Derm Therapeutics Flashcards
Ointments
Hydrating, emollient and protective.
(Are petrolium based, don’t need preservatives so have low risk of sensitization or irritation)
Has high potency for active ingredient.
Creams
Provide hydration (not as hydrating as ointments, are water based)
Significant risk and low irritation risk - patient preference
Gels
drying
delivers active ingredient w/ strong potency
significant sensitization risk and relatively high irritation risk
Oral mucosal surfaces and scalp
AVOID on fissures, erosions and macerated areas
Lotions/Solutions
Delivers active ingredients in low potency
Scalp and intertriginous areas are amenable (don’t use on fissures or erosions)
Foams
stable at room temp but melts at body temp
strong potency for active ingredients, quick-drying, stain-free, no residue -> also on hair bearing areas
What type of vehicle would you choose for a patient exposed to poison ivy?
Ointment
What of the following correctly describes the emulsion properties of creams?
A. Oil in water emulsion
B. Semisolid emulsion in alcohol base
C. Powder in water
D. Pressurized collections of gaseous bubbled in matrix of liquid film
A. Correct (cream)
B. Gel
C. Lotion/Emulsion
D. Foam
What is an FTU?
1 FTU=Fingertip Unit
1 FTU = .5 g
Both sides of one hand = 1 FTU.
1 gram of cream
10x10cm area of skin (1 gram of ointment spreads 10% further in cream!)
20g necessary to treat entire body of an adult man, 280g per week.
Topical corticosteroid therapy
Glucocoticoids inhibit inflammatory cytokines
Inhibition of NF-kappa B pathway
Seven classes have been proposed depending on potency -> superpotent is class 1, low potency =7
Potency developed on vasoconstrictor assays
“The Gentle Touch” - Hydrocortisone 2.5%
Cream or ointment
Class 7
Efficacious for mild eczema in children and adults, as well as inflammatory dermatoses in face, intriginous areas or groin
“Almost All-Purpose Weapon”
Triamcinolone Acetonide .1%
Cream or ointment
Class 4 (cream formulation, mid-potency)
Effective against most moderate spongiotic dermatoses (eczematois dermatitis, atopic dermatitis, allergic contact dermatitis, arthropod bite)
Use on trunk and extremities -> long term use no good for sensitive areas
“Hercules”
Clobetasol Propionate .05%
Class 1
Treatment for acute eruptions that need rapid cure, like drug eruptions or contact dermatitis
Don’t use in sensitive areas
Adverse effects of topical glucocorticosteroids
Skin atrophy: chronic use of super-potent topical steroids
Systemic side effects: adrenal suppression, Cushing’s syndrome and growth retardation in children
