Dermatologic Pharmacology Flashcards

1
Q

Drugs used in the treatment of the skin can be

A

delivered systemically
applied topically
injected directly to the dermis
phototherapy

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2
Q

pharmacologic responses are determined by:

A
  1. Regional variation in drug penetration
  2. Concentration Gradient
  3. Dosing schedule
  4. Vehicles & Occluion
  5. State of Stratum Corneum
  6. Presence of Penetration Enhancers
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3
Q

which part easily absorbs drug:

face, scrotum, axilla scalp vs soles of foot

A

face, scrotum, axilla, scalp

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4
Q

increase in conc gradient increases the

A

mass of drug transferred per unit time

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5
Q

may be long enough to permit

once daily application with short systemic half-lives

A

local half life

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6
Q

Topical absorption increased in dermatologic

disorders due to

A

presence of breaks/ lesions in the skin

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7
Q

these are added for better drug penetration

A

penetration enhancers

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8
Q

examples of penetration enhancers

A

Org solvents such as dimethyl sulfoxide urea, and salicylic acid

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9
Q

drug absorption i influenced by

A
  1. conc of drug in the vehicle
  2. The partition coefficient of drug between the
    stratum corneum and the vehicle
  3. Diffusion coefficient of the drug in the stratum
    corneum
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10
Q

Rate of diffusion is proportional to

A

concentration

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11
Q

drug’s ability to escape

from the vehicle.

A

partition coefficient

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12
Q

Increased lipid-solubility favors penetration through

the skin in

A

relatively lipophilic stratum corneum

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13
Q

refers to the extent to which the matrix of the barrier

restricts the mobility of the drug

A

Diffusion coefficient

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14
Q

Increase in the molecular size of the drug will

A

decrease the diffusion coefficient.

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15
Q

any of various media acting usually as

solvents, carriers, or binders for active ingredients.

A

vehicle

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16
Q

Acute inflammation with oozing, vesiculation &

crusting are best treated with

A
drying preparations (e.g. tinctures,
wet dressings, lotions)
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17
Q

Chronic Inflammation with xerosis, scaling &

lichenification are best treated with

A

more lubricating preparations (e.g.

Creams or Ointments)

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18
Q

Most effective hydrating agents

A

ointment

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19
Q

Most acceptable, accessible, and common

preparation

A

cream

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20
Q

Amount of ointment when squeezed out of a tube to the
palmar aspect of the index finger from the distal skin
crease to the end of the finger

A

FTU - fingertip unit

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21
Q

Known as steroids in laymen’s term

A

glucocorticoid

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22
Q

therapeutic effectiveness of topical glucocorticoids is based on

A

based on their anti-inflammatory activity

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23
Q

inhibition of accumulation of Neutrophils and monocytes at the site of inflammation would lead to

A

decreased proliferation and migration of lymphocytes and macrophages

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24
Q

Steroid to be used are chosen on the basis of

A

potency, ite of involvement and severity

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25
Q

T or F: application of steroid more than twice a day increases it efficacy

A

F more frequent application doen’t improve response due to half life

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26
Q

All absorbable topical corticosteroids possess the

potential to

A

suppress the pituitary adrenal axis

27
Q

use of steroids in children would result to

A

early closure of long bones/ growth retardation

28
Q

Intralesional glucocorticoids can cause

A

cutaneous atrophy and hypopigmentation

29
Q

Reserve for acute treatment of transient illnesses or lifethreatening
dermatoses

A

systemic glucocorticoids

30
Q

why do you need to gradually decrease the dosing schedule of glucocorticoids

A

for less adverse effect for withdrawal and to prevent adrenal crisis

31
Q

Used mainly for the treatment of psoriasis, dermatitis &

lichen simplex chronicus

A

tar compounds

32
Q

main cause of the discontinuation of

certain drug practices

A

sensitization

33
Q

why you should not advocate the use of topical antibacterial agent

A

exposure of the individual to the possibility of sensitization

34
Q

mode of action of bacitracin and B. Gramicidin

A

inhibits cell wall synthesis

35
Q

side effects of bacitracin

A

contact urticaria
anaphylaxis
systemic toxicity
contact dermatitis

36
Q

why is neomycin used in surgery

A

because it is an aminoglycoside and they are not aborbed in GI tract; they stay to disinfect the area

37
Q

Used to treat Impetigo contagiosa specifically

A

mupirocin

38
Q

New synthetic drug, newer than mupirocin

A

retapamulin

39
Q

retapamulin is effective in treatment of

A

uncomplicated superficial
skin infection caused by Grp. A beta-hemolytic strep
and S. aureus excluding MRSA for adult and pediatric
patients 9 months and older

40
Q

Peptide antibody effective against Gram (-) organism
including P. Aeruginosa, E. Coli, Enterobacter &
Klebsiella

A

polymyxin B sulfate

41
Q

why should you not exceed 200mg of Polymyxin B sulfate when applied to denuded skin

A

Causes neurotoxicity and nephrotoxicity

42
Q

MOA of Neomycin

A

inhibits CHON synthesis

43
Q

Adverse effects of aminoglycosides in general

A

neurotoxicity, nephrotoxicity and ototoxicity,

neuromuscular blockage

44
Q

What is cross sensitivity

A

means that even if an individual has
not been exposed to these drugs, he may still
develop allergies to other related drugs

45
Q

generally, aminoglycosides are for

A

Gm (-)

46
Q

clindamycin may cause rare cases of ___ when aborbed systemically

A

bloody diarrhea & pseudomembranous colitis

47
Q

clindamycin is known commercially as

A

Dalacin C

48
Q

effect of erythromycin

A

inhibotry on P. acnes

49
Q

side effect of erythromycin

A

burning drying irritation

50
Q

drug for amoebiasis

A

metronidazole

51
Q

Topical Gel effective in acne rosacea

A

metronidazole

52
Q

MOA of metronidazole

A

UNKNOWN but may relate to the inhibitory effects

on Demodex brevis (face mite)

53
Q

MOA of sodium sulfacetamide

A

Inhibition of P. Acnes by competitive inhibition of

PABA utilization

54
Q

sodium sulfacetamide is contraindicated in patients that are

A

sensitive to sulfonamides

55
Q

action of Retinoic acid in acne

A

decreased cohesion
between epidermal cells and increased epidermal cell
turnover which results in expulsion of open comedones

56
Q

For severe cystic acne

A

isotretinoin

57
Q

MOA of isotretinoin

A

inhibit sebaceous gland size & function

58
Q

Still a Vitamin A/retinoid;

Treatment of psoriasis especially pustular forms

A

etretinate

59
Q

MOA of doxepin

A

H1 & H2 antagonists property percutaneous

absorption

60
Q

why does doxepin cause urinary retention

A

anticholinergic effects

61
Q

For itchiness, we administer

A

anesthetics or antihistaminics

62
Q

why older h1 receptor antagonists sedating?

A

they can cross blood brain barrier

63
Q

difference of newer H1 receptor antagonists from the old ones

A

they do not cross the BBB and they don’t cause drowiness/ sedation

64
Q

why H2 receptor blockers are better used for patients with peptic ulcer

A

Decreases gastric acid secretion;

Inhibit HCl production