Dermatology

Question 1

What is the subcutaneous layer/hypodermis good for?

Answer 1

Good place for storage of fat

Potential reservoir for drugs given SQ that allows the drug to slowly be released over time = insulin, growth hormones

Question 2

How do drugs get absorbed in integumentary system?

Answer 2

1) Must penetrate epidermis/dermis/hair follicles to enter dermis
2) Enter bloodstream from the dermis to circulate around the body
3) Primarily occurs through passive diffusion

Question 3

What is the composition and benefits of Lotions?

Answer 3

Mostly water; some oil

Absorbs quickly; spreads easily

Question 4

What is the composition and benefits of creams?

Answer 4

Half oil; half water

Spreads easily; moderately hydrating

Question 5

What is the composition and benefits of ointments?

Answer 5

Mostly oil; some water

Used for occlusive benefit; preferred for dry/cracked skin

Question 6

What factors effect drug absorption?

Answer 6

Drug solubility
Drug concentration
Duration of contact
Physical skin condition
Molecular weight of drug

Question 7

What must medications pass trough in order for drug absorption to occur?

Answer 7

Epidermis and reach dermis

Question 8

What are the determinants of acne?

Answer 8

Androgens
Presence of bacteria P. acnes
Fatty acids in oil glands

Question 9

What is the DOC for acne?

Answer 9

Retinoids

Question 10

What are topical retinoids?

Answer 10

Vitamin A derivatives

avoid using too much

Question 11

What is benzoyl peroxide?

Answer 11

Common OTC cleansers/creams

Question 12

What are the side effects of benzoyl peroxide?

Answer 12

Dry skin
Photosensitivity
Orange hue

Question 13

What is Salicylic acid?

Answer 13

Keratolytic

Common OTC cleansers; facial pads

Concern if these are added to retinoids

Question 14

What is isotretinoin?

Answer 14

Systemic retinoid

Decreases oil production

Question 15

What are the ADRs of isotretinoin?

Answer 15

Dry skin
Photosensitivity 
Arthralgias
Lipid and sugar dysregulation
Agitation and mood swings
Teratogenic/Category X = ipledge program

Question 16

What drugs are used in acne therapy?

Answer 16

Topical retinoids
Benzoyl peroxide
Salicylic acid
Azelaic acid
Isotretinoin
Antibiotics
Androgen related = oral contraceptives; spironolactone

Question 17

What are antibiotics used for in acne treatment?

Answer 17

Oral and systemic

Inhibits growth of the P. acnes bacteria

Question 18

What is Eczema?

Answer 18

Most common in young children and infants; can occur at any age

Presents as itchy/red/sore skin rashes which become crusted/scaly; blisters may also develop

Common locations are the insides of the elbows, back of the knees, cheeks of the face, behind the ears, and hands and feet

Question 19

What is essential in treatment of Eczema?

Answer 19

Hydration, in order to reduce disease severity and outbreaks

Question 20

What are the treatment options for Eczema?

Answer 20

Antihistamines
Topical/systemic Steroids
Topical/systemic immune supressants (tacrolimus)

Question 21

What is the DOC for eczema?

Answer 21

Topical steroids

Question 22

What is psoriasis?

Answer 22

Chronic, autoimmune disorder that manifests on the skin

Plaque psoriasis is most common type and appears as raised, red patches covered with a silvery white build of dead skin cells

Question 23

What are the three treatments strategies for Psoriasis?

Answer 23

Topical treatments = steroids, retinoids, Vitamin D analogs

Systemic medications = biologics and steroids

Light therapy

Question 24

What is the DOC for psoriasis treatment?

Answer 24

Steroids

Question 25

What is bacitracin?

Answer 25

Peptide antibiotic against Gram + organisms streptococci and staphylococci Commonly found in "triple antibiotic ointment"

Question 26

What is neosporin?

Answer 26

Neomycin Polymixin B Bacitracin

Question 27

What is Mupirocin?

Answer 27

Prescription cream/ointment similar to bacitracin Has MRSA coverage Often given intranasally to eradicate nasal colonization of MRSA in adults and healthcare workers

Question 28

What are the three classes of chemical compounds most commonly used in sunscreens?

Answer 28

Benzophenones Dibenzoylmethanes PABA + its esters

Question 29

What is UVB?

Answer 29

the sunburn radiation Major offender for burning and skin cancer

Question 30

What is UVA?

Answer 30

Suppression of immune system and DNA damage Skin cancer; also augment the carcinogenic potential of UVB

Question 31

What is Sun Protection Factor (SPF)?

Answer 31

Measures how long it takes to burn versus not using sunscreen Measures UVB only

Question 32

What is the key to SPF?

Answer 32

the SPF scale is not linear so anything over 30 really isnt' giving you much more coverage from 30 and is also most likely only covering UVB/isn't broad spectrum SPF 15 blocks 93% of UVB rays SPF 30 blocks 97% of UVB rays SPF 50 blocks 98% of UVB rays

Question 33

What is important in application of sunscreens?

Answer 33

All sunscreens wash off easily Important to reapply after going in water and at least every 2 hours

Question 34

What does water resistant mean?

Answer 34

Resistant for 40-80 minutes

Question 35

What are the guidelines for terminology on sunscreens?

Answer 35

Waterproof or sweatproof can no longer be labeled on bottles Sublock, Instant protection, and protects for more than 2 hours all require FDA approval in order to have these labels on the bottle

Question 36

What is broad spectrum coverage of sunscreen?

Answer 36

Protects against UVB and UVA