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
2
Q
what are the most common pathogens that cause skin infections?
A
Staphyloccus aureus
Streptoccus pyogenes
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
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
5
Q
which topical medications are used to treat impetigo?
A
mupirocin
retapamulin
OTC bacitracin
combo of bacitracin & polymyxin B sulfate
6
Q
which oral medications are used to treat worsening impetigo or >5 lesions?
A
cephalexin
amoxicillin/clavulanate
dicloxacillin
clindamycin
7
Q
which oral medications are effective against S. aureus or S. pyogenes?
A
Cephalexin
Amoxicillin/clavulanate
Dicloxacillin
8
Q
if MRSA is suspected, what medications are used?
A
clindamycin
TMP/SMZ
doxycycline
9
Q
which pathogen causes furuncles?
A
usually S. aureus
10
Q
which medications are first line to treat furuncles?
A
cephalexin
amoxicillin/clavulanate
dicloxacillin
11
Q
which medications are used to treat perianal streptococcal infections?
A
penicillin
erythromycin
12
Q
what is the most common pathogen that causes cellulitis?
A
Most commonly Streptococcus pneumoniae, S. aureus
in children, Haemophilus influenzae
13
Q
which medications should be used to treat cellulitis?
A
Amox/clav
broad spectrum cephalosporin
14
Q
what are candida infections usually caused by?
A
C. albicans
dermatophyes
15
Q
what are the topical medications used to treat candidiasis?
A
nystatin (Mycostatin)
clotrimazole (Mycelex)
16
Q
what are the oral medications used to treat candidiasis?
A
fluconazole
17
Q
what are the oral antifungal medications used to treat tinea capitus?
A
griseofulvin
18
Q
what kind of shampoo can be used to treat tinea capitus?
A
selenium sulfide
ketoconazole
19
Q
what causes tinea corporis (ringworm) and tinea cruris?
A
commonly caused by :
Microsporum canis
T. tonsurans
Epidermophyton floccosum
20
Q
what is the classic presentation of ringworm?
A
an annular lesion with raised borders and a clear center
21
Q
what causes tinea pedis (athlete’s foot)?
A
dermatophytes E. floccosum
T. rubrum
T. mentagrophytes
C. albicans
22
Q
what is the treatment for athlete’s foot?
A
topical antifungals
23
Q
what causes tinea versicolor?
A
Pityrosporum orbiculare (formerly called Malassezia furfur)
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)
25
which medications are used to treat onychmoycosis?
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
26
what medications are used to treat superficial fungal infections?
```
Azoles
Allylamines: naftifine (Naftin)
Benzylamine: butenafine (Lotrimin Ultra)
Ciclopirox olamine
Tolnaftate (Tinactin)
Nystatin
```
27
what are the systemic antifungals used for fungal infections of the skin?
```
Griseofulvin
Azoles
Ketoconazole
Itraconazole
Fluconazole
Terbinafine (Lamisil)
```
28
what are the precautions when using systemic antifungals?
All should be used cautiously in patients with liver problems
Griseofulvin has possible cross-sensitivity with penicillin
29
what are the ADRs of topical antifungals?
```
skin irritation
itching
burning
rash
gentian violet may cause staining of skin ad clothing
```
30
Clotrimazole intravaginal preparations should not be administered concurrently with what?
nonoxynol-9 and octoxynol
31
cutaneous candidiasis should be treated with which medications?
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
32
tinea capitus should be treated with which medications?
```
griseofulvin
terbinafine
sporicidal shampoo
selenium sulfide
ketoconazole
```
33
tinea corporis should be treated with which medications?
topical azoles
naftifine
ciclopirox olamine
34
tinea cruris should be treated with which medications?
topical azoles
35
tinea pedis should be treated with which medications?
topical azoles
| treatment x4 weeks
36
tinea versicolor should be treated with which medications?
selenium sulfide shampoo
| topical antifungals
37
onychomycosis (tinea unguium) should be treated with which medications?
ciclopirox nail lacquer (Penlac) *only topical treatment*
systemic antifungals can be used
combo of ciclopirox and an oral antifungal is more effective
38
thrush should be treated with which medication?
nystatin
39
when taking systemic antifungals what should be monitored?
liver enzymes
40
when taking griseofulvin, what should be monitored?
renal
liver
CBC
41
when taking ketoconazole, what should be monitored?
liver function
| many drug-drug interactions
42
when taking itraconazole, what should be monitored?
liver function
| electrolytes
43
when taking terbinafine, what should be monitored?
liver enzymes
| CBC
44
what are the most common viral skin infections?
herpes viral infections
varicella
herpes zoster
45
what are the drugs of choice for recurrent outbreaks of HSV infection?
famiciclovir
| valacyclovir
46
although topical treatment is not recommended for viral skin infections, medications are available. which medications are available in topical form?
acyclovir (Zovirax)
penciclovir (Denavir)
OTC docosanol (Abreva)
47
in regards to outcome evaluation pertaining to viral skin infections, improvements should appear when?
should be noted for most infections fairly quickly
| resistance should be suspected if not responding
48
topical retinoids are used to treat what?
inflammatory and noninflammatory acne
49
what are some of the downsides to starting topical retinoids?
acne may initially worsen
| may cause redness and peeling of skin
50
how do topical antibiotics work to treat acne?
control acne by their bacteriostatic or bactericidal activity against P. acnes
51
which topical antibiotics are used to treat acne?
benzoyl peroxide (OTC)
erythromycin
clinidimycin
combo products containing benzoyl peroxide + erythro or clinida
52
which oral agents are used to treat acne?
tetracycline
doxycycline
minocycline
erythromycin
53
when are retinoids (isotretinoin) used to treat acne?
reserved for severe recalcitrant cystic acne
54
retinoids are pregnancy category what?
X- requires iPledge registration
55
what should be monitored when taking retinoids?
liver enzymes
| lipid levels
56
what is acne rosacea?
chronic inflammatory disorders of the blood vessels and pilosebaceous glands of the face
57
which medications are used to treat acne rosacea?
```
topical metronidazole (Metro-Gel, Noritate)
tx continues for life
```
58
when treating acne and acne rosacea, how long does it take to determine effectiveness?
6 to 8 weeks
59
what are topical antihistamines used for?
local reactions to insect bites, stings, and minor skin disorders (poison ivy, sumac, & oak)
60
which medications are considered topical antihistamines?
diphenhydramine (Benadryl)
| doxepin (Zonalon)
61
which medications are used during an acute eczema exacerbation?
```
topical corticosteroids
oral corticosteroids
immunomodulators
antipruritics
emollients
antibiotics
```
62
which immunomodulators are used to treat eczema?
pimecromlimus (Elidel)
| tacrolimus (Protopic)
63
immunomodulators are what line of treatment?
second line after corticosteroids
64
why do immunomodulators have a black box warning?
rare malignancy
65
which antipruritics are used to treat eczema?
oral antihistamines (diphenhydramine, hydroxyzine, cetirizine)
doxepin (oral or topical)
aveeno cream
moisturel cream
66
which medications are used in long-term therapy of eczema?
moisturizers, lubricants and emollients help retain H2O in the skin (4x day)
67
what are non-pharmacological measures that can be used to treat eczema?
hydrating baths
| avoiding offending agents
68
what is used to treat contact dermatitis?
topical corticosteroids
oral corticosteroids (may need 2-3 wks of therapy)
wet dressings or baths
69
what kind of wet dressings are used to treat contact dermatitis?
aluminum acetate solution (Burow's, Domeboro) is an astringent wet dressing applied for 30 minutes 4x/day
70
what kind of baths are used to treat contact dermatitis?
contain colloidal oatmeal solids (Aveeno) or oils (Alpha Keri bath oil, lubriderm bath oil)
71
what is used to treat diaper dermatitis?
```
barrier medications
anti-inflammatory medications
anti-fungals
wet soaks
non-pharmacologic management
```
72
what are the barrier medications used to treat diaper dermatitis?
white petrolatum
zinc oxide
OTC barrier medications (Balmex, Desitin)
73
which anti-inflammatory medications are used to treat diaper dermatitis?
low dose hydrocortisone (2-3 days)
74
which antifungals are used to treat diaper dermatitis?
nystatin
miconazole
clotrimaxole
75
what are the forms of non-pharmacological management for diaper dermatitis?
exposure to air
frequent changes
changing brand of diaper
76
what are the forms of treatment for seborrheic dermatitis?
topical anti-seborrheic shampoo
| topical corticosteroids
77
what are the topical anti-seborrheic shampoos?
selenium sulfide
ketoconazole
pyrithione zinc
78
topical immunomodulators should not be used in which pt population?
less than 2 yrs
79
what should you educate patients on in regards to dermatitis?
topical steroids should be applied sparingly
| use emollients generously for atopic dermatitis
80
which medications are used to treat psoriasis?
```
topicals (intermediate to high potency corticosteroids)- "pulse" therapy works best
coal tar (creams, shampoos, ointments, lotions, gels, and oils)
```
81
what are the vitamin D3 derivatives used to treat psoriasis?
Calcipotriene (Dovonex)
| Calcitriol
82
you should not exceed how many gm/WEEK of Calcitriol?
200 g
83
you should not exceed how many gm/WEEK of Calcipotriene (Dovonex) ?
100 g
84
which systemic medications can be used to tx psoriasis?
methotrexate
oral retinoids
immunosuppressants
tumor necorsis factor blockers
85
what should you educate patients on in regards to psoriasis?
proper application of medications
many medications can stain clothes and skin
some medications can cause photosensitivity
86
which medications are used to treat head lice infestations?
Pyrethrins and permethrin
Benzoyl alcohol (Ulesfia)
Second-line drugs: Lindane and malathion (Ovide)
Nit removal
87
which medications are used to treat body lice infestations?
Topical lindane and permethrin
88
which medications are used to treat pubic lice infestations?
Topical lindane*, pyrethrin and permethrin
89
which head lice medications are available OTC?
pyrethrins
| permethrin
90
which body lice medication is safer during pregnancy and infants?
permetherin 5%
91
which medications are used to treat scabies?
permetherin
lindane
topical corticosteroids for itching & inflammation
92
what is the most common agent in primary care used to treat burns?
silver sulfadiazine (Silvadene)
93
silver sulfadiazine (Silvadene) is pregnancy category what?
B, but considered D near term
94
silver sulfadiazine (Silvadene) should be used with caution in what patient population?
hepatic or renal disease
| those with hemotologic disorders
95
what can be used as an alternative to silver sulfadiazine (Silvadene)?
bacitracin
96
what are cauterizing and destructive agents used for?
umbilical granuloma
aphthous ulcer, vesicular, or bullous lesion
poorly healing wounds or ulcers
verruca (warts)
97
what are the cauterizing & destructive agents?
silver nitrate
| chloroacetic acid
98
what do keratolytics treat?
hyperkeratonic and scaling lesions (corns, calluses, warts)
99
which medication is a keratolytic?
salicylic acid- OTC
100
what are the topical anesthetics?
lidocaine-Prilocaine (EMLA)
| lidocaine 4% cream (LMX-4)
101
what is alopecia androgenetica?
common male pattern baldness- genetically determined
| women with increased androgen levels will have male pattern baldness
102
what are the medications used to treat alopecia?
```
Topical minoxidil (Rogaine)
Systemic finasteride
```
103
what are the adverse effects of minosidil?
may cause dermatitis
| can have cardiac effects
104
what are the adverse effects of finasteride?
sexual dysfunction
check PSA levels
pregnancy prevention in partner
105
how low does it take to determine is treatment for alopecia is effective?
3-4 months
