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Pharmacology > Dermatologic > Flashcards

Dermatologic Flashcards

1
Q

Which area of the skin will have the most permeation and absorption?

A 
#1 groin 
#2 face
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2
Q

Bacitracin-Neomycin-Polymyxin B (Neosporin) class

A

Topical antimicrobial

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3
Q

Bacitracin-Neomycin-Polymyxin B (Neosporin) indications

A

Superficial bacterial skin infx, eyes and external ear infx

can be used prophylactically against bacterial contamination of abrasions, burns, skin grafts or incisions

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4
Q

Bacitracin-Neomycin-Polymyxin B (Neosporin) MOA

A

polymyxin disrupts the structure of the bacterial cell membrane by interacting with phospholipids; bacitracin interferes with the peptidoglycans of the bacterial cell wall

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5
Q

Do not use Bacitracin-Neomycin-Polymyxin B (Neosporin) is __________

A

allergic to systemic aminoglycosides

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6
Q

Drugs of choice to tx impetigo

A

Mupirocin (Bactroban)

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7
Q

When to use topical therapy with tx impetigo

A

only if there is a limited # of lesions

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8
Q

Mupirocin (Bactroban) class

A

topical antibiotic

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9
Q

Mupirocin (Bactroban) MOA

A

inhibits bacterial protein synthesis

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10
Q

T/F: Mupirocin (Bactroban) can be used to tx MRSA colonization

A

TRUE

should be applied to nares to eradicate nasal carriage of infx

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11
Q

Mupirocin (Bactroban) local s/e

A

irritation

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12
Q

What is the MC type of Tinea?

A

Tinea pedis

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13
Q

Drug of choice to tx Tinea

A

Ketoconazole (Nizoral)

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14
Q

Ketoconazole (Nizoral) class

A

topical antifungal

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15
Q

Ketoconazole (Nizoral) MOA

A

inhibits sterol synthesis, a component of fungal cell membranes

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16
Q

Ketoconazole (Nizoral) local s/e

A

skin irritation

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17
Q

Commonly encountered conditions in which topical corticosteroids are used?

A

1) Atopic dermatitis/Eczema
2) Contact/allergic dermatitis - environmental exposure
3) Psoriasis

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18
Q

Potency of topical corticosteroids is based on

A

vasoconstriction effects (not on the anti-inflammatory effects)

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19
Q

Very high potency (Class I) corticosteroid considerations

A

1) do not discontinue abruptly - switch to lower potency agent
2) tx duration should not exceed 2-4 wks

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20
Q

High potency (Class II-III) corticosteroid considerations

A

avoid occlusive dressings with betamethasone dipropionate, use with caution in other high potency agents

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21
Q

Low potency (Class VI-VII) corticosteroid considerations

A

1) consider these agents for children, pregnant women, elderly, and pt. w/ large areas to be treated
2) preferred agents for face, groin, armpits, or skinfolds

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22
Q

potency classes of topical corticosteroids

A

Very high = Class I
High = Class II-III
Medium = Class IV-V
Low = Class VI-VII

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23
Q

cutaneous adverse rxn to topical corticosteroids

A

skin atrophy (thinning), telangiectasia, hypopigmentation, steroid acne, increased hair growth

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24
Q

________ topical corticosteroids can be systemically absorbed

A

Very high (Class I) and High (Class II-III) potency

25
Q

systemic/LT s/e of topical corticosteroids

A

insomnia, hyperglycemia, osteoporosis, impaired wound healing

26
Q

last line therapy for tx of atopic dermatitis/eczema, used if pt. have failed to respond to topical corticosteroids

A

Topical Calcineurin Inhibitors

27
Q

Tacrolimus (Protopic) ointment class

A

Topical Calcineurin Inhibitors

28
Q

Pimecrolimus (Elidel) cream class

A

Topical Calcineurin Inhibitors

29
Q

Topical Calcineurin Inhibitors local s/e

A

local stinging, burning

30
Q

Treat pruritis/hives with

A

systemic antihistamines

31
Q

Loratadine (Claritin) class

A

systemic antihistamines

32
Q

Cetirizine (Zyrtec) class

A

systemic antihistamines

33
Q

T/F: topical antihistamines can be used to treat pruritus/hives

A

FALSE

they are ineffective & topical doxepin carries risk of local contact dermatitis

34
Q

What are pharmacologic options for tx acne?

A

1) salicylic acid
2) benzoyl peroxide
3) topical retinoids
4) antibacterial agents
5) antisebum agents

35
Q

Which antibacterial agents are used to tx acne?

A

1) Erythromycin, clindamycin
2) azelaic acid
3) dapsone

36
Q

Which antisebum agents are used to tx acne?

A

1) oral contraceptives
2) spironolactone
3) isotretinoin

37
Q

Isotretinoin (Accutane) class

A

Vitamin A derivative

38
Q

Isotretinoin (Accutane) indications

A

acne, acne rosacea, and hidradenitis supperativa

39
Q

Isotretinoin (Accutane) MOA

A

1) reduction of hyperkeratinization
2) reduction in # of sebaceous glands and sebum production
3) reduction of Propionbacterium acne, the organism believed to contribute to acne-associated inflammation

40
Q

Isotretinoin (Accutane) ADRs

A

1) **Teratogenicity (1’ in first 3 wks)
2) Depression
3) Psychosis
4) Myalgias
5) Hyperlipidemia

41
Q

What is the iPLEDGE program?

A

that Isotretinoin (Accutane) Rx requires registration from: physician, patient, pharmacy, and wholesaler

goals: no female pt. starts Isotretinoin (Accutane) if pregnant and no female pt. on Isotretinoin (Accutane) becomes pregnant

42
Q

T/F: LT use of topical corticosteroids can cause systemic s/e such as insomnia, hyperglycemia, osteoporosis, and impaired wound healing

A

False

although depends on potency of steroid

43
Q

Treatment options for psoriasis

A

1) topical corticosteroids
2) topical vitamin D analog
3) topical vitamin A analog/retinoid (i.e. tazarotene)
4) phototherapy
5) systemic therapy

44
Q

Which systemic therapies are used to tx psoriasis?

A

1) oral steroids,
2) chemotherapy agents (methotrexate)
3) TNF-a inhibitors (Infliximab/Remicade and Etanercept/Enbrel)

45
Q

Cacipotriene (Dovonex) class

A

Vitamin D analog

46
Q

Cacipotriene (Dovonex) MOA

A

inhibits epidermal proliferation and stimulation of differentiation

47
Q

Cacipotriene (Dovonex) indications

A

plaque psoriasis, scalp psoriasis

48
Q

T/F: the vitamin D analog, Cacipotriene (Dovonex, is as effective as topical corticosteroids but has more frequent adverse effects

A

TRUE

49
Q

Cacipotriene (Dovonex) s/e

A
  • photosensitivity
  • hypercalcemia
  • may worsen psoriasis
  • skin irritation
50
Q

Cacipotriene (Dovonex) is potentially more effective in tx psoriasis when used with _________

A

Betamethasone

51
Q

Tazarotene (Tazorac) class

A

topical retinoid

52
Q

Tazarotene (Tazorac) indications

A

plaque psoriasis, acne

53
Q

Tazarotene (Tazorac) s/e

A

skin burning, irritation, stringing

54
Q

Tazarotene (Tazorac) is recommended to use with _______ for improved efficacy and tolerability when tx psoriasis

A

topical corticosteroids

55
Q

What is phototherapy?

A

use of UVA & UVB as therapeutic agents

56
Q

What is photochemotherapy?

A

adding an agent such as a psoralen drug (e.g. methoxsalen) to phototherapy tx

57
Q

PUVA

A

psoralen (P) + UVA

58
Q

phototherapy s/e

A
  • nausea
  • painful erythema and blistering
  • chronic use associated w/ incr. risk of skin cancer

Pharmacology (14 decks)

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