Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm > Dermatologic Pharm > Flashcards

Dermatologic Pharm Flashcards

(61 cards)

Start Studying
1
Q

Topical Corticosteroids

A
  • produce anti-inflammatory response in skin
  • used to systematic relief of itching
  • classified based on potency
  • used for eczema and psoriasis
  • low potency on thin skin
  • high potency on thick skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Adverse effects of topical steroids

A
  • high potency steroids increase chance of systemic effect and can permanently thin skin
  • local effects are more often seen in topical applications (atrophy, steroid acne,hypopigmentation, hypertrichosis, allergic contact dermatitis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Imiquimod (Aldara)

A

-topical steroid
-immunomodulator
MOA: stimulates immune system to make interferon and interleukin to get rid of skin lesion
Spectrum: genital/perianal warts, actinic keratoses on face and scalp, superficial basal cell of trunk, neck, and extremities
Adverse effects: local itching and redness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tacrolimus (Protopic) and Pimecrolimus (Elidel)

A

-topical steroid
-immunomodulator
MOA: T-cell activation leads to activation of calcineurin. Calcineurin activates gene prodcution to produce IL-2 activating immune response
-Calcineurin inhibitor
-used for moderate to severe atopic dermatitis
-short term or intermittent tx
-not for continuous long term use
-not for kids under 2 years old
-Adverse effects: burning, itching, redness.
-BBW: skin cancer and lymphomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ectoparasiticides

A
  • topical steroid
  • kill parasites
  • Permethrin (Elimite)
  • Ivermectin (SKLice)
  • Malathion (Ovide)
  • Lindane (Kwell)
  • Crotamiton (Eurax)
  • typically have to treat more than once (7-10 days after original tx)
  • Concern is drug systemically absorbed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Permethrin (Elimite & Nix)

A
  • topical steroid
  • Ectoparasiticides
  • spectrum: pediculus humanus (lice), pthirus pubis (crabs), sarcoptes scabiei (scabies)
  • lice/crabs: apply and leave on for 10 minutes
  • scabies: hleave on for 8-14 hours
  • Adverse effects: burning, pruritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ivermectin (Sklice)

A
  • topical steroid
  • Ectoparasiticides
  • used in pt over 6 months of age for head lice
  • scabies
  • apply to dry hair and rinse off after 10 minutes
  • adverse reactions: conjunctivitis, eye irritation, dandruff, dry skin, skin burning sensation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Malathion (Ovide)

A
  • topical steroid
  • tx of pediculus humanus capitis (head lice and their ova)
  • mildly effective for scabies
  • thoroughly cover and moisten hair, allow it to dry (8-12 hr)
  • repeat in 7-9 days
  • adverse effects: irritation of scalp and skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lindane (Kwell)

A
  • topical steroid
  • kills lice (shampoo)
  • Important difference: more systemic absorption, concentrates in brain, increased risk of neurotoxicity (seizures and death)
  • okay for small area (lice tx), but not okay for larger area (scabies)
  • BBW: do not give to infants, children, and pregnant women
  • Adverse effect: skin irritation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Topical Immunomodulators

A
  • modify the immune system in the skin
  • not systemic so less adverse reactions
  • Imiquidmod and Tacrolimus/Pimecroliumu
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Crotamiton (Eurax)

A
  • topical steroid
  • used for scabies
  • apply to the neck down once daily and repeat next day
  • repeat this cycle again in 1 week if needed
  • adverse effect: skin irritation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Topical Acne drugs

A
  • retinoids (tretinoin, adapalene, tazarotene)
  • benzoyl peroxice
  • azelaic acid (Finacea)
  • salicylic acid
  • topical antibiotics (erythromycin, clindamycin, gentamicin, sodium sulfacetamide)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Systemic acne drugs

A

Istretinoin (acutane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Oral antibiotics for acne

A
  • tetracycline
  • minocycline
  • doxycycline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tretinoin

A
  • topical tx for acne
  • topical form of vitamin A
  • cream and gel form
  • MOA: decreases cohesion between epidermal cells and comedones and stimulates turnover of follicular epithelial cells (cells shed more easily from the dermis)
  • adverse effects: skin irritation (worse over first 4-6 weeks)
  • don’t use around eyes, nose, and mouth
  • try cream before gel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Retinoids

A
  • topical acne tx
  • promotes dermal collagen synthesis, new blood vessel formation, and thickening of epidermis (decreased wrinkles)
  • derivatives: Adapalene (Differin) and Tazarotene (Tazorac)
  • Adapalene is less irritating then tretinoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Benzoyl Peroxide

A
  • topical acne tx
  • MOA: antibacterial and comedolytic properities and generates free radicles that oxidize proteins in Cuitbacterium ances cell wall
  • adverse effects: bleaching of hair and skin irritation
  • synergistic with clindamycin or erythromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Azelaic acid (Azelex or Finacea)

A
  • same drug, but different brand names
  • Azelex marketed for acne vulgaris
  • Finacea marketed for rosacea
  • MOA: not know, but possess antimicrobial activity
  • mild to moderate acne
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Topical Antibotics

A
  • Clindamycin, Erythromycin, Sodium Sulfacetamide
  • MOA: reduces number of Cutibacterium acnes
  • combining with retinoids or benzyol peroxice increase efficacy (work in different ways)
  • combining also decreases antibiotic resistance
  • Adverse effects: drying and stinging of skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Clindamycin, erythromycin, and sodium sulfacetamide MOA

A

-inhibit protein synthesis at 50s subunit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Isotretinoin (Accutane)

A
  • systemic acne tx
  • vitamin A derivatives (like retinoids, but PO)
  • MOA: reduces sebaceous gland size and reduces sebum production
  • Adverse reactions: hypervitaminosis A, dryness and itching of mucous membranes, depression
  • Teratogen
  • only prescribed by dermatologist
  • severe cystic acne
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

systemic antibiotic acne tx

A
  • reduces number of cutibacterium acnes
  • combining with benzoyl peroxide increases efficacy
  • can be more effective, but has more side effects
  • Tetracycline, erythromycin, minocycline, and doxycycline (mino and doxy most common)
  • Clindamycin uses topically, but not orally due to c.diff risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Minocycline and Doxycycline MOA

A

Inhibit protein synthesis at 30s subunit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Acne pharmacology

A
  • takes 6-8 weeks to work
  • most tx irritates skin
  • need to be careful with sun exposure
  • want drying effect so use lotions or gels and maybe some creams
  • avoid ointments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Mild acne
benzoyl peroxide or topical retinoid
26
Moderate acne
combination of benzoyl peroxide + topical retinoid/topcial antibiotics
27
Severe acne
combination therapy with oral antibiotics, topical retinoid, and benzoyl peroxide/topical antibotics
28
Tazarotene (Tazorac)
- topical drug for psoriasis - retinoid (vitamin A derivative) - can be teratogen - MOA: binds to retinoic acid receptor to reduce keratinocyte proliferation rate - helps normalize cell differentiation, prohibits formation of cornified envelope - ADR: irritates skin, phytosensitivity
29
Calcipotriene (Dovonex)
- topical drug for psoriasis - Vitamin D derivative - increased vitamin D receptors and inhibit epidermal proliferation and stimulation
30
Calcipotriene/betamethasone (Taclonex)
-ADR: hypercalcemia, irritates skin
31
Topical tx for psoriasis
- Tazarotene (Tazorac) - Calcipotriene (Dovonex) - Calcipotriene/betamethasone (Taclonex) - topical steroids: betamethasone, desoximetasone, flucinolone, halboetasol
32
Systemic tx for psoriasis
- Methotrexate | - Acitretin (Soritane)
33
Methotrexate
- systemic tx for psoriasis - used for symptomatic control of psoriasis that is unresponsive to other therapies - MOA: interferes with DNA synthesis, repair, and cellular replication
34
Acitretin (Soritane)
- systemic tx for severe psoriasis - dermatologist prescribed - MOA: blocks retinoid receptors to inhibit IL-6 resulting in anti-inflammatory, anti-proliferative, and keratinocyte differentiation in epithelium
35
ending mab
- monoclonal antibody - biologics - systemic tx for psoriasis
36
Occlusion
- prevents the evaporation of water from the skin to increase the moisture level of the skin - wrapping area in plastic, vehicle of the drug (most common way), patches
37
Types of vehicles
- Tinctures: drug dispersed in alcohol based liquid - lotions: drug suspended in liquid, need to shake to disperse drug - gels: semisolid system, drug evenly dispersed - creams: drug evenly dispersed in a semisolid base that spreads easily - ointments: drug evenly dispersed in semisolid base that is less easy to spread - most to least drying: tinctures, gels, lotions, creams, ointments
38
Transdermal delivery drugs
- applied for a systemic effect - generally not for disease of skin - Pros: delivered reliably, relatively pain free, avoid first pass effect (good bioavailability), maintenace drugs due to increased pt compliance - Cons: takes several days to see effect, difficult to titrate dose
39
Transdermal patches info
- don't cut patch as it destroys delivery system - when removed there is still drug in the patch - don't touch surface - keep out of reach of children as they think they are stickers
40
Clinical uses of topical antibiotics
- prevention - treatment: mild active skin infection in early stage only - decreasing nasal carriage of stap (MRSA) - Acne
41
Topical antibiotics
-OTC combinations: Neosportin (bacitracin, polymyxin B, neomycin) and polysporin (bactracin, polymyxin B)
42
Bacitracin
- topical antibiotic - MOA: inhibits peptidoglycan chain synthesis for bacterial cell wall synthesis - useful for G+ staph infections
43
Polymyxin B
- topical antibiotic - MOA: increasing bacterial cell membrane permeability leading to death of the cell (cell lysis) - useful for G-
44
Neomycin
- topical antibiotic - aminoglycoside - MOA: inhibits protein synthesis at 30s ribosomal subunit - Usual for G-
45
Topical antibiotics tx
- tx for mild active skin infection in early stage only - Standard of care for an active skin infection is oral antibiotics - Can combine with Retapamulin and Mupriocin for cases such as Impetigo
46
Retapamulin (Altabax)
- used with topical antibiotics - MOA: inhibit protein sysnthsis at 50s subunit - kills strep and staph but NOT MRSA - only use if methicillin-susceptible strains only
47
Mupirocin (bactroban)
- MOA: inhibits bacterial protein and RNA synthesis - Kills MRSA - decreases nasal carriage of MRSA
48
Antifungals
- takes 2-3 weeks for full effect - apply once or twice a day - 3 types: dermatophates, candida, malassezia furfur
49
Common fungal infections
- onchomycosis: toe/finger nail - Tinea Pedis: feet - Tinea Cruris: jock itch - Tinea Corporis: ringworm - Tina Capitis: fungal scalp infection
50
Topical Antifungals
- Azoles - Ciclopirox (Penlac) - Tolnaftate (Tinactin) - Naftifine (Naftin) - Terbinafine (Lamisil) - Nystatin
51
Topical Azoles (Imidazoles)
- Efinaconazole (Jublia) - nail lacquer - Ketoconazole - cream, gel, shampoo - Econazole - cream, foam - Itraconazole (Sporonox): capsule - Fluconazole (Diflucan): tablet, suspension, IV - Miconazole (Lotrimin, Monistate): cream, powder, ointment - good at killing a 3 fungus - often found in combination with corticosteroids - ADR: itching, redness, stinging
52
Ciclopriox (Loprox)
- topical fungal that kills dermatophytes, candida, and malassezia furfur - MOA: inhibits transport of essential elements of fungal cells, disrupt DNA, RNA, and protein synethesis - Indications: onychomycosis, seborrheic dermatitis of scalp, tindea pedis, cruris, corporis - ADR: application site reaction (erythema, pruritus, burning)
53
Tolnaftate (Tinactin)
- topical fungal (cream or powder) - kills dermatophytes, but no candida - ADR: pruritus (rarely) - recurrenes can occur more often - doesn't work on palms or soles of feel as well as azoles
54
Naftifine (Naftin) and Terbinafine (Lamisil)
- grouped together as they are allylamines - topical fungal (cream/powder) - MOA: inhibits squalene epoxidase (enzyme necessary for fungi biosythesis) which leads to deficiency in ergosterol and subsequent fungal death - good for dermatophytes (tineas) - no candida coverage - ADR: dry skin, erythema, pruritus, burning
55
Nystatin
- topical fungal (cream, ointment, powder, suspension) - kills candida, but not dermatophytes - MOA: binds to sterols in fungal cell membrane leading to leakage of cellular contents and cell death (tears holes in cell membrane) - well tolerated
56
Oral antifungal groups
- Oral azoles - Terbinafine - Griseofulvin
57
Oral Azoles
- antifungal - Fluconazole (Diflucan) and itraconazole (Sporanox) - effective for skin, less so for nails - do not give with statins, midazolam, or triazolam - 34A inhibitor
58
Fluconazole (Diflucan)
- oral azole - very long half life - can give every day or every other day - used for dermatophytes and candidia (espeially vaginal yeast infections)
59
Itraconazole (Sporanox)
- oral azole - last long time in skin and nails - can be used for nail infection, but has a lot of ADR including liver dysfunction - can give for 3 months which is a relatively short course of therapy - Monitor AST/ALT - hepatotoxic - avoid in heart failure -excarbates
60
Terbinafine (Lamisil)
- oral antifungal is effective, but can give topically - answer for nail infections - not to be used for a long time - 6 weeks for fingernails and 12 weeks for toenails - Need to check liver function tests periodically - ADR: headache, n/v, taste disturbances, increased liver enzymes
61
Griseofulvin
- oral antifungal - tx of dermatophyte infections not adequately treated by topical therapy - MOA: interferes with microtubule function - disrupting mitosis - uses: infection of hair/scalp (4-6 weeks), skin infection (3-4 weeks), nails (6-18 months) - ADR: teratogenic, headache, nausea, diarrhea, photosensivity, leukopenia, hepatotoxicity, may get reaction if allergic of pcn - not used much in US

Pharm (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions