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Pharm I > Dermatologic Pharmacology > Flashcards

Dermatologic Pharmacology Flashcards

1
Q

routes of medication delivery for the skin? which cause systemic effects?

A

topical
transdermal
oral
transdermal and oral can cause systemic effects

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2
Q

what are some factors that affect drug permeation?

A 
age 
condition
regional skin sites
skin hydration
skin metabolism
blood flow to the area
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3
Q

what are some dermatological agents we are going to talk about?

A 
antibacterials
antifungals
antivirals
glucocorticoids
retinoids
psoralens for PUVA therapy
sunscreens
keratolytic agents
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4
Q

what class is neosporin (bacitracin-neomycin-polymyxin B combo)?

A

topical antimicrobial

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5
Q

indications for neosporin?

A

superficial bacterial skin infxns, eyes and external ear infxn
used prophylactically against bac contamination of abrasions, burns, skin grafts or incisions

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6
Q

MOA of neosporin? when should it not be used?

A

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

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7
Q

drug of choice for impetigo? benefits of using this drug?

A

if limited # of lesions can use mupirocin/bactroban

benefits: limited systemic absorption, lower risk of bacterial resistance

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8
Q

class of mupirocin/bactroban? MOA? how can it be used against MRSA? SEs?

A

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

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9
Q

drug of choice for tinea infxns?

A

ketoconazole/nizoral

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10
Q

class of ketoconazole/nizoral? indication? MOA? SEs?

A

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

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11
Q

what two other sxs do we tend to see w/atopic dermatitis/eczema?

A

allergic rhinitis and asthma

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12
Q

non-pharm interventions for atopic derm/eczema?

A

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

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13
Q

what conditions are topical corticosteroids typically used in?

A

atopic derm/eczema
contact/allergic derm
psoriasis

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14
Q

classes of topical corticosteroids?

A

Class I= very high potency
Class II-III= high potency
Class IV-V= medium potency
Class VI-VII= low potency

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15
Q

characteristics of class II-III topical corticosteroids?

A

use for less than 3 weeks
good for lichenified lesions
do not use on face, mucous membranes, eyelids, skin folds

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16
Q

when are Class IV-V topical corticosteroids used?

A

chronic dz

17
Q

when are class VI-VII topical corticosteroids used?

A

in children

18
Q

characteristics of class I (very high potency) topical corticosteroids?

A

should not be discont abruptly, switch to lower potency as opposed to quitting abruptly
should not exceed 2-4 wks

19
Q

what do you need to avoid when using class II-III topical corticosteroids?

A

avoid occlusive dressings (esp w/betamethasone and dipropionate)

20
Q

when would it be indicated to use a low potency (class VI-VII) topical corticosteroids?

A

with children, PG women, elderly and pts w/large areas to be treated
preferred for face, groin, armpits or skin folds

21
Q

cutaneous adverse reactions that can come with topical corticosteroids?

A 
skin atrophy
telangiectasia
hypopigmentation
steroid acne
increased hair growth
22
Q

which classes of topical corticosteroids can be systemically absorbed? what are the systemic SEs?

A 
class I (very high potency)
class II-III (high potency)
systemic SEs: insomnia, hyperglycemia, osteoporosis, impaired wound healing
23
Q

what is another tx option aside from corticosteroids for atopic dermatitis/eczema?

A

topical calcineurin inhibitors

24
Q

when would you use topical calcineurin inhibitors?

A

as a last line therapy to tx atopic dermatitis/eczema

25
Q

tx options for pruritis/hives?

what is NOT recommended as a tx option?

A 
systemic antihistamines (loratadine, cetrizine)
DO NOT recommend topical antihistamines b/c ineffective, can carry risk of contact dermatitis and cutaneous sensitization
26
Q

non-pharm tx options of acne?

A

cleansing (no more than 2x daily)
comedone extraction using specialized tools
avoid oil-based skin products
diet changes

27
Q

pharm tx options of acne?

A

salicylic acid
benzoyl peroxide
topical retinoids
antibacterial agents (erythromycin, clindamycin, azelaic acid, dapsone)
antisebum agents (BC, spironolactone, isotretinoin)

28
Q

class of isotretinoin/accutane? indications? MOA? main concern w/using this as tx?

A

vit A derivative
indications: acne, acne rosacea, hidradentitis supperativa
MOA: reduction of hyperkeratinization, reduction in # of sebaceous glands and sebum production and reduction of p. acne
teratogenicity is the main concern with this tx (1st 3 wks of PG)
additional SEs: depression, psychosis, myalgias, hyperlipidemia

29
Q

what is the iPLEDGE program?

A

risk evaluation and mitigation strategies for use of prescribing isotretinoin/accutane
goal is to not have any female starting the tx if PG and to not get PG while on tx
requires females of child bearing age to have a PG test 7 d before getting rx refilled

30
Q

tx options for psoriasis?

A 
topical corticosteroids
topical vit D analog
topical vit A analog/retinoid
phototherapy
systemic tx including oral steroids, chemotherapy agents and TNF-a inhibitors
31
Q

what class is calcipotriene/covonex? used to tx what? MOA? SEs? potentially more effective when used with what?

A

vit D analog
used to tx plaque psoriasis, scalp psoriasis
MOA: inhibits epidermal proliferation and stimulation of differentiation
effective as topical corticosteroids but more frequent ADRs
SEs: photosensitivity, hypercalcemia, may potentially worsen psoriasis, skin irritation
potentially more effective when used with betamethasone

32
Q

class of tazarotene/tazorac? indication? SEs?

A

topical retinoid
use for plaque psoriasis, also used in acne
recommended to use w/topical corticosteroids for improved efficacy and tolerability
SEs: skin burning, irritation, stinging

33
Q

alternative tx of psoriasis?

A

phototherapy of UVA/UVB rays

photochemotherapy- psoralen drug added to the tx

34
Q

what does PUVA stand for?

A

psoralen and ultraviolet therapy in which the pt first given a psoralen then exposed to UVA light

35
Q

MOA of PUVA tx?

A

not fully understood, however has been proven effective in tx of psoriasis

36
Q

SEs of PUVA tx?

A

nausea, painful erythema, blistering, chronic use associated w/increased risk of skin CA

Pharm I (18 decks)

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