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Pharm II New Stuff Final > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Anatomy of human skin

A
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2
Q

What are Keratinocytes ?

What happens to old keratinocytes as new ones are made?

A
  • Cells that make up the basal layer of the epidermis
  • old ones migrate to the surfaces and become squamous cells that no longer multiply
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3
Q

What factors affect drug absorption and what can this lead to ?

A
  • Hydration
    • increased hydration leads to increased absorption
  • Damage to stratum corneum
    • more damage= increased absorption
  • temp/friction
    • increased t/f= increased absorption
  • Drug particle size
    • smaller, soluble drugs absorb better
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4
Q

Ointments (water in oil)

  • Pros vs. Cons?
A
  • Pros
    • most occlusive
      • Occlusive agents increase moisture levels in skin by providing a physical barrier to epidermal water loss
    • most useful for chronic lesions
    • relieves dryness, brittleness and provides protection
  • Cons
    • Greasy
    • cosmetically noticable
    • don’t apply to acute lesions
    • don’t apply to skin folds(intertriginous), burns, or hairy areas
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5
Q

Creams (oil in water)

  • Pros vs. Cons
A
  • Pros
    • most widely used
    • easily vanish when rubbed into skin
    • provides lubrication
  • Cons
    • more drying vs. ointment
    • Not occlusive
    • application mistakes
      • you apply to much
      • not rubbed in well
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6
Q

Lotions and Gels

  • Pros vs. Cons
A
  • Pros
    • cooling
    • may be good for oozing lesions
      • posion ivy
    • good for hairy areas or scalp
  • Cons
    • Drying
    • Not occlusive
    • Must be shaken well prior to use
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7
Q

For Acute lesions that are oozing, weeping, edema, itchy, red what type of vehicle would you use?

A
  • Solution
  • Powders
  • Lotions
  • Sprays
  • Bath/Soaks
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8
Q

For subacute lesions that are crusting, less oozing, itchy you use?

A
  • Creams
  • Gels
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9
Q

For Chronic inflammed lesions if its dry, red, itchy, scaling, thick you can use?

A

Ointment

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10
Q

What type of conditions would you see at these areas?

  1. Scalp
  2. Face
  3. Ears
  4. Chest or Abdomen
  5. Back
  6. Genital area
  7. Hands
  8. Feet
  9. Generalized
A
  1. Scalp= dandruff, seborrheic dermatitis
  2. Face=Acne, rosacea, seborrheic dermatitis, impetigo, herpes simplex, atopic dermatitis (eczema)
  3. Ears=Seborrheic dermatitis
  4. Chest or Abdomen =Tinea versicolor, tinea corporis, acne, herpes zoster
  5. Back =Tinea versicolor(fungal infection of the skin), tinea corporis (ring worm)
  6. Genital area =Scabies, warts, herpes simplex
  7. Hands =Scabies, warts
  8. Feet =Tinea pedis, contact dermatitis, onchomycosis
  9. Generalized =Contact dermatitis, photosensitivity
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11
Q

Explain the pathophysiology of acne ?

A
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12
Q
  • What medications do you give to normalize follicular keratinization ?
  • What medications do you give to decrease sebum production?
  • What medications do you give to suppress p.acnes?
  • What medications do you give to reduce inflammtion?
A
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13
Q

Topical Retinoids

  1. MOA?
  2. Agents available?
  3. C/I’s?
A
  1. Stimulate epidermal cell turnover and decrease cell cohesiveness (decrease kertinocytes stickiness)
    • Unplug follicles
    • Reduce inflammation
    • Tretinoin (formed from vit. A)
    • Adapalene (greater anti-inflammation then tretinoin)
    • Tazarotene (poorly tolerated)
  3. Pregnancy
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14
Q

Topical Retinoids

  1. ADR’s?
  2. Other considerations?
A
  1. irritated skin-dryness, peeling, redness, hyperpigmenation (T>A)
    • Acne gets worse before better
    • Wear sunscreen and avoid UV lights
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15
Q

Benzoyl peroxide (BPO)

  • MOA?
  • C/I?
  • ADR’s?
A
  • MOA: antimicrobial, anti-inflammatory, keratolytic effects
  • C/I: avoid use with trentinoin or use at separate times
  • ADR’s: dryness, peeling , bleaching
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16
Q

Azelaic acid

  1. ) MOA?
  2. ) Indication?

Salicyclic acid

  1. ) MOA?
  2. ) Indication?
A

Azelaic acid

  1. ) MOA-reduces p. acnes causing decreased inflammation and keratinization normalization
  2. ) Indication- if pt. cant tolerate everything else

Salicyclic acid

  1. ) MOA-keratolytic agent, lipid soluble (inc. absorption)
  2. ) Indication- less effective vs. retinoids and BPO
17
Q

Pathophysiology of Atopic dermatitis? (3 things)

A
  • epidermal and immune dysfunction
  • excessive water loss
  • IgE mediated hypersentivity rxn
18
Q

Emollients

  1. Indication?
  2. Agents available?
  3. Used in combo with?
A
  1. cornerstone of management for atopic dermatitis
  • Lanolin
  • Mineral Oil
  • Shea butter
  • Cocoa butter
    3. ) with topical steroids - apply emollient first then wait 5-15 mins then apply steroid
19
Q

Topical steroids

  1. MOA?
  2. Indication?
  3. Categorized by…..? but no single agent has been proven?
A

1.) causes vasoconstriction to minimize redness and inflammation

2.)Used for acute flares of atopic dermatitis

3.) categorized by potency but no single agent proven better than another

20
Q

What agents are in what potentcy group ?

A
21
Q
  • Considerations for High potency drugs
  • Considerations for Medium potency drugs
  • Considerations for Low potency drugs
A
22
Q

ADR’s of Topical Steroids?

A
  • Skin atrophy
  • Striae (stretch marks)
  • Rosacea
  • Hypopigmentation in darker skin tones
  • Tolerance
  • Systemic side effects
    • Adrenal supression
    • HTN
    • Hyperglycemia
23
Q

How do you apply topical steroids ?

A
24
Q

Crisaborole

  1. MOA?
  2. C/I?
  3. ADE?
  4. Vehicle?
  5. Indication?
A
  1. Non- steroid inhibitor of PDE-4 (non steroid- can be used long term)
  2. Don’t use in kids less than 2 (CrisaboroLE you must be at least 3 )
  3. buring/stinging
    1. rare: hives
  4. Ointment
  5. mild to moderate atopic dermatitis
25
Q

Pathophysiology of Psoriasis

For smaller areas of psoriasis you should be taking ? For larger areas?

A
  • immune mediated
    • t-cells cause hyperproliferation of keratinocytes
      • leads to plaque formation (dark, silver, scaly)
    • cytokines/TNF-alpha further inflammation
  • Small= topical
  • large=oral
26
Q

What are the pros and cons for each topical agent when treating psoriasis ?

  • Emollients
  • Keratolytics
  • Coal tar
  • Calcipotriene (synthetic vit D3 analong)
  • Topical steroids
A
27
Q

Calcipotriene

  1. MOA:?
  2. Can be comined with?
  3. Can help improve?
  4. ADR’s?
A
  1. inhibits epidermal keratinocyte hyperproliferation (synthetic vit. D3 analog b/c vit D3 deficiency leads to increase keratinocyte hyperproliferation)
  2. Can be combined with other treatments including steroids (steroid sparing effect)
  3. can help improve UVB light therapy (appply after not before)
  4. hypercalcemia (rare in large areas only)
28
Q

Describe each

  • UV-A
  • UV-B
  • UV-C
A
  • UV-A
    • most abudant- penetrate into deep layers of skin (wrinkles)
  • UV-B
    • absorbed into supericial layer of skin (causes suburn and inc. risk of skin cancer)
  • UV-C
    • doesnt reach eart surface
29
Q
  • SPF stands for?
  • SPF 15 protects you against
  • SPF 45 protects you against
  • How do you apply it ?
A
30
Q

Active ingrediants in sunscreens

A
31
Q

Chemical sunscreen vs physical vs broad spectrum ?

A
32
Q

waterproof sunscreen vs sweatproof sunscreen?

A

Pharm II New Stuff Final (2 decks)

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