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PT3 GI and DERM > DERM therapeutics > Flashcards

DERM therapeutics Flashcards

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Dermatology Board Prep flashcards
1
Q

epidermis features/function

A
  • outer barrier
  • keratin
  • melanin
  • touch
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2
Q

dermis features/function

A
  • supports epidermis and protects from injury
  • connective tissue
  • nerves
  • blood vessels
  • hair follicles
  • immune response
  • oil, sweat glands
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3
Q

hypodermis features/function

A
  • adipose tissue
  • larger blood vessels
  • regulation of temperature
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4
Q

pediatric skin anatomy

A
  • more water
  • thinner
  • enhanced drug absorption
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5
Q

elderly skin anatomy

A
  • drier
  • thinner
  • slower healing
  • enhanced drug absorption
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6
Q

macule

A
  • flat, non-palpable

- different color

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7
Q

macule example

A

freckles

drug eruption

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8
Q

papule

A

solid
elevated
can palpate
no visible fluid

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9
Q

papule example

A

wart

insect bite

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10
Q

nodule

A

firm papule that extends into the dermis or subcutaneous tissue

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11
Q

nodule example

A

severe acne

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12
Q

vesicle

A

small, elevated, fluid filled blisters

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13
Q

vesicle example

A

contact dermatits

burns

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14
Q

bulla

A

a larger vesicle

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15
Q

pustule

A

vesicles that contain pus

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16
Q

pustule example

A

acne

folliculitis

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17
Q

wheals

A
  • elevated and transient plaque or papule caused by localized edema
  • almost always itches
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18
Q

other names for a wheal

A

hive

urticaria

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19
Q

wheal example

A

hypersensitivity to drugs, bee sting

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20
Q

topical formulations to use on hairy skin

A 
solutions
lotions
gels
aerosols
foams
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21
Q

topical formulations to avoid on hairy skin

A

ointments

patches

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22
Q

topical formualtions to us for moist area between skin folds

A

solutions
lotions
creams
powders

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23
Q

topical formulations to avoid for moist area between skin folds

A

ointments

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24
Q

how many grams to cover the whole body once

A

30g

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25
Q

dermatitis is synonymous with what

A

eczema

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26
Q

atopic dermatitis is most common in

A

young children

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27
Q

areas of body most commonly affected by atopic dermatitis in infants

A
  • face/cheeks
  • trunk
  • neck
  • arms/legs
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28
Q

areas of body most commonly affected by atopic dermatitis in children/adults

A

antecubital and popliteal fossa
hands
face

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29
Q

atopic triad

A

IgE mediated diseases

  • dermatitis
  • allergic rhinitis
  • asthma
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30
Q

factors with increased prevalence of atopic dermatitis

A
  • air polluted areas
  • industrialization
  • urban
  • dietary changes
  • higher socioeconomic status
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31
Q

hygiene hypothesis

A

having less exposure to infectious agents at a younger age can make you more susceptible later in life

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32
Q

symptoms of atopic dermatitis

A
  • chronic with flares and remissions
  • intense itch
  • dry, flaky
  • inflamed/red
  • weepy
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33
Q

atopic dermatitis nonpharm treatment

A

reduce the following:

  • allergens
  • stress
  • excessive bathing
  • detergents
  • sun exposure
  • itching the rash
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34
Q

first line treatments for atopic dermatitis

A

-skin hydration with thick creams or ointments twice daily
or
-topical corticosteroids

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35
Q

what dosage form to avoid in treating atopic dermatitis

A

lotions

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36
Q

topical corticosteroids use duration

A
  • for very high or high potency use 7-14 days then switch to lower potency
  • medium or low potency can be used longer safely
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37
Q

corticosteroid adverse effects

A 
skin atrophy
hypopigmentation
bruising
stretch marks
rash
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38
Q

corticosteroid affect on HPA axis

A

suppresses production of cortisol

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39
Q

suppression of HPA axis causes what side effects

A 
growth retardation
adrenal insufficiency
Cushings
secondary infections
mood changes
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40
Q

benefit of using bid dosing over QD in high potency steroids

A

none

HPA side effect risk is low if used less than 2 weeks

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41
Q

dosage form absorption comparison

A

ointment > cream > lotion

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42
Q

atopic dermatits second line treatment

A

calcineurin inhibtors

UV light therapy

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43
Q

calcineurin inhibitor drugs

A

tacrolimus

pimecrolimus

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44
Q

calcineurin inhibitors use features

A

do not cause skin atrophy and can be used on the face

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45
Q

calcineurin inhibitors are equivalent in effectiveness to what strength steroids

A

low-moderate

46
Q

atopic dermatitis third line treatment

A

oral immunosuppressive drugs

47
Q

things to avoid in atopic dermatitis

A
  • all antihistamines
  • systemic antibiotics
  • probiotics
  • immunotherapy
  • food elimination based only on allergy tests
  • special laundry products
48
Q

drug induced skin reactions presentation

A
  • hives, vomiting, diarrhea, anaphylaxis

- occurs minutes to hours after drug exposure

49
Q

DRESS acronym

A

Drug Reaction with Eosinophilia and Systemic Symptoms

50
Q

DRESS features

A
  • rash, fever, hematologic effects
  • occurs 1-4 weeks after starting drug
  • can be fatal if not treated
51
Q

common drugs that cause DRESS

A

allopurinol
sulfa
anticonvulsants

52
Q

stevens-johnson syndrome features

A
  • severe blistering
  • fever, HA, respiratory distress
  • acute onset
53
Q

drugs that cause stevens-johnson syndrome

A 
sulfa drugs
penicillins
anticonvulsants
NSAIDS
allopurinol
54
Q

toxic epidermal necrolysis

A

SJS when over 30% of the body is involved or reaction is even more severe

55
Q

pseudoallergic reaction characterized by

A

direct mast cell activation

56
Q

example of pseudoallergic reaction

A

vancomycin causing red man syndrome

57
Q

fixed drug eruption features

A
  • pruritic, red raised lesions
  • occur in same area when drug is given
  • appears quickly
58
Q

drugs that cause fixed drug eruptions

A

tetracycline
sulfonamides
codeine

59
Q

which medication can cause purple toe syndrome

A

warfarin

60
Q

which medication causes blue skin

A

amiodarone

colloidal silver

61
Q

which drug can cause hypertrichosis

A

minoxidil

cyclosporine

62
Q

which medication can cause permanent tooth discoloration

A

tetracyclines

63
Q

comedone

A

obstructed sebaceous follicle

64
Q

pathophysiology of acne

A
  • obstructed follicle
  • increased sebum production
  • colonizaiton by propionibacterium acnes
  • hyperproliferation of ductal epidermis
  • inflammation at acne sites
65
Q

blackhead

A

open comedone

non-inflammatory

66
Q

white head

A

close comedone

non-inflammatory

67
Q

mild acne definition

A

<20 comedones
<15 inflammatory lesions
<30 total lesions

68
Q

moderate acne definition

A

20-100 comedones
15-20 inflammatory lesions
30-125 lesions total

69
Q

severe acne definition

A

> 5 cysts
100 comedones
50 inflammatory lesions
125 total lesions

70
Q

exacerbating factors of acne

A
  • heat and humidity
  • pimple popping
  • excessive scrubbing or washing
  • sunlight exposure
  • stress
  • dietary changes
71
Q

medications that can worsen acne

A 
phenytoin
isoniazid
rifampin
phenobarbital
lithium
steroids
B vitamins
72
Q

first line treatment for mild acne

A 
benzoyl peroxide
or 
topical retinoid
or
topical combo with antibiotic
73
Q

first line treatment for moderate acne

A

combo therapy

using any combination of BP, retinoid, topical antibiotic and oral antibiotic

74
Q

first line treatment for severe acne

A

oral antibiotic + any two of BP, retinoid, topicl antibiotic
OR
oral isotretinoin

75
Q

gels tend to be

A

drying

76
Q

creams and lotions tend to be

A

moisturizing

77
Q

solutions tend to do what to the skin

A

drying

78
Q

preferred dosage form for patients with oily skin

A

gels

79
Q

benzoyl peroxide used for

A

first line option for acne

80
Q

benzoyl peroxide directions

A

wash face and apply bid

when using with retinoids separate timing

81
Q

benzoyl peroxide adverse effects

A

irritation

can bleach or discolor fabric

82
Q

salicylic acid use

A
  • for keratolytic and comedolytic acne

- useful if retinoids cannot be tolerate

83
Q

salicylic acid adverse effects

A
  • erythema
  • peeling
  • scaling
84
Q

retinoids use

A
  • first line option for acne

- for comedolytic, karatolytic and anti-inflammatory

85
Q

retinoids directions

A

wash face and apply in evening

86
Q

retinoid adverse effects

A

photosensitivity

dryness/flaking

87
Q

specific retinoid to not use with benzoyl peroxide

A

tretinoin, breaks down when used at the same time

88
Q

topical antimicrobials place in acne treatment

A

first line option when used in conjunction with BP or a retinoids

89
Q

clindamycin foam (Evoclin) unique use instructions

A

dispense foam onto cool surface, not had and apply small amounts with fingertips

90
Q

dapasone co-administration with BP causes

A

orange-brown skin discoloration

91
Q

best topical antibiotics

A

clindamycin
erythromycin
dapsone

92
Q

oral antibiotics use in acne

A
  • mod-severe for a limited course

- don’t use at the same time as topicals

93
Q

oral antibiotic options for acne

A

minocyclin > doxycycline > tetracycline

Macrolides

94
Q

side effects of tetracyclines

A

phototoxicity

tooth discoloration

95
Q

oral isotretinoin use in acne

A

severe cases

potential for long term improvement

96
Q

oral isotretinoin MoA

A

decreases sebum production and shrinks sebaceous glands

97
Q

oral isotretinoin directions for use

A

qd or bid with meals

98
Q

oral isotretinoin max duration of use

A

20 weeks

99
Q

oral isotretinoin adverse effects

A

hepatotoxicity
hypertriglyceridemia
highly teratogenic

100
Q

secondary options for acne

A 
oral contraceptives (estrogen dominant ones)
spironolactone
101
Q

how long to typically see improvement in acne

A

8 weeks

102
Q

psoriasis cause

A

pathogenic T-cell production

103
Q

factors that improve psoriasis

A

warmth

sunlight

104
Q

factors that worsen psoriasis

A 
cold
stress
alcohol
smoking
obesity
105
Q

medications that trigger psoriasis flares

A 
NSAIDs
ACEI
antimalarials
beta blockers
lithium
salicylates
steroid withdrawal
106
Q

non pharm treatment for psoriasis

A

UV A or B
smoking cessation
balneotherapy?

107
Q

emollients in psoriasis

A

avoids dryness

apply multiple times per day

108
Q

keratolytics in psoriasis

A

removes scales and decreases hyperkeratosis

can increase penetration of other agents

109
Q

corticosteroids in psoriasis

A

apply 1-4 times per day and taper

110
Q

vitamin D analogs in psoriasis

A

inhibit keratinocyte proliferation

apply BID

111
Q

retinoids in psoriasis

A

use with steroids

apply in evening

112
Q

second line agents for psoriasis

A

topical calcineurin inhibitors

methotrexate

PT3 GI and DERM (8 decks)

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