aesthetic treatment
4- Sun protection ++++
