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SBL Block 1 > Dermatologic Pharmacology > Flashcards

Dermatologic Pharmacology Flashcards

1
Q

Percutaneous Pharmacokinetic Variables (4)

A

Regional: Permeability of skin in that area

Concentration Gradient: drug Mass per unit Time

Dosing Schedule: Longer t 1/2 on skin = less doses/day

Vehicles/Occlusion: stay on skin longer to maximize penetration

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2
Q

Mosturizers

Components with Descriptions (3)

A

Emollients:
Form oily layer on skin to trap water

Humectants:
Draw water into top layer of skin

Horny Substance (Keratin) Softeners:
Loosen bonds to top layer of skin allowing dead skin to fall off and help skin retain water
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3
Q

Sun Protection Component Descriptions
Sunshades (2) Sun Protective Factor
Sunscreen Description and Examples:
PABA (1), Benzophenones (2) Dibenzoylmethanes (2)

A

Sunshades: Reflect UV rays, Titanium oxide

Sun Protective Factor (SPF): Ratio of erythema with or without sunscreen

Sunscreen: absorbs UV light
PABA - absorb UVB rays
Benzophenones - wide range, less effective than PABA
Dibenzoylmethanes - Active in UVA range, Useful for drug-related photosensitivity

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4
Q

Antiseptics
Soap vs Alcohol (2)
Common Examples with Targets
Glutaraldehyde (2) Amines, Halogens (2) Peroxygens

A

Soap required for C. difficile
Alcohol faster and effective against bacteria and viruses

Glutaraldehyde: targets cell membrane and Macromolecule cross linking

Quaternary Amines: Targets Cytoplasmic Membrane

Halogens: Targets DNA and acts as oxidizing agent

Peroxygens: Act as oxidizing agents

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5
Q

Chlorhexidine

Mechanism of Action (2) Spectrum of Action (5)

A

Targets Inner cytoplasmic membrane either decreasing integrity or congealing cytoplasm

Bacterial spores
Mycobacteria
Yeasts
Enveloped Viruses
Protozoa
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6
Q 
Microbial Resistance Mechanisms
Biofilm Actions (4)
A

Decrease penetration
Neutralize antibiotics with enzymes
Contain persistent non-replicative cells
Slow growth of cells

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7
Q

Wound Management
Disinfecting (2) Priorities (3) Debridement (2)
Skin Growth Agents: Example, MOA, Indication, BBW

A

Cadexemer iodine and silver used for disinfecting

Prioritize glycemic control, proper nutrition and adequate oxygenation

Debridement appropriate to remove necrotic tissue and debris

Becaplermin:
PDGF to increase cell proliferation and angiogenesis
Used for Chronic Diabetic Foot Ulcers
Malignancy: 3+ tubes increases risk by 4x

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8
Q

Wound Dressings
General Principles (2)
Types Used at Different Stages:
Debridement, Granulation (2) Epithelialization (2)

A

Keep moist
Don’t expose to air

Hydrogels for Debridement stage

Foam and Low adherence dressings for Granulation

Hydrocolloid and Low adherence dressing for epithelialization

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9
Q

Topical Antibacterial Agents

Examples (3) with Classification and MOA

A

Bacitracin:
Peptide
Inhibits cell wall synthesis

Neomycin:
Aminoglycoside
Binds 30s subunit to block protein synthesis

Polymixin B
Peptide
Binds phospholipids to alter permeability and damage cytoplasmic membrane

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10
Q

Topical Imidazoles
Mechanism of Action
Examples (4) with Indications (1/1/1/3)

A

Block ergosterol synthesis

Miconazole: vulvovaginal candidiasis
Clotrimazole: vulvovaginal candidiasis

Efinaconazole: onychomycosis

Ketoconazole: Dermatophytosis, Candidiasis, Seborrheic dermatitis

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11
Q

Ciclopirox

Mechanism of Action and Indications (3)

A

Disrupts macromolecule synthesis

Dermatophytes
Candidiasis
Malassezia

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12
Q

Terbinafine

Mechanism of Action (3) and Indication

A

Allylamine
Inhibits squalene epoxidase
Blocks ergosterol synthesis

Dermatophytes

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13
Q

Tolnaftate

Mechanism of Action (2) and Indications (2)

A

Distorts hyphae, stunts mycelial growth

Dermatophytes
Malassezia

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14
Q

Nystatin*

Mechanism of Action and Indications (2)

A

Binds sterols to alter membrane permeability

Cutaneous and mucosal Candidiasis

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15
Q

Amphotericin B

Mechanism of Action and Indication

A

Binds sterols to alter membrane permeability

Cutaneous Candidiasis

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16
Q

Acyclovir

Mechanism of Action and Indication

A

Guanine analog that inhibits viruses

Orolabial HSV-1 or HSV-2 (herpes labialis)

17
Q 
Pruritis
Common Causes (3) Corticoseroid Use Principles (3) TRP Topical Agents (2)
A

Infections
Neuropathic: compression or degeneration of nerves
Systemic Diseases

Corticosteroids
Useful for pruritis caused by inflammation
Use low potency on face, genitals, skin folds
Use high potency and titrate downwards for other areas

Capsaicin: TRPV1 agonist that desensitizes area
Menthol: TRPM8 agonist

18
Q

Ectoparasitic Infection Agents

Examples (4) with Mechanisms of Action

A

Malathion: organophosphate cholinesterase inhibitor

Permethrin: bind Na+ channels to block repolarization

Ivermectin: Bind Glu-Chloride channel to hyperpolarize
Oral

Lindane: Disrupt GABA transmission
Used as last resort (due to toxicity)

19
Q

Acne Vulgaris Treatment
Topical Retinoids: Examples (3) Adverse Effects (3/2/1)
Oral Retinoid: Example, Adverse Effects (2)

A

Tretinoin: Local irritation, sun sensitivity, fish allergies
Adapalene: Local irritation, sun sensitivity
Tazarotene: Pregnancy Category X

Isoretinoin: Teratogenic, Hypertriglyceridemia

20
Q

Acne Vulgaris Treatment
Topical Antimicrobials: Examples (3) Adverse Effects (2/1/0)
Oral Agents: Examples (4) Adverse Effects (2/2/1/2)

A

Benzoyl Peroxide: local irritation, may bleach things
Clindamycin: Pseudomembranous colitis
Erythromycin

Tetracycline/Doxycycline: Contraindicated in pregnancy, photosensitivity
Minocycline: contraindicated in pregnancy, drug SLE
Erythromycin/Azithromycin: GI distress
TMP-SMX: Stevens Johnson syndrome, epidermal necrolysis

21
Q

Azaleic Acid

Classification, Effects (2) Uses (2)

A

Dicarboxylic acid

Kills acne bacteria
Decreases keratin production

Acne
Post-inflammatory hyperpigmentation

22
Q

Acne Vulgaris Treatment

Hormonal Agents: Examples (2) Adverse Effects

A

Oral Contraceptives: Thromboembolic events

Sprionolactone: Contraindicated in pregnancy
Used for women with menstrual-related breakouts

23
Q 
Psoriasis Therapy
First Line (2) Other Topical Agents (6) UV Options with Descriptions (2)
A

Emollients and Corticosteroids

Vitamin D (reduce keratin)
Tar
Tazarotene (retinoid)
Calcineurin Inhibitors
Anthralin
Salt Water bath

UVB: done to point of erythema, immunomodulator
Photochemotherapy (PUVA): used with ingested photosensitizer psoralen, increased melanoma risk

24
Q

Apremilast

Mechanism of Action (3) Indication, Delivery, Adverse Effects (2)

A

Inhibits PDE4 causing increased cAMP
Decreases NO synthase, TNFa, IL-23
Increases IL-10

Psoriasis

Oral

Severe diarrhea
Headache

25
Q

Ustekinumab

Mechanism of Action (2) Indications (3) Delivery, Adverse Effect

A

monoclonal Ab against IL-12 and IL-23

Psoriasis
Psoriatic Arthritis
Crohn Disease

Subcutaneous injection

Increased risk of infection

26
Q

Secukinumab

Mechanism of Action (2) Indications (3) Delivery, Adverse Effect

A

monoclonal Ab against IL-17A

Psoriasis
Psoriatic Arthritis
Ankylosing Spondylitis

Subcutaneous injection

Increased risk of infection

27
Q

Actinic Keratosis
Topical Treatments: MOA, Adverse Effects
5-Fluorouracil, Imiquimod, Ingenol Mebutate, Diclofenac

A

5-Fluorouracil:
Inhibits thymidylate synthase, blocks DNA synthesis
Inflammation and destructive lesions

Imiquimod:
stimulates local cytokines

Ingenol Mebutate:
Initially disrupts plasma membranes/mitochondria causing cell necrosis
Then neutrophil-mediated Ab-dependent cell toxicity

Diclofenac:
NSAID

28
Q

Skin Cancer Therapy Examples with MOA

Basal Cell Carcinoma (2) Melanoma (2)

A

Basal Cell:
Vismodegib or Sonidegib
Oral SHH pathway inhibitors

Melanoma
Chemo: Dacarbazine
Vemurafenib: MAPK inhibitor, causes apoptosis

29
Q

Alopecia Treatments

Examples (3) with MOA

A

Minoxidil:
Causes K+ channel opening that leads to vasodilation

Finasteride:
Oral DHT inhibitor (can cause sex dysfunction)

Diphenylcyclopropenone (DPCP):
Topical immunotherapy, increases hair growth by causing contact dermatitis
Used in Alopecia Areata

SBL Block 1 (6 decks)

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