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Disease & Defense - Unit 3 > Dermatologic Therapeutics > Flashcards

Dermatologic Therapeutics Flashcards

1
Q

Drug factors affecting percutaneous absorption of topical medications

A

 Active drug concentration
 Composition of the vehicle
 Molecular size of the drug or prodrug
 Lipophilicity of the drug

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2
Q

Patient factors affecting percutaneous absorption of topical medications

A

 Presence of barrier disruption
 Anatomic location (including thickness of the stratum corneum)
 Skin hydration
 Occlusion

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3
Q

Types of vehicles for topical medications

A

 Ointments: Water in oil emulsion
 Creams: Oil in water emulsion
 Gels: Semisolid emulsion in alcohol base
 Lotions/Solutions: Powder in water (some oil in water)
 Foams: pressurized collections of gaseous bubbles in a matrix of
liquid film

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4
Q

Ointment characteristics and sites of use

A
  • strong potency
  • hydrating
  • very low sensitization; low irritation risk
  • good sites: non-intertriginous
  • bad sites: face, hands, groin
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5
Q

Cream characteristics and sites of use

A
  • moderate potency
  • some hydration < ointments
  • significant sensitization risk; low irritation risk
  • good sites: most
  • bad sites: areas w/maceration
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6
Q

Gel characteristics and sites of use

A
  • strong potency
  • drying
  • significant sensitization; high irritation risk
  • good sites: oral mucosa, scalp
  • bad sites: areas w/fissures, erosions, or maceration
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7
Q

Lotions/solutions characteristics and sites of use

A
  • low potency
  • variably drying
  • significant sensitization; moderate irritation risk
  • good sites: scalp, intertriginous regions
  • bad sites: areas w/fissures, erosions
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8
Q

Foams characteristics and sites of use

A
  • stable at room temp but melts at body temp
  • supersatured solution allows maximal delivery of active ingredients
  • strong potency
  • good sites: hair-bearing areas
  • bad sites: areas w/fissures, erosions
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9
Q

Important factors in selecting appropriate vehicle

A
  1. anatomic location
  2. contact allergy/sensitization
  3. irritancy
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10
Q

FTU definition

A
  • amount dispensed from 5mm diameter nozzle that fits in the distal third of the index finger
  • 1 FTU=0.5g
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11
Q

FTUs required to cover face and neck

A

2.5 FTU

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12
Q

FTUs required to cover trunk (front or back)

A

7 FTU

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13
Q

FTUs required to cover arm

A

3 FTU

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14
Q

FTUs required to cover hand (both sides)

A

1 FTU

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15
Q

FTUs required to cover leg

A

6 FTU

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16
Q

FTUs required to cover foot

A

2 FTU

17
Q

Mechanism of action of corticosteroids

A
  • bind receptors in cytoplasm of cells –> ultimately alter transcription
  • alter mRNA production of several inflammatory pathways:
  • cAMP/CREB-binding protein
  • nhibits nuclear factor-kb –> decreases cytokines, adhesion mlx, inflammatory enzymes
  • interacts w/activating protein 1 (AP-1) which controls trxn of growth factor and cytokine genes
18
Q

General classes of topical glucocorticosteroids

A
  • Class 1(Superpotent)
  • Class 2 (High potency)
  • Class 3 (High potency)
  • Class 4 (Medium potency)
  • Class 5 (Medium potency)
  • Class 6 (Low potency)
  • Class 7 (Low potency)
19
Q

Prototypical corticosteroids

A
  • “gentle touch”: Hydrocortisone 2.5% (cream or ointment)
  • “almost all-purpose weapon”: Triamcinolone Acetonide 0.1% (cream or ointment)
  • “hercules”: Clobetasol Propionate 0.5% (cream or ointment)
20
Q

Hydrocortisone 2.5% characteristics

A
  • class 7 (lowest potency)
  • good for:
  • mild eczema in children and adults
  • inflammatory dermatoses @ face, intertriginous areas, groin
21
Q

Triamcinolone Acetonide 0.1%

A
  • class 4 (medium potency)
  • good for:
  • moderate spongiotic dermatoses (e.g. eczema, atopic dermatitis, allergic contact derm, athropod bites, drug reactions) @ trunk, extremities
  • not on face, groin, intertriginous regions
22
Q

Clobetasol Propionate 0.5%

A
  • class 1 (superpotent)
  • acute eruptions that need quick resolution (e.g. contact dermatitis or acute drug eruptions)
  • not on face, groin, intertriginous regions
23
Q

Adverse effects of topical glucocorticosteroids

A
  • more potent = greater adverse effects
  • skin atrophy = shiny, thin skin, telangiectasia, striae formation
  • systemic side effects=adrenal suppression, Cushing’s syndrome, growth retardation in children

Disease & Defense - Unit 3 (18 decks)

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