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Dermatology > Dermatologic Pharmacology > Flashcards

Dermatologic Pharmacology Flashcards

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Dermatology Board Prep flashcards
1
Q

Regional variation of skin in drug penetration

A

Refers to tendency for scrotum, face, axilla and scalp to be far more permeable than the forearm or thicker skinned areas

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2
Q

The skin has a ___ effect of many drugs allowing for ___ dosing conditions

A

reservoir, once daily

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3
Q

To maximize effective absorption of drugs thru the skin, sometimes ____ can be very useful for transfer (but may lead to toxicity)

A

Occlusion

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4
Q

Characteristics of good dermatologic vehicles (3) (vehicles meaning ointments, gels, powders, etc)

A
  • ability to hydrate the stratum corneum
  • increased solubility
  • increased rate of release
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5
Q

Treat wet lesions with ___ and dry lesions with ____

A

drying agents, moisturizing agents

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6
Q

topical glucocorticosterois function

A

Used to relieve inflammation and itching associated with variety of dermatologic disorders

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7
Q

Topical gucocorticoids absorption

A

Extent is proportional to duration of use and area where preparation has been applied, absorption is higher where skin is easily permeable or inflamed and lower in thicker regions

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8
Q

Topical glucocorticoids ADRs (2)

A
  • local rxns (atrophy of dermis and peidermis)

- systemic toxicity such as growth retardation or adrenal suppression

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9
Q

Keratolytic agents

A

Drugs that promote the shedding of the stratum corneum layer of skin causing peeling to extensive desquamation

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10
Q

Salicylic acid drug class and function

A

Keratolytic agent, promotes desquamation by disllolving intracellular cement that binds scales to stratum corneum used in low conc. to treat dandruff, seborrheic dermatitis, acne, psoriasis, warts, and corn

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11
Q

Salicylic acid ADR

A

-salicylism (same as in aspirin thru absopriton of skin) casuing tinnitus and hyperpnea

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12
Q

Sulfur drug class and function

A

Promotes drying and peeling to treat acne, dandruff, psoriasis, seborrheic dermatitis, it is a kerotlyitc agents

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13
Q

Benzoyl peroxide function

A

First line drug employed topically to treat mild to moderate acne, penetrates stratum corneum or follicular openings unchanged converted metabolically within epidermis promoting keratoysis and suppressing growth of P. acnes (does not cause resistance)

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14
Q

Benzoyl peroxide ADR’s (2)

A
  • drying and peeling of skin

- local burning

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15
Q

Often benzoyl peroxide will be used alongside topical ___ or ___

A

clindamycin, erythromycin

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16
Q

Dapsone function

A

Topical agent that provides modest decrease in inflammation often as an alternative to benzoyl peroxide

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17
Q

Tretinoin drug class and function

A

Retinoids, derivatives of vit A, approved for treatment of mild to moderate acne thru decreasing cohesion between epidermal cells remove existing comedones aand preventing formation of new plugs

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18
Q

Isotretinoin (accutane) drug class and function

A

Retinoid, restricted for treatment of severe nodulocystic acne vulgaris

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19
Q

Isotretinoin (accutane) ADR’s (7)

A
  • nosebleeds
  • inflamation of lips
  • dryness and itching of skin, nose and mouth
  • loss of night vision
  • UV sensitivity
  • psychological effects
  • teratogenic during pregnancy
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20
Q

Isotretinoin (accutane) drug interactions (2)

A
  • Tetracyclines increase risk of psuedotumor cerebri

- vit A can produce generalized intensification of toxicity

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21
Q

iPledge program

A

FDA mandated program to manage accutane related teratogenicity requires 2 active forms of birth control

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22
Q

Tazarotene (tazorac) drug class and function

A

Derivative of vitA, used for topical therapy of acne and psoriasis

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23
Q

Women at least 15 who want contraception, have achieved menarche, and do not respond to topical drugs is criteria for…

A

….PO contraceptive use for acne treatment

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24
Q

Spironolactone (aldactone) drug class and function

A

Androgen receptor, additional PO contraception for treatment of acne

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25
Q

2 targets of drug therapy in psoriasis

A
  • keratinocytes

- inflammatory cells

26
Q

Mild to moderate psoriasis drug treaetments (3)

A
  • topical glucocorticoids (most commonly used)
  • keratolytic agents
  • UV therapy
27
Q

Moderate to severe psoriasis drug treatments (3)

A
  • methotrexate
  • cyclosporine
  • IL-23 antagonist
28
Q

Anthralin drug class and function

A

DNA synthesis inhibitor, used for topical treatment of psoriasis

29
Q

Tars drug class and function

A

DNA synthesis inhibitor, used in combinations to treat plaque type psoriasis despite unpleasant odor and irritation

30
Q

Calcipotriene and calcitriol drug class and function

A

Analogs of D3, topical prep for mild to moderate psoriasis applied BID to affected skin suppresing cell differentiation

31
Q

Tazarotene gel drug class and function

A

Retinoid, marketed for use to patients with stable mild to moderate psoriasis

32
Q

Tazarotene gel ADR’s

A

-teratogenic effects on pregnancy

33
Q

Methotrexate drug class and function

A

Immunosuppressent, cytotoxic agent that targets tissues with high growth rate, only should be used when severe psoriasis has not responded to safer therapy

34
Q

Methotrexate ADR’s

A
  • systemic administration can result in toxic effects
  • GI effects
  • bone marrow suppression
35
Q

Acitretin (soriatane) drug class and function

A

Systemic retinoid agent for severe psoriasis

36
Q

Acitretin (soriatane) ADR’s (3)

A
  • hair loss
  • dry skin
  • damaged liver cirrhosis
37
Q

Treatment of psoriasis with glucocorticoids

A

Effective but rarely used because it is worsened when discontinued

38
Q

Cyclosporine drug class and function

A

Immunosuppressant that can treat moderate to severe psoriasis

39
Q

Tumor necrosis factor antagonsists function

A

Inhibition of TNF suppresses immune function reducing inflammation in psoriais, very effective but can increase risk of opportunistic infections

40
Q

Interleukin 12/23 antagonists function

A

Human monoclonal antibody directed againast interleukins 12 and 23 that promte inflammatory response, to decrease psoriasis

41
Q

Phototherapy

A

Use of UV light for widespread disease or when psoriasis is unresponsive to topical agents, UVB is narrow band and safer and more effective

42
Q

Phototherapy ADR’s (3)

A
  • itching
  • burning
  • dryness
43
Q

PUVA therapy

A

Use of long wave UVA radiation with methoxsalen (oxsoralen) a photosensitive drug, after absorbed UVA radiation causes methoxsalen to undergo rxn creating DNA psoralen complex decreasing proliferaiotn of epidermal cells

44
Q

PUVA therapy ADR’s (3)

A
  • pruritis
  • increased risk of skin cancer
  • erythema
45
Q

Ketoconazole function

A

Antifungal cream and shampoo for seborrheic dermatitis

46
Q

Topical minoxidil (rogaine) function

A

Used in a solution to treat male pattern baldness and thinning of hair in women by increasing cutaneous blood flow via vasodilation

47
Q

Finasteride (propecia) drug class and function

A

5-a reductase inhibitor, Indicated for treatment of hair loss of males, inhibits conversion of testosterrone to DHT causing decrease in DHT conc. in scalp

48
Q

Flurouracil function

A

PO antineoplastic agent used for topical treatment of multiple actinic keratoses and superficial basal cell carcinoma thru interupting DNA and RNA synthesis

49
Q

Fluorouracil ADR

A

-itching, burning rash

50
Q

Glucocorticoids for topical eczema can cause these 3 things with high enough doses

A
  • skin atrophy
  • hypopigmentation
  • systemic effects
51
Q

Tacrolimus (protopic) oitnment drug class and function

A

Calcineurin inhibitor (immunosuppressent) used to treat severe atopic dermatitis by reducing local immune response

52
Q

UVA vs UVB

A

UVA is 95% of terrestrial UV radiation and penetrates skin much more deeply causing most skin aging, UVB is 5% and main cause of tanning and sunburn

53
Q

Organic (chemical) sunscreens vs inorganic (physical) sunscreens

A

Organic absorb UV radiation and dissapate the heat, can cause contact dermatitis and photosensitivity rxns, inorganic reflect light (such as zinc oxide) by forming physicalbarriers

54
Q

SPF to sunburn protection relationship

A

As SPF increases, protection increment becomes smaller, with values greater than 30 providing minimal benefit and products not being allowed to be labeled above 50 (just called 50+)

55
Q

Mupirocin (bactroban) function

A

Inhibitor of protein synthesis and thus bactericidal topical agent against MRSA often used to treat impetigo or intranasal use for elimination of nasal carriage of S aureus

56
Q

2 topical therapy choices for rosacea

A
  • metronidazole

- azelaic acid

57
Q

2 DOCs for scabies and pediculosis (lice)

A

permethrin and malathion

58
Q

Lindane function

A

Absorbed thru the chitin shell laye of adult mites and lice causing death by inducing convulsions, eltahl to all eggs

59
Q

Lindane ADR’s (2)

A

-irritation

convulsions if penetrates intact skin too much

60
Q

Permethrin function

A

Agent of choice for mites and lice, toxic to them and their ova killing them by causing paralysis with minimal side effects

61
Q

Malathion function

A

Agent of choice for mites and lice, has enzyme that kills lice and ova as an insecticide, devoid of significant ADR’s

Dermatology (18 decks)

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