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Dermatology Flashcards

1
Q

When is drug absorption increased?

A

broken, damaged skin, dry or wet skin, inflammation, large surface area, thinner skin

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2
Q

when is drug absorption decreased?

A

hairiness, small surface area, thicker skin

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3
Q

What are the risk factors of xerosis?

A

cold weather, dehydration, elderly, endocrine disorders, frequent hand washing

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4
Q

Xerosis treatment

A

reduce risk factors, emollients, humectants, urea, allantoin

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5
Q

When should xerosis treatment be administered?

A

everyday, every other for prevention

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6
Q

Topical acne treatments

A

retinoic acid, adapalene, adapalene/benzoyl peroxide, dapsone

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7
Q

What are the antibiotics of choice for antibiotics?

A

clindamycin, doxycycline, erythromycin, minocycline, sulfamethoxazole/trimethoprim

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8
Q

What is the dosage of isotretinoin

A

1-2 mg/kg divided in two doses daily for 4-5 months

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9
Q

What is considered to be the most efficacious for acne?

A

isotretinoin (Accutane)

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10
Q

What is the cause of seborrheic dermatitis

A

unknown but due to fungal infections

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11
Q

What is the treatment of seborrheic dermatitis?

A

selenium sulfide, cortisone, diphenydramine, cetrizine, fexofenadine, loratadine, ketoconazole, urea, coal tar

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12
Q

Examples of psoriasis meds

A

hydrocortisone, salicylic acid, urea, eucerin, aquaphor, calamine, coal tar, lactic acid

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13
Q

What are the RX steroids for psoriasis

A

triamcinolone, betamethasone

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14
Q

Adverse effects of steroids in psoriasis

A

dermatitis, atrophy, systemic side effects

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15
Q

What is the class 1 steroid?

A

clobetasol

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16
Q

Calcipotriene, calcitriol for plaque psoriasis

A

synnthetic vit D3, up to 8 weeks of therapy, ADRs- burning, itching, irritation

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17
Q

Tazarotene treatment of psoriasis

A

retinoid prodrug, anti-inflammatory,, antiproliferative, once daily

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18
Q

Systemic treatment of psoriasis

A

acitretin (Soriatane), methotrexate

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19
Q

Acitretin pearls

A

retinoid metabolite, effective in pustular psoriasis, 25-50 mg daily, ADR- liver failure, high cholesterol, teratogenic

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20
Q

Methotrexate pearls

A

immunosuppressant, antifolate, must give folic acid, dosed weekly to limit toxicity, ADR- abdominal, nausea, immunosuppression, liver failure, renal failure

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21
Q

What are contraindications of methotrexate?

A

pregnancy, hepatitis, renal impairment, thrombocytopenia, leukemia

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22
Q

Biologic treatment for psoriasis

A

hymire, enbrel, infliximab

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23
Q

Adalimumab (Humira) dosage

A

80 mg SQ, then 40 mg every other week

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24
Q

Etanercept (Enbrel)

A

50 mg SQ twice weekly x3 months, then 50 mg weekly

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25
Infliximab (remicade)
5 mg/kg/IV infusion, repeated at week 2 and 6 then every 8 weeks
26
ADRs of biologic
serious infections, increased risk of lymphoma, require negative TB test prior to initiation
27
OTC dermatitis treatment
cortisone, Benadryl, zyrtec, allegra, Claritin, eucerin, aquaphor, tecnu
28
Dermatitis prescription treatment
phototherapy, tacrolimus, pimecrolimus
29
Tacrolimus (Prograf)
suppresses inflammation, apply twice daily until skin is clear, available as .03% and .1%, ADR of burning and local irritation
30
Pimecrolimus (Elidel)
suppresses inflammation, apply twice daily until skin is clear, is available in 1% cream, ADR- burning and local irritation
31
OTC wart treatment
freeze away, compound-W, caustic pencil (silver nitrate)
32
Salicylic acid in wart treatment
solubilize cell surface protein that keep the stratum corneum intact, keratolytic at concentrations 3-6%, ADR- urticaria, local irriation, inflammation, salicylism
33
Urea in wart treatment
breaks hydrogen bonds that keep the stratum corneum intact, 20% concentration is keratolytic
34
Genital wart treatment options
surgical removal, cryosurgery, laser treatment, imiquimod (Aldara), Sinecatechins (Veregen), podophyllum resin, podofilox
35
Imiquimod (Aldara)
anti-proliferative, apply 3 times per week leave on 6-10 hours, ADR- pruritis, erythema, superficial erosion
36
Sinecatechins (Veregen)
water extract from green tea leaves, apply TID, long duration of therapy, no more than 16 weeks,, ADR- local irritation
37
Podophyllum resin, podofilox
cytotoxic agents, resin- apply 25% conc to wart then remove after 2-3 hours, if no improvement after 3-5 therapies consider alternative options, podofilox- apply .5% conc BID x3 days then at least 4 days of no treatment
38
ADRs of resin and podofilox
highly irritating, toxic if systemically absorbed, NV, muscle weakness, neuropathy
39
Treatment options of lice
lice comb, petroleum jelly, mayo, PB, benzyl EtOH, malathion
40
Rid treatment of lice
synergized pyrethrins, head+ pubic lice, apply for 10 mins then shampoo and comb, does not kill eggs so repeat in 7 days
41
Nix treatment of lice
permethrin, head lice only, apply washed hair, leave on for 10 mins and comb through, may repeat in 7-9 days if active lice seen
42
Ovide treatment of lice
malathion, head+ pubic lice, apply to dry hair, leave on 8-12 hrs, then shampoo and comb, may repeat 7-9 days, most efficacious, but$$
43
OTC scabies treatment
Calcmine lotion, camphor, benadryl, zyrtec, allegra, claritin
44
Prescription treatment of scabies
permethrin, 5%, Croamiton (eurax), lindane
45
Crotamiton (Eurax)
MOA unknown, 10% conc of cream or lotion, apply twice, separated by 24 hrs, ADR- dermatitis, local irritation
46
Lindane
single application left on for 8-12 hrs, repeat if active mites and >1 week after initial treatment, ADR- local irriation, systemic absorption leading to neurotoxicity and hematotoxicity, may be carcinogenic
47
Topical treatment for bacterial infections
Bacitracin/polymixin B/neomycin (Neosporin), bacitracin, gramicidin, mupirocin, retapmulin, neomycin, gentamycin
48
Bacitracin and gramicidin
peptide abx, ADR- allergic contact dermatitis, urticaria
49
Mupirocin (bactroban)
inhibits synthesis, eradication of nasal colonization of MRSA, adr- pruritis, localized burning
50
Retapamulin (Altabax)
inhibits protein synthesis, ADR- eczema, pruritus, irritation
51
Neomycin (neo-fradin)
aminoglycoside abx, activity against gram -, partial activity against gram +, ADR- allergic contact dermatitis
52
Gentamycin (Garamycin)
aminoglycoside abx, activity against gram -, partial activity against gram +, if applied to large SA, detectable serum conc possible, ADR- nephrotoxicity, neurotoxicity (systemic only)
53
OTC fungal infection products, topical
terbinafine (Lamisil), clotrimazole (Lotrimin), Ketoconazole (Nizoral), miconazole (Desenex), Tolnaftate (Tinactin), Naftifine (Naftine)
54
OTC fungal infection products, internal
niconazole (Monistat), tioconazole (vagistat)
55
Imidazole
reduce ergosterol synthesis by inhibiting fungal cytochrome P450, applied once/twice dialy for 2-3 weeks, combo w/ steroid for more rapid symptomatic improvement
56
Allylamines
active against dermatophytes, less against yeast, selectively inhibit squalene epixidase, a key enzyme in the synthesis of ergosterol, applied BID
57
Nystatin
active against yeast not dermatophytes, binds to ergosterol and forms pires, leading to potassium loss, adicofication and cell death, apply 2-4 times/ day, minimal SE, loca irritation, amphotericin B- yellow skin
58
Dosage of azole derivatives
Fluconazole- 100 mg, itraconazole- 200 mg, ketoconazole- 200 mg
59
ADR of azole deriviatives
nausea, elevations of hepatitic enzymes, hepatitis
60
Terbinafine (terbinex)
alters fungal cell membrane, causing cell death, 250 mg daily for 6 weeks, or 12 weeks for toe infections, ADR- hepatitc infection

Pharmacology (61 decks)

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