Dermatologic

Question 1

MOA of Polymyxin B?

Answer 1

Disrupts the structure of the bacterial cell membrane by interacting with phospholipids

Question 2

MOA of Bacitracin?

Answer 2

Interferes with the peptidoglycans of the bacterial cell wall

Question 3

What are the four topical antimicrobials?

Answer 3

Bacitracin
Neomycin
Polymyxin B
Neosporin

Question 4

What is the drug of choice for Impetigo?

Answer 4

Mupirocin/Bactroban

Question 5

MOA of Mupirocin/Bactroban?

Answer 5

Inhibits bacterial protein synthesis

Question 6

Drug of choice for Tinea?

Answer 6

Ketoconazole/Nizoral

Question 7

MOA of Ketoconazole/Nizoral?

Answer 7

Inhibits sterol synthesis, a component of fungal cell membranes

Question 8

What three skin conditions are typically treated with topical corticosteroids?

Answer 8

Atopic dermatitis/eczema
Contact/allergic dermatitis
Psoriasis

Question 9

What is the classification system of corticosteroids?

Answer 9

Class I - very high potency
to
Class VII - low potency

Question 10

What are two important considerations when prescribing Class I corticosteroids?

Answer 10

It should not be discontinued abruptly

Tx duration should not exceed 2-4 weeks

Question 11

What is a consideration when using betamethasone dipropionate?

Answer 11

Avoid occlusive dressings and use with caution in other high potency agents

Question 12

What are common cutaneous adverse reactions to topical corticosteroids?

Answer 12

Skin atrophy
Telangiectasia
Hypopigmentation
Acne
Increased hair growth

Question 13

What is a last line therapy for atopic dermatitis?

Answer 13

Topical calcineurin inhibitors

• Tacrolimus
• Pimecrolimus

Question 14

What is the tx for pruritus/hives?

Answer 14

Systemic antihistamines

• Loratadine
• Cetirizine

Question 15

Should you recommend topical antihistamines like diphenhydramine or doxepin for pruritus/hives?

Answer 15

No, they are ineffective, can cause contact dermatitis and cutaneous sensitization

Question 16

What are the five categories of pharmacologic treatment options for acne?

Answer 16

Salicylic acid
Benzoyl peroxide
Topical retinoids
Antibacterial agents
Antisebum agents

Question 17

What topical acne medication may cause bleaching of skin, hair, fabrics, and carpeting, and promotes tumors in lab animals?

Answer 17

Benzoyl peroxide, seriously, but it’s still a first-line treatment, go figure.

Question 18

What is the main concern in using Isotretinoin?

Answer 18

Teratogenicity

Question 19

MOA of Isotretinoin?

Answer 19

Reduction of hyperkeratinization, # of sebaceous gland and sebum production, propionibacterium acne

Question 20

What are five categories of therapy for Psoriasis?

Answer 20

Topical corticosteroids
Topical vit. D analog
Topical vit. A analog
Phototherapy
Systemic therapy (oral steroids, chemotherapy, TNF-a inhibitors)

Question 21

Class and MOA of Calcipotriene?

Answer 21

Vit. D analog

Inhibits epidermal proliferation and stimulation of differentiation

Question 22

What topical retinoid is recommended to use with topical corticosteroids for improved efficacy and tolerability?

Answer 22

Tazarotene

Question 23

What class of drug is given in combination with phototherapy because it reacts to ultraviolet A light?

Answer 23

Psoralen (i.e. methoxsalen), this is called PUVA therapy