Dermatology Flashcards

1
Q

Drug class for Bacitracin

A

topical antibiotic

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2
Q

MoA for Bacitracin

A

inhibits cell wall formation by interfering w/ incorporation of peptidoglycan subunits in bacterial cell wall

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3
Q

Indications for Bacitracin

A

superficial G+ skin or mucosal infections

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4
Q

SE/ADRs for Bacitracin

A

burning sensation

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5
Q

Contra-indications for Bacitracin

A

hypersensitivity

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6
Q

Dx-Dx interactions for Bacitracin

A

none

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7
Q

Why is Bacitracin only used topically?

A

highly nephrotoxic systemically

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8
Q

Drug class for Mupirocin

A

topical antibiotic

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9
Q

MoA for Mupirocin

A

reversibly binds to tRNA synthase & inhibits bacterial protein synthesis

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10
Q

Indications for Mupirocin

A

superficial G+ (including MRSA) & selected G- skin, mucosal infections; impetigo

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11
Q

SE/ADRs for Mupirocin

A

burning, stinging

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12
Q

Contra-indications for Mupirocin

A

hypersensitivity

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13
Q

Dx-Dx interactions for Mupirocin

A

none

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14
Q

Drug class for Polymixin B sulfate

A

topical antibiotic

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15
Q

MoA for Polymixin B sulfate

A

interacts w/ phospholipids & disrupt bacterial cell membrane; bind to & inactive endotoxin

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16
Q

Indications for Polymixin B sulfate

A
  • superficial G- (pseudomonas, E. coli, enterobacter, klebsiella)
  • no G+, proteus, & neisseria coverage sec to resistance
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17
Q

SE/ADRs for Polymixin B sulfate

A

systemic toxicity includes muscle weakness, apnea, paresthesias, vertigo, slurred speech (but minimally absorbed w/ topical use)

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18
Q

Contra-indications for Polymixin B sulfate

A

ESRD

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19
Q

Dx-Dx interactions for Polymixin B sulfate

A

aminoglycosides

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20
Q

Monitoring for Polymixin B sulfate

A

CrCl for long term or high dose use, local response

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21
Q

Monitoring for Bacitracin

A

local response

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22
Q

Monitoring for Mupirocin

A

local response

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23
Q

Drug class for Nystatin

A

oral/topical antifungal

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24
Q

MoA for Nystatin

A

binds to sterols in fungal cell membrane, increasing cell permeability

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25
Q

Indications for Nystatin

A

topical skin & mucosal candida infections only

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26
Q

SE/ADRs for Nystatin

A

N/D, bitter taste, contact dermatitis, SJS

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27
Q

Contra-indications for Nystatin

A

hypersensitivity

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28
Q

Dx-Dx interactions for Nystatin

A

none

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29
Q

Monitoring for Nystatin

A

local response

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30
Q

PG category for Nystatin

A

PG C

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31
Q

Drug class for Ciclopirox Olamine

A

topical antifungal

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32
Q

MoA for Ciclopirox Olamine

A

inhibits uptake of precursors of macromolecular synthesis inhibiting fungal cell membrane formation

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33
Q

Indications for Ciclopirox Olamine

A

dermatophytes, candida, P orbiculare

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34
Q

SE/ADRs for Ciclopirox Olamine

A

HA, alopecia, dry skin, burning, stinging

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35
Q

Contra-indications for Ciclopirox Olamine

A
  • hypersensitivity

- avoid occlusive dressing

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36
Q

Dx-Dx interactions for Ciclopirox Olamine

A

none

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37
Q

Monitoring for Ciclopirox Olamine

A

local response

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38
Q

PG category for Ciclopirox Olamine

A

PG B

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39
Q

Drug class for Fluconazole

A

oral antifungal

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40
Q

MoA for Fluconazole

A

alters permeability of fungal cell wall

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41
Q

Indications for Fluconazole

A

candida & dermatophyte fungal infections; crytococcal meningitis (AIDS)

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42
Q

SE/ADRs for Fluconazole

A

N/V, HA, seizures, dizziness, increase cholesterol; chemical hepatitis, SJS

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43
Q

Contra-indications for Fluconazole

A

hypersensitivity; marked renal or hepatic disease

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44
Q

Dx-Dx interactions for Fluconazole

A

HMG-CoA (statins) increase risk rhabdomyolysis

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45
Q

Monitoring for Fluconazole

A

response

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46
Q

PG category for Fluconazole

A

PG C

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47
Q

Drug class for Terbinafine

A

oral/topical antifungal

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48
Q

MoA for Terbinafine

A

inhibits sterol synthesis & disrupts fungal cell wall

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49
Q

Indications for Terbinafine

A
  • oral: onychomycosis

- topical: tinea pedis

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50
Q

SE/ADRs for Terbinafine

A

HA, fever, rash, pruritis, increase AST/ALT

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51
Q

Contra-indications for Terbinafine

A

marked hepatic or renal dysfunction; PG (oral)

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52
Q

Dx-Dx interactions for Terbinafine

A
  • tricyclic antidepressants (increase toxicity of TCA)
  • decrease codeine effectiveness
  • cimetadine increase serum level
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53
Q

Monitoring for Terbinafine

A

hepatic function, CrCl, CBC; response

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54
Q

PG category for Terbinafine

A

PG B

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55
Q

Drug class for Acyclovir

A

nucleoside anti viral oral/topical

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56
Q

MoA for Acyclovir

A

blocks herpes virus nucleic acid synthesis

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57
Q

Indications for Acyclovir

A

HSV-1, HSV-2, VZV, EBV, CMV, HHV-6 (tx & suppression)

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58
Q

SE/ADRs for Acyclovir

A

N/D, HA, nephritis, tremors, delirium, seizures w/ overdose

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59
Q

Contra-indications for Acyclovir

A

hypersensitivity

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60
Q

Dx-Dx interactions for Acyclovir

A
  • probenicid, cimetidine increase concentration (risk neuro & renal toxicity)
  • acyclovir decreases elimination of MTX
61
Q

Monitoring for Acyclovir

A

CrCl, response

62
Q

PG category for Acyclovir

A

PG B

63
Q

Drug class for Tretinoin

A

acne topical

64
Q

MoA for Tretinoin

A

bind to RARs & RXRs to regulate gene expression & increases epidermal cell turnover

65
Q

Indications for Tretinoin

A

acne vulgaris & adjunct for tx skin photoaging

66
Q

SE/ADRs for Tretinoin

A

erythema, dryness, stinging, pigmentation changes, potent teratogen

67
Q

Contra-indications for Tretinoin

A

hypersensitivity

68
Q

Dx-Dx interactions for Tretinoin

A

astringents, abrasives, drying agents

69
Q

Monitoring for Tretinoin

A

PG, response

70
Q

PG category for Tretinoin

A

PG C

71
Q

Drug class for Isotretinoin

A

acne oral

72
Q

MoA for Isotretinoin

A

undefined to normalize keratinization in sebaceous gland follicle & inhibit sebaceous gland size & function; reduces P. acne numbers

73
Q

Indications for Isotretinoin

A

oral tx of refractory, severe cystic acne

74
Q

SE/ADRs for Isotretinoin

A

dryness, itching, HA, corneal opacities, anorexia myalgias, arthraglias, hyperostosis, lipid increase, abnormal menses, bronchospasm, photosensitivity, IBD, hepatotoxicity, premature epiphyseal closure

75
Q

Drug class for Benzyl Peroxide

A

acne topical

76
Q

MoA for Benzyl Peroxide

A

undefined but maybe antimicrobial activity against P. acnes, peeling & comedolytic activity

77
Q

Indications for Benzyl Peroxide

A

acne vulgaris

78
Q

SE/ADRs for Benzyl Peroxide

A

dry skin, pruritus, peeling, sunburn, oxidant (may bleach hair or fabrics), contact sensitizer (1%)

79
Q

Contra-indications for Benzyl Peroxide

A

hypersensitivity

80
Q

Dx-Dx interactions for Benzyl Peroxide

A

none

81
Q

Monitoring for Benzyl Peroxide

A

response

82
Q

Drug class for Adapaline

A

acne topical product

83
Q

MoA for Adapaline

A

retinoid-like compound, a modulate or cellular differentiation, keratinization, & inflammatory processes, all of which features in the pathology of acne vulgaris

84
Q

Indications for Adapaline

A

mild to moderate acne

85
Q

SE/ADRs for Adapaline

A

sun sensitization, irritation of skin; dryness, erythema of skin, stinging

86
Q

Contra-indications for Adapaline

A

broken, abraded, sunburned, or eczematous skin

87
Q

Dx-Dx interactions for Adapaline

A

Vitamins ADEK may amplify photosensitization effect

88
Q

Monitoring for Adapaline

A

skin irritation, photosensitization

89
Q

PG category for Adapaline

A

PG C

90
Q

Drug class for Permethrin

A

topical pediculicide (antiparasitic agent)

91
Q

MoA for Permethrin

A

inhibits Na channel in parasite cell membrane disrupting nerve transmission causing paralysis & death

92
Q

Indications for Permethrin

A

5% cream-scabies

1% cream rinse-head lice

93
Q

SE/ADRs for Permethrin

A

skin irritation

94
Q

Contra-indications for Permethrin

A

external use only

95
Q

Dx-Dx interactions for Permethrin

A

none

96
Q

Monitoring for Permethrin

A

skin irritation, resolution of parasitic infection

97
Q

PG category for Permethrin

A

PG B

98
Q

Drug class for Triamcinolone acetone 0.025%

A

topical steroid intermediate efficacy

99
Q

MoA for Triamcinolone acetone 0.025% & 0.5% & Clobetasol proprionate

A

attaches to GR receptor & inhibits protein synthesis

100
Q

Indications for Triamcinolone acetone 0.025% & 0.5% & Clobetasol proprionate

A

anti-inflammatory

101
Q

SE/ADRs for Triamcinolone acetone 0.025 & 0.5% & Clobetasol proprionate

A

striae, easy brushing, fat distribution changes, skin atrophy, hyperglycemia, HPA suppression, HTN, increases susceptibility to infection, myopathy, behavioral disturbances, cataracts

102
Q

Contra-indications for Triamcinolone acetone 0.025% & 0.5% & Clobetasol proprionate

A

gastric ulcer, osteoporosis

103
Q

Dx-Dx interactions for Triamcinolone acetone 0.025% & 0.5% & Clobetasol proprionate

A

NSAIDs, immunosuppressants

104
Q

Monitoring for Triamcinolone acetone 0.025%& 0.5% & Clobetasol proprionate

A

long term use: lipids, glucose, CrCl, response

105
Q

PG category for Triamcinolone acetone 0.025% & 0.5% and Clobetasol proprionate

A

PG C

106
Q

Drug class for Triamcinolone acetonide 0.5%

A

topical steroid high efficacy

107
Q

Drug class for Clobetasol proprionate

A

topical steroid highest efficacy

108
Q

When are side effects more likely with Clobetasol proprionate?

A

With occlusive dressings

109
Q

Drug class for Calcipotriene

A

psoriasis drug: topical Vit D

110
Q

MoA for Calcipotriene

A

regulates skin cell production & proliferation

111
Q

Indications for Calcipotriene

A

moderately severe plaque psoriasis

112
Q

SE/ADRs for Calcipotriene

A

burning, itching, dry skin; skin atrophy, hyper-pigmentation, hypercalcemia

113
Q

Contra-indications for Calcipotriene

A

hypersensitivity, hypercalcemia, Vit D toxicity

114
Q

Dx-Dx interactions for Calcipotriene

A

none

115
Q

Monitoring for Calcipotriene

A

[Ca+], response

116
Q

Drug class for Sulfasalazine

A

psoriasis drug: oral

117
Q

MoA for Sulfasalazine

A

undefined & local impact & systemic impact of decrease prostaglandins & other inflammatory cytokine production

118
Q

Indications for Sulfasalazine

A

psoriasis (off label), psoriatic arthritis (off label), RA, ulcerative colitis, Crohn’s (off label)

119
Q

SE/ ADRs for Sulfasalazine

A

HA, N/V/D, photosensitivity, hemolytic anemia, SJS/TEN

120
Q

Contra-indications for Sulfasalazine

A

hepatic impairment

121
Q

Dx-Dx interactions for Sulfasalazine

A

varicella virus vaccines increase concentration

122
Q

Monitoring for Sulfasalazine

A

CrCl, LFTs, CBC; response

123
Q

PG category for Sulfasalazine

A

PG B

124
Q

Drug class for Methotrexate

A

psoriasis drug: oral folate antimetabolite

125
Q

MoA for Methotrexate

A

DHFR inhibitor which inhibits proliferation & induces apoptosis of immune inflammatory cells

126
Q

Indications for Methotrexate

A

psoriasis, RA

127
Q

SE/ADRs for Methotrexate

A

vasculitis, seizures, alopecia, photosensitivity, hepatic fibrosis, bone marrow suppression, pulmonary fibrosis

128
Q

Contra-indications for Methotrexate

A

other folate inhibiting drugs, renal or hepatic dysfunction, alcoholic cirrhosis

129
Q

Dx-Dx interactions for Methotrexate

A

other folate inhibitors

130
Q

Monitoring for Methotrexate

A

CrCl, liver function, CBC, CSR or PFTs, response

131
Q

PG category for Methotrexate

A

PG X

132
Q

What is the problem with Methotrexate & other folate inhibiting drugs?

A

they compete at protein binding sites & can increase MTX serum concentration w/ bone marrow suppression

133
Q

Drug class for Hydroxyurea

A

psoriasis drug: oral antimetabolite

134
Q

MoA for Hydroxyurea

A

undefined interference w/ DNA synthesis

135
Q

Indications for Hydroxyurea

A

psoriasis (off label)

136
Q

SE/ADRs for Hydroxyurea

A

edema, drowsiness, alopecia, vasculitis, myelosuppression, hepatotoxicity, peripheral neuropathy, pulmonary fibrosis

137
Q

Contra-indications for Hydroxyurea

A

hyperuricemia, hepatic or renal impairment

138
Q

Dx-Dx interactions for Hydroxyurea

A

live vaccines

139
Q

Monitoring for Hydroxyurea

A

CBC, LFTs, CrCl, uric acid, CXR or PFTs; response

140
Q

PG category for Hydroxyurea

A

PG D

141
Q

Drug class for Etanercept

A

psoriasis drug:biologic response modifier (BRM) TNF alpha, beta blocker

142
Q

MoA for Etanercept

A

blocks TNF alpha receptor binding thereby inhibiting TH1 activity

143
Q

Indications for Etanercept

A

refractory psoriasis unresponsive to other modalities, psoriatic arthritis, JRA, ankylosing spondylitis

144
Q

SE/ADRs for Etanercept

A

HA, URIs, activation or reduced resistance to serious infection, anemia, marrow suppression, exacerbation CHF & demyelinating disorders

145
Q

Contra-indications for Etanercept

A

TB, HIV, Hep B, CHF

146
Q

Dx-Dx interactions for Etanercept

A

none

147
Q

Monitoring for Etanercept

A

IPPD, LFTs, CBC, response

148
Q

PG category for Etanercept

A

PG B