Dermatologic Pharmacology Flashcards
routes of medication delivery for the skin? which cause systemic effects?
topical
transdermal
oral
transdermal and oral can cause systemic effects
what are some factors that affect drug permeation?
age condition regional skin sites skin hydration skin metabolism blood flow to the area
what are some dermatological agents we are going to talk about?
antibacterials antifungals antivirals glucocorticoids retinoids psoralens for PUVA therapy sunscreens keratolytic agents
what class is neosporin (bacitracin-neomycin-polymyxin B combo)?
topical antimicrobial
indications for neosporin?
superficial bacterial skin infxns, eyes and external ear infxn
used prophylactically against bac contamination of abrasions, burns, skin grafts or incisions
MOA of neosporin? when should it not be used?
polymyxin disrupts the structure of the bacterial cell membrane by interacting w/phospholipids; bacitracin interferes w/peptidoglycans of the bacterial cell wall
do not use if allergic ot systemic aminoglycosides
drug of choice for impetigo? benefits of using this drug?
if limited # of lesions can use mupirocin/bactroban
benefits: limited systemic absorption, lower risk of bacterial resistance
class of mupirocin/bactroban? MOA? how can it be used against MRSA? SEs?
class: topical antibiotic
MOA: inhibits bacterial protein synthesis
use in MRSA colonization: should be applied to the nares to eradicate nasal carriage of the infxn
SEs: local irritation
drug of choice for tinea infxns?
ketoconazole/nizoral
class of ketoconazole/nizoral? indication? MOA? SEs?
topical antifungal
indication: superficial fungal infxn such as tinea pedis, tinea cruris, tinea corporis
MOA: inhibits sterol synthesis, component of fungal cell membranes
SEs: skin irritation
what two other sxs do we tend to see w/atopic dermatitis/eczema?
allergic rhinitis and asthma
non-pharm interventions for atopic derm/eczema?
avoid triggers such as harsh chemicals, drying soaps, extreme temps
maintain skin patency: keep moist and hydrated, apply ointment, cream or lotion right after cleansing, air and pat dry
use cotton sheets and pajamas
what conditions are topical corticosteroids typically used in?
atopic derm/eczema
contact/allergic derm
psoriasis
classes of topical corticosteroids?
Class I= very high potency
Class II-III= high potency
Class IV-V= medium potency
Class VI-VII= low potency
characteristics of class II-III topical corticosteroids?
use for less than 3 weeks
good for lichenified lesions
do not use on face, mucous membranes, eyelids, skin folds
when are Class IV-V topical corticosteroids used?
chronic dz
when are class VI-VII topical corticosteroids used?
in children
characteristics of class I (very high potency) topical corticosteroids?
should not be discont abruptly, switch to lower potency as opposed to quitting abruptly
should not exceed 2-4 wks
what do you need to avoid when using class II-III topical corticosteroids?
avoid occlusive dressings (esp w/betamethasone and dipropionate)
when would it be indicated to use a low potency (class VI-VII) topical corticosteroids?
with children, PG women, elderly and pts w/large areas to be treated
preferred for face, groin, armpits or skin folds
cutaneous adverse reactions that can come with topical corticosteroids?
skin atrophy telangiectasia hypopigmentation steroid acne increased hair growth
which classes of topical corticosteroids can be systemically absorbed? what are the systemic SEs?
class I (very high potency) class II-III (high potency) systemic SEs: insomnia, hyperglycemia, osteoporosis, impaired wound healing
what is another tx option aside from corticosteroids for atopic dermatitis/eczema?
topical calcineurin inhibitors
when would you use topical calcineurin inhibitors?
as a last line therapy to tx atopic dermatitis/eczema
