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Pharm Exam III > Dermatology > Flashcards

Dermatology Flashcards

1
Q

what are the topical antibacterial medications?

A

Mupirocin (Bactroban, Centany)
Retapamulin (Altabax)
Bacitracin
Double antibiotic: bacitracin and polymixin B
Triple antibiotic: bacitracin, neomycin and polymixin B

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2
Q

what are the most common pathogens that cause skin infections?

A

Staphyloccus aureus

Streptoccus pyogenes

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3
Q

what are the basic principles of using topical anti-infectives?

A 
know or suspect the pathogen, if unsure culture it
treat empirically
follow progress and culture
watch for resistance
change anti-infective if appropriate
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4
Q

systemic antibiotics are required for which disease states?

A 
moderate to severe impetigo
boils or abcesses (furuncle)
perianal strep
cellulitis
MRSA suspected skin infection
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5
Q

which topical medications are used to treat impetigo?

A

mupirocin
retapamulin
OTC bacitracin
combo of bacitracin & polymyxin B sulfate

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6
Q

which oral medications are used to treat worsening impetigo or >5 lesions?

A

cephalexin
amoxicillin/clavulanate
dicloxacillin
clindamycin

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7
Q

which oral medications are effective against S. aureus or S. pyogenes?

A

Cephalexin
Amoxicillin/clavulanate
Dicloxacillin

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8
Q

if MRSA is suspected, what medications are used?

A

clindamycin
TMP/SMZ
doxycycline

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9
Q

which pathogen causes furuncles?

A

usually S. aureus

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10
Q

which medications are first line to treat furuncles?

A

cephalexin
amoxicillin/clavulanate
dicloxacillin

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11
Q

which medications are used to treat perianal streptococcal infections?

A

penicillin

erythromycin

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12
Q

what is the most common pathogen that causes cellulitis?

A

Most commonly Streptococcus pneumoniae, S. aureus

in children, Haemophilus influenzae

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13
Q

which medications should be used to treat cellulitis?

A

Amox/clav

broad spectrum cephalosporin

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14
Q

what are candida infections usually caused by?

A

C. albicans

dermatophyes

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15
Q

what are the topical medications used to treat candidiasis?

A

nystatin (Mycostatin)

clotrimazole (Mycelex)

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16
Q

what are the oral medications used to treat candidiasis?

A

fluconazole

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17
Q

what are the oral antifungal medications used to treat tinea capitus?

A

griseofulvin

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18
Q

what kind of shampoo can be used to treat tinea capitus?

A

selenium sulfide

ketoconazole

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19
Q

what causes tinea corporis (ringworm) and tinea cruris?

A

commonly caused by :
Microsporum canis
T. tonsurans
Epidermophyton floccosum

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20
Q

what is the classic presentation of ringworm?

A

an annular lesion with raised borders and a clear center

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21
Q

what causes tinea pedis (athlete’s foot)?

A

dermatophytes E. floccosum
T. rubrum
T. mentagrophytes
C. albicans

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22
Q

what is the treatment for athlete’s foot?

A

topical antifungals

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23
Q

what causes tinea versicolor?

A

Pityrosporum orbiculare (formerly called Malassezia furfur)

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24
Q

what is the treatment for tinea versicolor?

A

topical application of selenium sulfide shampoo (Selsun)

topical antifungal, commonly one of the imidazoles (miconazole, clotrimazole, econazole)

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25
Q

which medications are used to treat onychmoycosis?

A

Months of a systemic antifungal medication, (griseofulvin, ketoconazole, itraconazole, or terbinafine)
Topical ciclopirox nail laquer can be used, or added to systemic antifungals
Efinaconazole (Jublia) – topical
Labeled to use for 48 weeks

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26
Q

what medications are used to treat superficial fungal infections?

A 
Azoles
Allylamines: naftifine (Naftin)
Benzylamine: butenafine (Lotrimin Ultra)
Ciclopirox olamine 
Tolnaftate (Tinactin)
Nystatin
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27
Q

what are the systemic antifungals used for fungal infections of the skin?

A 
Griseofulvin
Azoles
     Ketoconazole
     Itraconazole
     Fluconazole
Terbinafine (Lamisil)
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28
Q

what are the precautions when using systemic antifungals?

A

All should be used cautiously in patients with liver problems
Griseofulvin has possible cross-sensitivity with penicillin

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29
Q

what are the ADRs of topical antifungals?

A 
skin irritation
itching
burning
rash
gentian violet may cause staining of skin ad clothing
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30
Q

Clotrimazole intravaginal preparations should not be administered concurrently with what?

A

nonoxynol-9 and octoxynol

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31
Q

cutaneous candidiasis should be treated with which medications?

A

OTC azoles
nystatin
prescription azoles
gentian violet can be used for thrush refractory to azoles
fluconazole may be used systemically for thrush or vaginal candidiasis

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32
Q

tinea capitus should be treated with which medications?

A 
griseofulvin
terbinafine
sporicidal shampoo
     selenium sulfide
     ketoconazole
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33
Q

tinea corporis should be treated with which medications?

A

topical azoles
naftifine
ciclopirox olamine

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34
Q

tinea cruris should be treated with which medications?

A

topical azoles

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35
Q

tinea pedis should be treated with which medications?

A

topical azoles

treatment x4 weeks

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36
Q

tinea versicolor should be treated with which medications?

A

selenium sulfide shampoo

topical antifungals

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37
Q

onychomycosis (tinea unguium) should be treated with which medications?

A

ciclopirox nail lacquer (Penlac) only topical treatment
systemic antifungals can be used
combo of ciclopirox and an oral antifungal is more effective

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38
Q

thrush should be treated with which medication?

A

nystatin

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39
Q

when taking systemic antifungals what should be monitored?

A

liver enzymes

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40
Q

when taking griseofulvin, what should be monitored?

A

renal
liver
CBC

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41
Q

when taking ketoconazole, what should be monitored?

A

liver function

many drug-drug interactions

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42
Q

when taking itraconazole, what should be monitored?

A

liver function

electrolytes

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43
Q

when taking terbinafine, what should be monitored?

A

liver enzymes

CBC

44
Q

what are the most common viral skin infections?

A

herpes viral infections
varicella
herpes zoster

45
Q

what are the drugs of choice for recurrent outbreaks of HSV infection?

A

famiciclovir

valacyclovir

46
Q

although topical treatment is not recommended for viral skin infections, medications are available. which medications are available in topical form?

A

acyclovir (Zovirax)
penciclovir (Denavir)
OTC docosanol (Abreva)

47
Q

in regards to outcome evaluation pertaining to viral skin infections, improvements should appear when?

A

should be noted for most infections fairly quickly

resistance should be suspected if not responding

48
Q

topical retinoids are used to treat what?

A

inflammatory and noninflammatory acne

49
Q

what are some of the downsides to starting topical retinoids?

A

acne may initially worsen

may cause redness and peeling of skin

50
Q

how do topical antibiotics work to treat acne?

A

control acne by their bacteriostatic or bactericidal activity against P. acnes

51
Q

which topical antibiotics are used to treat acne?

A

benzoyl peroxide (OTC)
erythromycin
clinidimycin
combo products containing benzoyl peroxide + erythro or clinida

52
Q

which oral agents are used to treat acne?

A

tetracycline
doxycycline
minocycline
erythromycin

53
Q

when are retinoids (isotretinoin) used to treat acne?

A

reserved for severe recalcitrant cystic acne

54
Q

retinoids are pregnancy category what?

A

X- requires iPledge registration

55
Q

what should be monitored when taking retinoids?

A

liver enzymes

lipid levels

56
Q

what is acne rosacea?

A

chronic inflammatory disorders of the blood vessels and pilosebaceous glands of the face

57
Q

which medications are used to treat acne rosacea?

A 
topical metronidazole (Metro-Gel, Noritate)
tx continues for life
58
Q

when treating acne and acne rosacea, how long does it take to determine effectiveness?

A

6 to 8 weeks

59
Q

what are topical antihistamines used for?

A

local reactions to insect bites, stings, and minor skin disorders (poison ivy, sumac, & oak)

60
Q

which medications are considered topical antihistamines?

A

diphenhydramine (Benadryl)

doxepin (Zonalon)

61
Q

which medications are used during an acute eczema exacerbation?

A 
topical corticosteroids
oral corticosteroids
immunomodulators
antipruritics
emollients
antibiotics
62
Q

which immunomodulators are used to treat eczema?

A

pimecromlimus (Elidel)

tacrolimus (Protopic)

63
Q

immunomodulators are what line of treatment?

A

second line after corticosteroids

64
Q

why do immunomodulators have a black box warning?

A

rare malignancy

65
Q

which antipruritics are used to treat eczema?

A

oral antihistamines (diphenhydramine, hydroxyzine, cetirizine)
doxepin (oral or topical)
aveeno cream
moisturel cream

66
Q

which medications are used in long-term therapy of eczema?

A

moisturizers, lubricants and emollients help retain H2O in the skin (4x day)

67
Q

what are non-pharmacological measures that can be used to treat eczema?

A

hydrating baths

avoiding offending agents

68
Q

what is used to treat contact dermatitis?

A

topical corticosteroids
oral corticosteroids (may need 2-3 wks of therapy)
wet dressings or baths

69
Q

what kind of wet dressings are used to treat contact dermatitis?

A

aluminum acetate solution (Burow’s, Domeboro) is an astringent wet dressing applied for 30 minutes 4x/day

70
Q

what kind of baths are used to treat contact dermatitis?

A

contain colloidal oatmeal solids (Aveeno) or oils (Alpha Keri bath oil, lubriderm bath oil)

71
Q

what is used to treat diaper dermatitis?

A 
barrier medications
anti-inflammatory medications
anti-fungals
wet soaks
non-pharmacologic management
72
Q

what are the barrier medications used to treat diaper dermatitis?

A

white petrolatum
zinc oxide
OTC barrier medications (Balmex, Desitin)

73
Q

which anti-inflammatory medications are used to treat diaper dermatitis?

A

low dose hydrocortisone (2-3 days)

74
Q

which antifungals are used to treat diaper dermatitis?

A

nystatin
miconazole
clotrimaxole

75
Q

what are the forms of non-pharmacological management for diaper dermatitis?

A

exposure to air
frequent changes
changing brand of diaper

76
Q

what are the forms of treatment for seborrheic dermatitis?

A

topical anti-seborrheic shampoo

topical corticosteroids

77
Q

what are the topical anti-seborrheic shampoos?

A

selenium sulfide
ketoconazole
pyrithione zinc

78
Q

topical immunomodulators should not be used in which pt population?

A

less than 2 yrs

79
Q

what should you educate patients on in regards to dermatitis?

A

topical steroids should be applied sparingly

use emollients generously for atopic dermatitis

80
Q

which medications are used to treat psoriasis?

A 
topicals (intermediate to high potency corticosteroids)- "pulse" therapy works best
coal tar (creams, shampoos, ointments, lotions, gels, and oils)
81
Q

what are the vitamin D3 derivatives used to treat psoriasis?

A

Calcipotriene (Dovonex)

Calcitriol

82
Q

you should not exceed how many gm/WEEK of Calcitriol?

A

200 g

83
Q

you should not exceed how many gm/WEEK of Calcipotriene (Dovonex) ?

A

100 g

84
Q

which systemic medications can be used to tx psoriasis?

A

methotrexate
oral retinoids
immunosuppressants
tumor necorsis factor blockers

85
Q

what should you educate patients on in regards to psoriasis?

A

proper application of medications
many medications can stain clothes and skin
some medications can cause photosensitivity

86
Q

which medications are used to treat head lice infestations?

A

Pyrethrins and permethrin
Benzoyl alcohol (Ulesfia)
Second-line drugs: Lindane and malathion (Ovide)
Nit removal

87
Q

which medications are used to treat body lice infestations?

A

Topical lindane and permethrin

88
Q

which medications are used to treat pubic lice infestations?

A

Topical lindane*, pyrethrin and permethrin

89
Q

which head lice medications are available OTC?

A

pyrethrins

permethrin

90
Q

which body lice medication is safer during pregnancy and infants?

A

permetherin 5%

91
Q

which medications are used to treat scabies?

A

permetherin
lindane
topical corticosteroids for itching & inflammation

92
Q

what is the most common agent in primary care used to treat burns?

A

silver sulfadiazine (Silvadene)

93
Q

silver sulfadiazine (Silvadene) is pregnancy category what?

A

B, but considered D near term

94
Q

silver sulfadiazine (Silvadene) should be used with caution in what patient population?

A

hepatic or renal disease

those with hemotologic disorders

95
Q

what can be used as an alternative to silver sulfadiazine (Silvadene)?

A

bacitracin

96
Q

what are cauterizing and destructive agents used for?

A

umbilical granuloma
aphthous ulcer, vesicular, or bullous lesion
poorly healing wounds or ulcers
verruca (warts)

97
Q

what are the cauterizing & destructive agents?

A

silver nitrate

chloroacetic acid

98
Q

what do keratolytics treat?

A

hyperkeratonic and scaling lesions (corns, calluses, warts)

99
Q

which medication is a keratolytic?

A

salicylic acid- OTC

100
Q

what are the topical anesthetics?

A

lidocaine-Prilocaine (EMLA)

lidocaine 4% cream (LMX-4)

101
Q

what is alopecia androgenetica?

A

common male pattern baldness- genetically determined

women with increased androgen levels will have male pattern baldness

102
Q

what are the medications used to treat alopecia?

A 
Topical minoxidil (Rogaine)
Systemic finasteride
103
Q

what are the adverse effects of minosidil?

A

may cause dermatitis

can have cardiac effects

104
Q

what are the adverse effects of finasteride?

A

sexual dysfunction
check PSA levels
pregnancy prevention in partner

105
Q

how low does it take to determine is treatment for alopecia is effective?

A

3-4 months

Pharm Exam III (4 decks)

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