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pharm 2 > Dermatologic Drugs > Flashcards

Dermatologic Drugs Flashcards

1
Q

What are side effects of Polymyxin B when given via IV

A

ototoxicity and nephrotoxicity

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2
Q

What should you not use polymyxin B topical

A

if there is perforation of the TM

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3
Q

If MRSA is recurrent, what area should be swabbed

A

nares. often carries MRSA

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4
Q

What antibiotic is still effective against a topical MRSA infection

A

Mupirocin (Bactroban)

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5
Q

what drug class is ketoconazole

A

topical antifungal

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6
Q

where should topical glucocorticoids generally not be used

A

over bacterial infection, on the face, genitalia, other thin skin areas, over a viral infection

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7
Q

what are the topical delivery forms of derm drugs (least oil to most oil content)?

A

solution (least oil)
lotion
cream
ointment (most oil)

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8
Q

what aspects of a drug allows for increased penetration?

A

decreased molecular size, increased lipid content, and increased concentration

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9
Q

what aspects of the skin allow for increased penetration of drug?

A

decreased integrity of skin, thinner skin (face, armpit, genitalia), applying large surface area: body (i.e. children)

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10
Q

what is neosporin indicated for?

A

Superficial bacterial skin infections, eyes and external ear infection. Used prophylactically against bacterial contamination of abrasions, burns, skin grafts or incisions. Application may prevent infection and permit normal healing.

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11
Q

what is the MOA of Neosporin?

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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12
Q

what is Mupirocin/bactroban indicated for?

A

Impetigo and other bacterial infections. Best against staph and strep. Also MRSA. NOT for fungal or viral

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13
Q

what is the MOA of mupirocin?

A

inhibits bacterial protein syn

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14
Q

what is ketoconazole/nizarol indicated for?

A

Superficial fungal infection such as tinea pedis, tinea cruris and tinea corporis (ring worm), superficial yeast infections and seborrheic dermatitis.

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15
Q

conditions where topical steroids are used?

A

atopic/contact/allergic dermatitis, psoriasis, eczema, bullous pemphigus, SLE, and sarcoidosis

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16
Q

how are the classes of topical glucocorticoids grouped in terms of potency?

A

Class 1 is the most potent class of topical glucocorticoids whereas class 7 is the least potent class of topical steroid.

17
Q

what is the most potent form of corticosteroid?

A

Halogenated corticosteroids are generally the most potent forms of topical steroids.

18
Q

some side effects of topical glucocorticoids

A 
Skin atrophy
Striae
Telangiectasias
Purpura
Acneiform lesions
Perioral dermatitis*
Overgrowth of skin fungus and bacteria
Hypopigmentation
Rosacea*
19
Q

what are some systemic side effects of highly potent glucocorticoids?

A

suppression of the hypothalamic-pituitary-adrenal axis, increased risk for hyperglycemia, osteoporosis and osteonecrosis.

20
Q

what is a local side effect of injected intralesional corticosteroids?

A

may develop atrophy of underlying fat and/ or muscle

21
Q

what is the MOA of hydrocortisone/cortef?

A

Anti-inflammatory. Affects gene transcription to either stimulate or repress protein production.

22
Q

what are some conditions that respond to retinoids?

A 
Cystic and papular acne
Actinic keratosis
Psoriasis
Basal cell cancer
Squamous cell cancer
Cutaneous aging
23
Q

how is acne generally treated?

A

Topical agent, if that fails then oral antibiotics or oral retinoins (accutane)

24
Q

what class is Tretinoin/Retin A

A

Vitamin A derivative

25
Q

what is tretinoin indicated for?

A

acne and tx of photodamaged skin

26
Q

what the MOA of tretinoin?

A

Reduction of hyperkeratinization that leads to microcomedone formation, the initial lesion in acne. Retin A also increases epidermal thickness and increases dermal collagen synthesis.

27
Q

Side effects of tretinoin that you need to parq ?

A

Erythema, peeling, burning and stinging. Photosensivity.

28
Q

what is Isoretinoin/Accutane indicated for?

A

Acne, acne rosacea and hidradenitis superativa

29
Q

what is the MOA of Isoretinoin/Accutane?

A

Reduction of hyperkeratinization, reduction in sebaceous gland number and sebum production and reduction of Propionibacterium acne, the organism that is believed to contribute to acne associated inflammation.

30
Q

*Side effects of Accutane?

A

*Teratogenicity – most noted in the first three weeks of gestation. Pregnancy is an absolute contraindication (2 forms of birth-control are recommended). Pregnancy test at every visit and you only write one month script at a time.

Other potential side effects include headache, myalgias, arthralgias, hyper-lipidemia, fatty liver, hepatitis and pancreatitis.

31
Q

Additional warnings about Accutane?

A

use of the drug may cause “depression, psychosis, and on rare occasions suicidal ideation, suicide attempts and suicide.“

32
Q

treatment options for psoriasis?

A

Topical corticosteroids
Topical vitamin D (ex. Calciprotriene)
Topical vitamin A analogs (ex. Tazarotine)
Phototherapy (PUVA)
Systemic therapy including oral steroids: chemo agents

33
Q

what does phototherapy for psoriasis involve?

A

UVA or UVB often with psoralen (photochemotherapy agent that reacts with light)

34
Q

MOA of PUVA?

A

not fully understood, however, there is evidence that it induces an anti-inflammatory affect through immunosuppression as well as an inhibitory effect on DNA synthesis.

35
Q

what other conditions can be treated with PUVA?

A

vitiligo, T-cell lymphomas, alopecia areata and urticaria pigmentosa

36
Q

serious puva side effects?

A

increased risk for the development of skin cancer., markedly advanced aging of the skin and actinic keratosis

pharm 2 (18 decks)

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