Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3R1 - DALR (Categorized) 📕 > Dermatology & Andrology TTT > Flashcards

Dermatology & Andrology TTT Flashcards

1
Q

what are the advantages of topical therapy in dermatology?

A
  • Topical therapy plays a major role in dermatologic treatment.
  • It has many advantages, the most important of which is that:
    ❶ The active agent reaches the lesion directly and in a sufficient concentration
    ❷ slight or no systemic side effects.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Components of topical therapy

A

Any topical preparation consists of 2 components:

❶ Active agent: e.g., antibiotics, corticosteroids.

❷ Vehicle (base): Vehicles may have some therapeutic effects and sometimes may be used alone without the addition of active agent.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Liquid Vehicles

A
  • Example: water, alcohol, Ca hydroxide & glycerin. They are used in the preparation of solutions, lotions, tinctures, paints, creams
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Vehichles in topical therapy

A
  • Ideally a vehicle should be: Non-toxic, non-irritant and non-allergic.
  • Forms of Vehicles: Liquids, powders, creams or ointments.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Powder Vehicles

A
  • Usually applied to normal skin folds to reduce friction.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Creams

A
  • Semisolid emulsion of oil in water.
  • They are used in subacute condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ointments

A
  • Greasy base used for dry hyperkeratotic or lichenified skin disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Gels

A
  • Non-greasy transparent, semisolid emulsions that liquefy on contact with the skin, drying as a thin greaseless, non-staining film.
  • They are suitable for treating hairy areas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Uses of Topical Corticosteroids (TCS)

A

Topical corticosteroids are commonly prescribed for treatment of many skin diseases including:

❶ Atopic dermatitis
❷ Discoid eczema
❸ Contact dermatitis, seborrheic dermatitis
❹ Psoriasis
❺ Lichen planus
❻ DLE (discoid lupus erythematous)
❼ Vitiligo
❽ Alopecia areata, and many others.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Forms of Topical Corticosteroids (TCS)

A

Topical steroids are available in the form of:
- Creams
- Ointment
- Lotion

It can be mixed with salicylic acids, calcipotriene, antifungal, or antibiotics. Many OTC (over the counter preparations) are also available containing TCS, antifungal, and antibacterial.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Classification of Topical Corticosteroids (TCS)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Examples of Ultrapotent TCS

A
  • Clobetasol propionate 0.05% [Dermovate ®]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Examples of Highly potent TCS

A
  • Mometasone furoate 0.1% (Elocon , Elica)
  • Betamethasone dipropionate (Diprosone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Examples of Moderately potent TCS

A
  • Betamethasone valerate (Betnovate, Betaderm, Betaval)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Examples of Moderate/weekly potent TCS

A
  • Hydrocortisone butyrate (Texacort)
  • Prednicarbate (Dermatop)
  • Alclometasone dipropionate 0.05% (perderm, weak)
  • Hydrortisone acetate (the weakest TCS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Examples of Combination TCS

A
  • Momenta (contain potent TCS)
  • Kenacomb, quadriderm, pandermal (contain moderately potent TCS)
  • Fucicort cream, Fusizon cream (contain moderately potent TCS)
  • Daktacort (contain hydrocortisone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Side effects of TCS

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Systemic side effects of TCS

A
  • Growth retardation in children
  • Iatrogenic Cushing syndrome.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what causes side effects by TCS?

A
  • prolonged use of more potent steroids especially on: Delicate skin including child skin (any site), face, flexures, and genitalia.
  • Even hydrocortisone acetate can produce skin atrophy with prolonged use especially on thin skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Prescription of TCS

A
  • TCS are used once daily in most of cases.
  • Ultrapotent TCS and potent CS should not be prescribed by general practitioner.
  • Any type of TCS should not be prescribed without definite diagnosis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Treatment of impetigo

A
  • Topical
  • Systemic antibiotic
  • Treatment of predisposing factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Topical treatment of impetigo

A

for mild and localized infection.

  • Removal of the crust by olive oil.
  • Antiseptic lotion, e.g., K. permenganate.
  • Antibiotics, e.g., e.g., Mupirocin 2%, 2% fucidic acid, or neomycin- bacitracin,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Systemic antibiotics for treatment of impetigo

A
  • B-lactamase-resistant penicillin
    (e.g.or dicloxacillin or amoxicillin/clavulinic acid) or flucloxacillin 1-1.5gm/d (infant, children 25-50mg/d)
  • first-generation cephalosporin (e.g. cephalexin or cefadroxil).
  • Clindamycin or Azithromycin if the patient is sensitive to penicillin. or erythromycin 1g/d (40mg/kg in infants and children)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Dose and indications of antibiotics in impetigo

A
  • They are given for 7-10 days and are indicated in:
  1. Extensive lesions.
  2. Fever.
  3. Regional lymphadenitis.
  4. Bullous impetigo.
  5. Nephrogenic strain of streptococcal impetigo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Treatment of predisposing factors in cases of impetigo

A
  • When pediculosis is present, it should be treated topically after control of impetigo because pediculocidal drugs are toxic, so they are not applied on raw areas.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment of Furunculosis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Treatment of carbuncle

A
  • Penicillinase resistant penicillin.
  • Surgical incision & drainage of pus.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Treatment of erysipelas and cellulitis

A
  1. Rest and antipyretic (usually paracetamol) with leg elevation.
  2. Penicillin for 10-14 days is the drug of choice.
    - Aqueous penicilin C: for severe cases 600,000-2000,000 unt IV/6hr.
    - Oral penicillin: for mild cases 250-500 mg/6hr. For 10days.
    - Benzathine P: for rec. cases. 1,200,000 U. I.M/2-4ws for ms or ys
    - Erythromycin: 1-2 gm/day for 10 days.
  3. Erythromycin: is an alternative therapy for those who are allergic to penicillin.
  4. Antibiotics that covers both strept and staph are recommended in cellulitis (e.g. dicloxacillin, cephalexin, clindamycin, or combinations).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Treatment of Streptococcal intertrigo

A
  • Topical antiseptic.
  • Topical & systemic antibiotic.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Etiology, predisposing factors & treatment of angular cheilitis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Treatment of erythrasma

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treatment of Lupus vulgaris

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Treatment of leprosy

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Antifungal drugs

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Absorption of Amphotericin B

A
  • poorly absorbed from the GIT and is usually administered IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Category of Amphotericin B

A

B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

MOA of Amphotericin B

A
  • Amphotericin B binds ergosterol in fungal cell membrane&raquo_space; form pores in cell membrane&raquo_space;>cell content leak out»> cell death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Pharmacokinetics of Amphotericin B

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Side effects of Amphotericin B

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Forms of Nystatin

A

available as suspension, ointment, cream, powder and tablet (tablet for local use)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Uses of Nystatin

A
  • only topically in Candida infections.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Other Uses of Nystatin

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Side effects of Nystatin

A
  • They include nausea and bitter taste.
  • Category A in pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Category of Nystatin

A
  • Category A in pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Examples of Azoles

A

Topical:
- Miconazole
- Clotrimazole

Systemic:
- Ketoconazole
- Fluconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Uses of Miconazole & Clotirazole

A

They are used topically for
- Dermatophytic (tinea)
- Candida infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Forms of Miconazole & Clotirazole

A

They are available as
- cream, gel, lotion
- solution, spray
- vaginal pessary, etc.
- Clotrimazole lozenge is also available.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Characters of Ketoconazole

A
  • It is orally effective
  • Ketoconazole is the most toxic among azoles, but it is less toxic than amphotericin B.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Side effects of Ketoconazole

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Administration of Fluconazole

A

For oral and i.v. administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Indications for Fluconazole

A

Fluconazole is a drug of choice in
- esophageal and
- oropharyngeal candidiasis.

A single oral dose usually eradicates vaginal candidiasis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Drug interactions of azoles

A
  • All azoles inhibit the hepatic CYP450 3A4 isoenzyme to varying degrees.
  • Patients on concomitant medications that are substrates for this isoenzyme may have increased concentrations and risk for toxicity (e.g warfarin).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Contraindications of azoles

A
  • Azoles are considered teratogenic, and they should be avoided in pregnancy unless the potential benefit outweighs the risk to the fetus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Uses of Terbinafine

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Side effects of Terbinafine

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Side effects of Griseofulvin

A

disulfiram-like reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Uses of Griseofulvin

A
  • Active only against dermatophytes (orally,not-topically)
  • by depositing in newly formed keratin and disrupting microtubule structure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

MOA of Echinocandins (Caspofungin & other fungins)

A

Inhibit the synthesis of beta-1,2 glucan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Uses of Echinocandins

A
  • A critical component of fungal cell walls (not membrane)
  • Back-up drugs given IV for disseminated and mucocutaneous Candida infections or invasive aspergillosis
  • Monitor liver function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are the most commonly used antifungal drugs for oral candidiasis?

A
  • Clotrimazole, nystatin and fluconazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Antifungal drugs used in pregnancy

A
  • Nystatin and amphotericin B can be used in pregnancy but azoles are better avoided
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What are antifungal drugs used in systemic fungal infections?

A

Azoles, amphotericin B and caspofungin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Indication of Topical azoles

A

dermatophytes and candida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Indication of Amphotericin B

A

systemic fungal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Indication of Fluconazole

A
  • esophageal &oropharyngeal candidiasis
  • vaginal candidiasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Indication of Griseofulvin & Terbinafine

A
  • dermatophytes only
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Indication of Echinocandins

A
  • Disseminated candidiasis
  • mucocutaneous candidiasis
  • Invasive aspergillosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Indication of Nystatin

A
  • candidal infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Route of adminstration of Amphotericin B

A

IV infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Route of adminstration of Ketoconazole & griseofulvin

A

Oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Route of adminstration of Fluconazole

A

Oral & IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Route of adminstration of Echinocandins

A

IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Treatment of T.Capitis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

TTT of T.Barbae

A

Similar to tinea capitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

TTT of T.Corporis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

TTT of T.Cruris

A

Similar to T. Circinata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

TTT of T.Pedis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

TTT of T.Manum

A

Similar to T.Pedis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

TTT of Onchyomycosis (T.Unguium)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Topical antifungals for dermatophyte infections

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Systemic antifungals for dermatophyte infections

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

TTT of Pityriasis Versicolor

A

Topical & Systemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Topical TTT of Pityriasis Versicolor

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Systemic TTT of Pityriasis Versicolor

85
Q

TTT of candida

A
  • TTT of predisposing factors
  • Topical
  • Systemic
86
Q

Topical TTT of Candida

87
Q

Systemic TTT of Candida

88
Q

TTT of Reactivated HS

89
Q

TTT of Chicken Pox (Varicella)

A

symptomatic TTT & Systemic Anticirals

90
Q

Symtomatic TTT of Chicken Pox (Varicella)

A

Required for most children (immunocompetent) (no specific treatment)

  • Antipyretic for fever:(avoid salicylate).
  • Antihistamine for itching.
  • Antibiotic for secondary infection.
  • Topical antiseptic.
91
Q

Systemic TTT of Chicken Pox (Varicella)

A
  • Acyclovir or Valacyclovir (which must be given within
    24-72 hours of onset of lesion).
92
Q

Indications of Systemic TTT in Chicken Pox (Varicella)

A
  • Immunocompromised patients .
  • Varicella in pregnant woman.
  • Severe varicella in immunocompetent children
  • Neonatal varicella (Acyclovir IV Infusion)
93
Q

Prophylaxis from Chicken Pox (Varicella)

A
  • Varicella-zoster immune globulin: immediate post exposure prophylaxis
  • Live attenuated varicella vaccine (Varivax®): routine vaccination (active immunity).
94
Q

TTT of pregnant woman with Chicken Pox (Varicella)

A
  • IV acyclovir
  • women who are not immune to varicella but are exposed may be treated with VZIG
95
Q

Category of acyclovir

A

Category B

  • Safe in pregnancy(category B) Fetal risk not demonstrated in animal studies but there are no controlled studies in pregnant women, or animal reproduction studies have shown an adverse effect that was not confirmed in controlled studies in women during first trimester and there is no evidence of risk in later trimesters)
96
Q

TTT of infant with Chicken Pox (Varicella)

A
  • Infants whose mothers develop varicella 5 d. before delivery or 2 d. following delivery should receive VZIG after birth.
  • Infants who develop varicella during the first 2 w. of life should be treated with IV acyclovir.
97
Q

Dose of VZIG in Chicken Pox (Varicella)

98
Q

TTT of Herpes Zoster (shingles)

A
  • Topical
  • Systemic
  • TTT of PHN
99
Q

Topical TTT of Herpes Zoster (shingles)

A
  • antiseptic, antibiotic.
100
Q

Systemic TTT of Herpes Zoster (shingles)

A
  • Must be given within 7 days after the onset of skin lesions.
  • Acyclovir, Famciclovir and Valacyclovir
101
Q

Indications of Systemic TTT of Herpes Zoster (shingles)

A
  • Patient older than 50 years.
  • Immunocompromised patients.
  • Ophthalmic zoster.
  • Ramsay Hunt syndrome.
  • Antibiotic: For neuralgic pain: (Tegretol 200-800mg/d, tryptizol 25-100mg/d, neurosurgical advice)
102
Q

TTT of PHN

A
  • Gabapentin (Neurontin® or pregabalin)
  • Tricyclic antidepressants (CA) as Amitriptyline (tryptizol 25-100mg/d) and nortriptyline.
  • Carbamazepine(Tegretol 200-800mg/d)
  • Other lines: lidocaine patches, narcotic analgesics, and nerve blocks + Neurosurgical advice
103
Q

TTT of Pityriasis Rosea

A
  • Reassurance.
  • Avoid soap, hot bath and woolen clothing.
  • Antihistamines for itching.
  • Antipruritic topical agent or mild steroid for irritable lesions.
  • UVR.
104
Q

TTT of Warts

A

Because of the benign and self-limited nature of warts, aggressive treatments that cause scarring should be avoided especially in children

  • Electrocautery
  • Cryotherapy
  • Chemicalcautery
  • Others
105
Q

Elctrocautery in Warts

A
  • Used in painful and resistant warts, but carries risk of scarring.
  • NOT used in
    1. plantar wart
    2. larger wart more than 1cm
    3. warts on the small joints of toes and fingers
    4. large periungual warts (nail dystrophy).
106
Q

Cryotherapy in TTT of Warts

A
  • Using coz snow or liquid nitrogen, cause destruction by freezing
107
Q

Chemical Cautery in TTT of warts

108
Q

Other methods used in TTT of warts

109
Q

TTT of Anogenital wart

110
Q

TTT of Planter wart

A

Salicylic acid, if multiple use formalin

111
Q

TTT of Common wart

A

Salicylic acid, Imiquimod

112
Q

TTT of Condyloma Accuminata

A

Podophyllin, if resistant use interferon

113
Q

TTT of Plane wart

A

Retinoic topical, Imiquimod

114
Q

TTT of Resistant & Multiple warts

A

Levimizole

115
Q

TTT of Anogenital wart

116
Q

Prevention of Warts

A

proactive vaccine for genital HPV infection

117
Q

TTT of Mulluscum Contagiousm

118
Q

Classes of Antiretroviral drugs

A
  • Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
  • Non-nucleoside Reverse Transcriplase Inhibilors NNRTIs)
  • Protease Inhibitors (Pls)
119
Q

MOA of Nucleoside Reverse Transcriptase Inhibitors (RTIs)

120
Q

Examples of Nucleoside Reverse Transcriptase Inhibitors (RTIs)

A

Nucleoside Reverse Transcriptase Inhibitors (NRTIs):
- Zidovudine [Azidothymidine (AZT)]

Other Nucleoside Reverse Transcriptase Inhibitors (NRTIs):
- Didanosine, Stavudine, Emtricitabine and Lamivudine

121
Q

Uses of Zidovudine [Azidothymidine (AZT)]

122
Q

AE of Zidovudine [Azidothymidine (AZT)]

A

The common side effects:
- Bone marrow suppression, anaemia and neutropenia.

Initial stages of therapy commonly seen:
- Nausea, vomiting, abdominal discomfort, headache, and insomnia

Long-term therapy:
- May cause hepatotoxicity, myopathy with fatigue and lactic acidosis.

123
Q

Uses of Didanosine, Stavudine, Emtricitabine and Lamivudine

A
  • They are effective orally.
  • Lamivudine is a commonly used agent in antiretroviral therapy because of its efficacy and low toxicity.
124
Q

AE of Didanosine, Stavudine, Emtricitabine and Lamivudine

A

1- peripheral neuritis
2- pancreatitis, gastrointestinal disturbances
3- lactic acidosis
4- skin rashes, etc.

125
Q

Examples of Non-nucleoside Reverse Transcriplase Inhibilors NNRTIs)

A

Nevirapine & Efavirenz

126
Q

MOA of Non-nucleoside Reverse Transcriplase Inhibilors NNRTIs)

127
Q

AE of Non-nucleoside Reverse Transcriplase Inhibilors NNRTIs)

A

1- Skin rashes, pruritus.

2- Fever, nausea.

3- CNS disturbances like headache, confusion, insomnia, bad dreams, amnesia, etc.

128
Q

Examples of Protease Inhibitors (Pls)

A

Lopinavir, Saquinavir, Ritonavir (navir)

129
Q

MOA of Protease Inhibitors (Pls)

130
Q

AE of Protease Inhibitors (Pls)

131
Q

Drug interactions of Protease Inhibitors (Pls)

A
  • Drug interactions are a common problem for PIs, because they potent inhibitors of CYP450 isoenzymes.
  • Drugs that rely on metabolism for their termination of action on CYP450 isoenzymes, may accumulate to toxic levels.

Examples of potentially dangerous interactions with PIs include excessive bleeding with warfarin

132
Q

Introduction to Treatment of HIV Infection

A
  • Retroviruses contain RNA-dependent DNA polymerase (reverse transcriptase) enzyme.
  • They cause selective depletion of CD4 cells leading to a profound decrease in cell-mediated immunity.
  • Hence, the infected person is prone to severe opportunistic infections and lymphoid malignancies.
133
Q

Objectives of anti-HIV therapy

134
Q

Regimens in anti-HIV therapy

135
Q

How require prophylactic therapy to HIV?

A
  • Doctors, nurses, technicians and other healthcare workers who have had accidental exposure to HIV infection with surgical instruments, blood transfusion or needle-prick injury
136
Q

Principles of anti-HIV therapy

137
Q

The need of HIV PEP depens on ……

A

The need for postexposure prophylaxis (PEP) depends on
1. The degree of exposure to HIV (viral load)
2. The HIV status of the exposure source.

138
Q

Basic & Expanded regimens in prophylaxis of HIV

139
Q

Activity, Clinical Uses of Acyclovir

140
Q

MOA of Acyclovir

A
  • Monophosphorylated by viral thymidine kinase (K),
  • Then further bioactivated by host-cell kinases to the triphosphate
  • Acyclovir triphosphate is both a substrate for and inhibitor of viral polymerase when incorporated into the DNA molecule
141
Q

AE of Acyclovir

A
  • Minor with oral use
  • More obvious with IV
  • Crystalluria (maintain full hydration) and neurotoxicity (agitation, headache, confusion)
  • Acyclovir is not hematotoxic
142
Q

MOA of Ganciclovir

A

Similar to that of acyclovir First phosphorylation step is viral-specific; involves :
1. thymidine kinase in HSV

  • phosphotransferase (UL97) in cytomegalovirus (CMV)
  • Triphosphate form inhibits viral DNA polymerase and causes chain termination
143
Q

Activity, Clinical Uses of Ganciclovir

A

Of Ganciclovir

  • HSV, VZV, and CMV
  • Mostly used in prophylaxis and treatment of CMV infections, including retinitis, in AIDS and transplant
144
Q

AE of Ganciclovir

A
  • Dose-limiting hematotoxicity (leukopenia, thrombocytopenia),
  • Mucositis, fever, rash, crystalluria(maintain hydration);
  • Seizures in overdose
145
Q

TTT of Scabies

A
  • General Treatments
  • Topical Scabicides
  • Systemic Scabicidies
146
Q

Topical Scabicides in TTT of Scabies

147
Q

Systemic TTT of Scabies

148
Q

General Measures During TTT of Scabies

A
  • Boiling of cloths, bed linens, towels.
  • The mites cannot survive at temperature about 50°C for longer than 5min.
  • It cannot survive at room temperature in blanket or clothing for more than 2w
  • Treatment of all members of the family except in animal scabies.
  • Treatment of infested animals.
149
Q

TTT of Nodular Scabies

A

1- Intralesional injection of steroid
2- Surgical excision.

150
Q

TTT of Pediculosis

151
Q

TTT of Urticaria

152
Q

TTT of Atopic Dermatitis

153
Q

TTT of Atopic Dermatitis

A
  • General Measures
  • Regular Emollient therapy
  • Topical Anti-inflammatory Therapy
  • Systemic therapy
154
Q

General Measures of Atopic Dermatitis

A
  • Avoid exposure to irritants, wool, synthetic cloths or other rough fabrics, dust mites.
  • Careful drug taking is advised particularly with penicillin, antitetantic serum and other drugs known to induce anaphylactic reaction.
155
Q

Regular Emolient Therapy in Atopic Dermatitis

A

(ointment or water in oil creams): Basic line in treatment of all cases.

156
Q

Systemic Therapy in Atopic Dermatitis

157
Q

Topical Anti-Inflammatory therapy in Atopic Dermatitis

A
  • Topical corticosteroids ointment: the main line
  • Topical calcineurin inhibitors (CIs) : Tacrolimus 0.03% and 0.1% ointment and pimicrolimus 1% cream.
  • Zinc oxid cream
158
Q

Side effects of TCS

159
Q

TTT of Pompholyx

A

Topical:
- Drying lotion.
- Topical steroid.

Systemic:
- Antibiotic.
- short course steroid.

160
Q

TTT of Pityriasis Alba

A

topical emollient.

161
Q

TTT of Infective Dermatitis

A
  • Topical drying lotion: KMn04,saline.
  • Topical Abic-steroid combination
  • Systemic Abic.
162
Q

TTT of Contact Dermatitis

163
Q

TTT of Erythema Multiforme

A

1- Elimination of cause

2- Symptomatic and supportive

3- prevention (Recurrent cases):
Oral acyclovir (400 mg twice daily for 6 months) to prevent recurrence of herpes associated E.M

164
Q

TTT of Erythema Nodosum

A

1- Treatment of the cause.

2- Bed rest and supportive bandages.

3- Non-steroidal anti-inflammatory drugs (NSAIDs)

4- potassium iodide for 2 weeks in severe cases

165
Q

TTT of drug reactions

A
  • Elimination of the offending drug
  • Symptomatic treatment:
    1. Antihistamines.
    2. Topical steroid.
    3. Systemic steroids in severe cases.
166
Q

TTT of Epidermal Necrolysis

A
  • Early(immediate) withdrawal of suspected drugs.
  • Rapid initiation of supportive care in intensive care burn unit
167
Q

TTT of Pemphigus vulgaris

A
  • Refer to dermatologist
  • Systemic steroids & immunosuppressive (cytotoxic) drugs.
168
Q

TTT of Psoriasis

A
  • Topical
  • Phototherapy
  • Systemic
169
Q

Topical TTT of Psoriasis

A
  • Steroids
  • Salicylic Acid
  • Tar
  • Calcipotriol (vitamin D analogue)
170
Q

when is Tar Contraindicated in Psoriasis?

A
  • Application on face, flexures & genitals.
  • Erythroderrnic and generalized pustular psoriasis.
  • Severe acne & folliculitis.
171
Q

Steroids In TTT of Psoriasis

A
  • Antimitotic & anti-inflammatory. (Topical, intralesional)
  • They are applied alone or in combination with salicylic acid.
  • Intralesional injection of steroid is used in localized small resistant lesion.
  • Also, it is used for nail psoriasis by injection in the nail fold. However.
172
Q

Salicylic acid in TTT of Psoriasis

A
  • Keratolytic agent which is used to remove the scales. It is usually used in combination with steroid, tar or anthralin.
173
Q

Calcipotriol in TTT of Psoriasis

A

(vitamin D analogue)

  • It inhibits proliferation of keratinocytes.
  • It is applied twice daily with maximum dose of 100 gm weekly for 6 week
  • This drug may increase serum calcium.
174
Q

Tar in TTT of Psoriasis

A

Antimitotic 2-5% tar ointment is applied at night, and then removed in the next day by mineral oil before exposure to UVB. (goekerman technique)

175
Q

Phototherapy in TTT of Psoriasis

A
  • UVB (broad band or narrow band) exposure 3 times weekly in mildly erythemogenic dose.
176
Q

Systemic Therapy in TTT of Psoriasis

A
  • Methotrexate. (given once weekly, hepatotoxic and myelotoxic)
  • PUVA (psoralen+ UVA).
  • Retinoids (acitretin), etretinate: teratogenic.
  • Cyclosporine: nephrotoxic.
  • Biologic therapy as TNFa blockers (as adalimumab, etanercept) and IL-17 antagonists (as sekicinumab)
177
Q

Indications of Systemic Therspy in TTT of Psoriasis

A

should be used only by specialist in:

  • Extensive psoriasis vulgaris not responding to topical therapy.
  • Erythrodermic psoriasis.
  • Pustular psoriasis.
  • Arthropathic psoriasis
178
Q

Why are Systemic corticosteroids absolutely contraindicated in psoriasis vulgaris?

A

Cause flare at withdrawl

179
Q

TTT of Lichen Planus

180
Q

TTT of Discoid lupus erythematosus (DLE)

181
Q

Systemic TTT of Discoid lupus erythematosus (DLE)

A
  • Antimalarial drugs as hydroxychloroquine in cases not responding to topical steroid.
  • Prednisone 15 mg/d.
  • Etretinate
182
Q

Introduction to TTT of SD

183
Q

2 steps regimen in TTT of SD

184
Q

TTT of Infantile SD

185
Q

TTT of Acne Vulgaris

186
Q

Topical in TTT of Acne Vulgaris

A
  • Comedolytic agents
  • Antibacterial agents
187
Q

Comedolytic agents in TTT of Acne Vulgaris

188
Q

what is cornerstone in acne ttt?

A

Topical retinoids

189
Q

AV = Acne Vulgaris

Topical retinoids in TTT of AV

A

Retinoic acid (0.05-0.1%) is used in gradually increasing concentration

190
Q

SE of Topical retinoids in TTT of AV

A

It may cause dryness & irritant dermatitis. (Most common side effect)

191
Q

what are examples of Topical Retinoids?

192
Q

Antibacterial agents in TTT of AV

193
Q

Characters of Benzoyl peroxide (BPO) (2.5, 5, 10)%

A
  • no resistance has mild comedolytic effect.
  • It may cause contact dermatitis.(irritant)
194
Q

what are topical antibiotics used in TTT of AV?

A

erythromycin and clindamycin are effective in pustular lesions. (not alone)

195
Q

Indication for topical TTT of AV

196
Q

Systemic TTT of AV

A
  • Antibiotics
  • Antiandrogens
  • Isotretinoin
  • Dapsone
  • Miscellanous therapy
  • TTT of scars
197
Q

what is the systemic antibiotic of choice in acne?

A
  • Doxycycline: 100mg/day is the antibiotic of choice in acne.
  • This dose is given until acne clears then dec. the dose gradually for 6 months
  • Erythromycin and Azithromycin are good alternatives.
  • clindamycin
198
Q

MOA of antibiotics in systemic TTT of AV

A
  • Reduce inflammation
  • Reduce P: acne population> reducing bacterial production of inflammatory factors as FFA
  • Intrinsic anti-inflammatory
  • Reduce PMN (poly morphonuclear leukocytes) migration
199
Q

Indication of using of antiandroges on TTT of AV

A

used only in females with severe nodulocystic acne

200
Q

Examples of antiandroges used in TTT of AV

A

1- contraceptive as Yasmin

2- Cyproterone acetate (with OCPs diane)

3- Spironolactone (K sparing diuretic but has
antiandrogen effect)

201
Q

Effects of isotretinoin used in systemic TTT of AV

A
  • It decreases sebum secretion
  • Decrease P. acne.
  • Decrease follicular hyperkeratosis
  • has anti-inflammatory effect
202
Q

AE of isotretinoin used in systemic TTT of AV

A

It is teratogenic drug with serious side effects, so it should be used only in severe acne and by highly experienced dermatologists.

203
Q

Dapsone Systemic TTT of AV

A

Anti-inflammatory drug used in severe acne with special precautions.

204
Q

Miscellaneous therapy

Systemic TTT of AV

A

Comedonae removal:
- If comedones are resistant

intralesional steroids:
- Triamcinolone acetonide (2-5 mg/ml)
- Used for large inflammatory nodules/cysts

205
Q

TTT of scars

Systemic TTT of AV

A
  • Dermabrasion, laser resurfacing, deeper chemical peels
  • Filler substances
  • Punch excision (ice-pick) scar
206
Q

Treatment according to the severity of acne can be given as follow (overview)

207
Q

TTT of Miliaria (Sweat rash)

208
Q

TTT of Alopecia Areata

209
Q

TTT of Vitiligo

Y3R1 - DALR (Categorized) 📕 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions