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Dermatopharmacology Flashcards

1
Q

___ are 1/2 water and 1/2 oil with an emulsifier

A

Cream

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2
Q

Indication for a cream

A

oozing “wet” skin conditions

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3
Q

Characteristics of Creams (3x)

A

1) Spread easily (good for large areas)
2) Well absorbed
3) Wash off with water

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4
Q

___- are 20% water in 80% oil

A

Ointments

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5
Q

Components of Ointments (2x)

A

1) Mineral Oil
2) Petroleum Jelly
* ** Hydrocarbons

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6
Q

Characteristics of Ointments (3x)

A

1) Greasy and Occlusive
2) Stay on skin surface
3) Not well absorbed

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7
Q

Indications of Ointments (2x)

A

1) Dry skin since they trap moisture

2) Increase absorption of active ingredient

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8
Q

Ointments or Creams are less likely to cause an allergic rxn

A

Ointments

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9
Q

When to clean hands

A

1) Before touching a patient
2) Before clean/aseptic procedures
3) After body fluid exposure
4) after touching pt
5) After touching pts surroundings

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10
Q

Alcohol-base disinfectant isn’t effective against ___

A

C. Diff

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11
Q

List the components of moisturizers

A

1) Emollients
2) Humectants
3) Horny Substances Softeners

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12
Q

Examples of Emollients (components of moisturizers) (4x)

A

1) Petrolatum
2) Lanolin
3) Mineral Oil
4) Dimethoate

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13
Q

Examples of Humectants (3x)

A

1) Glycerin (glycerol)
2) Lecithin (glycerophospholipids)
3) Propylene glycol

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14
Q

Examples of Horny Substances (3x)

A

1) alpha hydroexyacids (lactic, citric, glycolic)
2) Salicylic Acid
3) Urea

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15
Q

List the different bases for Sunscreen (3x)

A

1) PABA and its Esters
2) Benzophenones
3) Dibenzoylmethanes

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16
Q

PABA is active in the ___ range but isn’t used as much anymore due to ___ rxn

A

1) UVB

2) Hypersensitivity

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17
Q

___ are active in the UVA and UVB range and contain salicylate stabilizers

A

Benzophenones

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18
Q

List two examples of Benzophenones

A

1) Oxybezone

2) Octocrylene

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19
Q

List two examples of Salicylate Stabilizer

A

1) Homosalate

2) Octosalate

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20
Q

____ are active in the UVA range only and are useful for __ induced photosensitivity and cutaneous lupus

A

1) Dibenzoylmethanes

2) Drug

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21
Q

Active component in Sunshades-

A

Titanium Dioxide

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22
Q

___- is the ratio of minimal erythema dose with sunscreen divided by the minimal erythema dose w/o sunscreen

A

SPF

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23
Q

What is the common disinfectant that is used in hospitals

A

Chlorhexidine

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24
Q

Name the growth factor that promotes wound healing

A

Becaplermin (Platelet-Derived Growth Factor)

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25
Q

____ is a platelet-derived growth factor that promotes proliferation and angiogenesis

A

Becaplermin

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26
Q

____ is the only FDA approved drug that is used for chronic diabetic foot ulcers

A

Becaplermin

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27
Q

wound Dressings: When a wound is in the debridement stage use a ____

A

Hydrogel

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28
Q

Wound Dressings: When the wound is in the granulation stage use ___ dressing

A

Foam and low adherence

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29
Q

When the wound is in the epithelization stage use ____ dressing

A

Hydrocolloid and Low Adherence

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30
Q

List the 3 active agents in Neosporin

A

1) Bacitracin
2) Neomycin
3) PolymyxinB

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31
Q

Mechanism of Action of Bacitracin

A

Inhibits cell wall synthesis

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32
Q

Indication for Bacitracin (4x)

A

1) Gram + Organisms
2) Anaerobic Cocci
3) Neisseria
4) Tetanus Bacillus

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33
Q

Neomycin is an ___glycoside

A

aminoglycoside

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34
Q

MOA of Neomycin

A

Binds 30s Subunit to decrease protein synthesis

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35
Q

Indication for Neomycin

A

Gram Negative Organisms

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36
Q

MOA of PolymyxinB

A

Binds to phospholipids to alter membrane permeability and damage cytoplasm

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37
Q

Indications of Polymyxin B (5x)

A

1) Gram Negative Organisms
2) P. Aeruginosa
3) E Coli
4) Enterobacter
5) Klebsiella

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38
Q

Imidazoles are an anti-____ agent

A

Fungal

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39
Q

MOA of Imidazoles

A

Block ergosterol synthesis

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40
Q

Indications for Imidazoles

A

Dermatophytes and Yeast

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41
Q

List the different types of Imidazoles

A

1) Miconazole
2) Clotrimazole
3) Efinaconazole
4) Ketoconazole

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42
Q

What two agents are used for Vulvovaginal Candidias

A

1) Miconazole

2) Clotrimazole

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43
Q

What agent is used for onychomycosis

A

Efinaconazole

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44
Q

Antifungal is used for dermatophytosis, Candidiasis, and Seborrheic Dermatitis

A

Ketoconazole

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45
Q

MOA of ciclopirox

A

Disrupts macromolecular synthesis

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46
Q

Ciclopirox is a ____ spectrum antifungal

A

Broad

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47
Q

Indications for Ciclopirox

A

1) Dermatophytes
2) Candida
3) Malassezia

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48
Q

Terbinafine is an anti-____

A

Fungal

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49
Q

List all of the Antifungals (6x)

A

1) Imidazole
2) Ciclopirox
3) Terbinafine
4) Tolnaftate
5) Nystatin
6) Amphotericin B

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50
Q

MOA of Terbinafine

A

Inhibits squalene epoxidase

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51
Q

Purpose of Squalene Epozidase

A

1) Key enzyme of Ergosterol

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52
Q

indication for Terbinafine

A

1) Dermatophytes BUT NOT YEAST

2) Mucous Membranes

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53
Q

Indication for Tolnaftate

A

Dermatophyte and Malessezia

***NOT Candida

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54
Q

Which two anti-fungals can treat Malassezia

A

Ciclopirox

Tolnaftate

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55
Q

Nystatin MOA

A

Alters membrane permeability

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56
Q

Indications for Nystatin

A

1) Mucosal Candida
- Hold in mouth before swallowing
2) Cutaneous Candida

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57
Q

MOA of Amphotericin B

A

Alters membrane permeability

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58
Q

Indication of Amphotericin B

A

Candida (Cutaneous)

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59
Q

Which antifungals cannot treat Candida?

A

1) Tolnaftate (Lamisil)

2) Terbinafine (Tinactin)

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60
Q

MOA of Acyclovir

A

Synthetic Guanine Analog

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61
Q

Indication of Acyclovir

A

Orolabial Herpes Simplex virus infection

62
Q

Where should you use low potency steroid use?

A

1) Face
2) Genitals
3) Skin Folds

63
Q

Salicylic Acid is a ___ softener

64
Q

MOA of Salicylic Acid

A

Cox inhibitor

65
Q

Indications for Salicylic Acid

A

1) Calluses and Warts

2) Lichen Simplex Chronicum

66
Q

Which two agents treat Rosacea

A

1) Brimonidine

2) Oxymetazoline

67
Q

MOA of Brimonidine

A

1) Alpha2 adrenergic agonist

- stimulate post synaptic vascular a2 receptors

68
Q

MOA of Oxymetazoline

A

a1/a2 adrenergic agonist

69
Q

Which 4 agents treat eye vasodilation

A

1) Naphazoline
2) Tetrahydrozoline
3) Phenylephrine
4) Oxymetazoline (can also treat Rosacea)

70
Q

All agents that treat the eye are ___ receptor agonist

A

adrenergic

71
Q

List the four agents that kill ectoparasites

A

1) Malathion
2) Permethrin
3) Ivermectin
4) Lindane

72
Q

Malathion MOA - Ectoparasite

A

Organophosphate cholinesterase inhibitor

73
Q

Permethrin MOA - Ectoparasite

A

Insect Na+ channel, blocks repolarization

74
Q

Ivermectin MOA - Ectoparasite

A

Binds glutamate-gated Cl- channels –> hyperpolarizes nerve and muscle cell

75
Q

Lindane MOA - Ectoparasite

A

Disrupts GABAergic transmission in insects

76
Q

Which ectoparasite agent should only be used if the others fail?

77
Q

List all the possible ways that you can Generally treat Acne Vulgaris (6x)

A

1) Topical Retinoids
2) Topical Antimicrobials
3) Azelaic Acid
4) Oral Antibiotics
5) Hormonal Agents
6) Oral Retinoid

78
Q

List a Topical retinoid that is used for Acne Vulgaris

79
Q

What are the Adverse Effects of Tretinoin

A

1) Local Skin Irritation, Dryness, Flaky and sun sensitivity

80
Q

Before administering Tretinoin which is a __, you want to make sure that pts dont have a sensitivity or allergy to ___

A

1) Topical Retinoid

2) Fish

81
Q

List the Topical Antimicrobials

A

1) Benzoyl Peroxide
2) Clindamycin
3) Erythromycin

82
Q

What are the adverse effects of benzoyl peroxide

A

Local skin irritation, may bleach hair or clothing

83
Q

Clindamycin is a ____. List the adverse effects of Clindamycin.

A

1) Topical Antibiotic

2) Pseudomembranous Colitis

84
Q

Azelaic Acid MOA

A

1) Kill acne bacteria and decrease production of keratin

85
Q

Adverse effect for Azelaic Acid

A

Local skin irritation

86
Q

List all of the oral antibiotics that can treat Acne Vulgaris

A

1) Tetracycline
2) Doxycycline
3) Minocycline
4) Erythromycin
5) Azithromycin
6) Trimethoprim-sulfamethoxazole

87
Q

List the hormonal agents that can treat Acne Vulgaris

A

1) Oral Contraceptives (Estrogen/Progestin)

2) Spironolactone

88
Q

Spironolactone is indicated in ____

A

Adult women w/ menstrual acne

89
Q

Tetracycline and Doxycycline Adverse Effects

A

1) Photosensitivity

2) GI Distress

90
Q

Minocycline Adverse Effects

A

Dizziness and Drug-induced lupus and Skin coloration

91
Q

Erythromycin and Azithromycin Adverse Effects

A

Gastrointestinal Distress

92
Q

Trimethoprim-Sulfamethoxazole Adverse Effects

A

1) Steven Johnsons Syndrome

2) Toxic Epidermal Necrolysis

93
Q

List the contraindications of Tetracycline, Doxycycline, and Minocycline

A

Pregnant Women and Children

94
Q

List the contraindication of Spironolactone

95
Q

List the Oral Retinoid that is use for Acne Vulgaris

A

Isotretinoin

96
Q

MOA of Isotretinoin

A

1) Decreases cohesiveness of keratinocytes

2) Decreases Follicular occlusion and microcomedone formation

97
Q

When is Isotretinoin an absolute contraindication

A

Pregnancy - Teratogenicity

98
Q

Adverse effects of Isotretinoin (3x)

A

1) Teratogenicity
2) Mucocutaneous effects
3) Hypertriglyceridemia

99
Q

Adverse Effects of Spironolactone

A

1) Menstrual Irregularity
2) Breast Tenderness
3) Orthostatic Hypotension
4) Hyperkalemia

100
Q

Adverse Effects of Oral Contraceptives

A

1) Nausea
2) Breast Tenderness
3) Weight Gain
4) Thromboembolic Events

101
Q

List the general treatments of Psoriasis

A

1) Topical Therapies
2) UV Light Therapies
3) Systemic Therapies

102
Q

List the Topical Therapies

A

1) Emollients and Corticosteroids
2) Topical Vit D analog
3) Tar
4) Anthralin

103
Q

What is the initial choice for mild to moderate psoriasis

A

Emollients and Corticosteroids

104
Q

MOA of Topical Vit D analog in treating Psorasis

A

Decreased Keratinocyte proliferation

105
Q

MOA of Tar in treating Psoriasis

A

Decreased Proliferation

106
Q

Anthralin MOA in treating Psoriasis

A

Anti-inflammatory

107
Q

What are the two UV Light therapies that can treat Psoriasis

A

1) UVB

2) PUVA (Photochemotherapy UVA Radiation)

108
Q

MOA of UVB therapy for Psoriasis

A

Immunomodulation

109
Q

How would you administer UVB therapy with a pt who has psoriasis

A

Radiation to the point of erythema + Topical Tar

110
Q

PUVA treatment has increased ___ risk

111
Q

Pts who undergo PUVA treatment have to be protected from the ___

112
Q

MOA of PUVA therapy

A

Penetrates deep into skin w/o sunburn

113
Q

Pts must ingest photosensitizer ___ 2hr before treatment

114
Q

List the systemic therapies for Psoriasis

A

1) Apremilast
2) Ustekinumab
3) Secukinumab and Ixekuzumab

115
Q

MOA of Apremilast in treatment for Psoriasis

A

Inhibits Phosphodiesterase 4 (PDE4)

116
Q

Apremilast, treatment for Psoriasis, inhibits Phosphodiesterase 4 (PDE4). This results in ….. (2x)

A

1) Increased cAMP levels

2) Increased IL10 and Decreased inflammatory mediators

117
Q

Adverse Effects of Apremilast

A

D/N/V; Headache; Depression

118
Q

ustekinumab is an agent that treats ____. what is the MOA

A

1) Psoriasis

2) Targets IL12 and 23

119
Q

Since Ustekinumab targets ___ and ___ when treating Psoriasis systemically, what are the effects? (3x)

A

1) Decreased NK Cells
2) Decreased CD4+ T-cell
3) Decreased inflammatory molecule expression

120
Q

Adverse side effect of Ustekinumab

A

Increased risk of infections

121
Q

Secukinumab and Ixekuzumab are treatments for ___. The MOA is is targeting ____. The effects are____. The Adverse Effects are___.

A

1) Psorasis
2) IL-17A
3) Can’t produce any other inflammatory drug
4) Increased risk of infection

122
Q

When wanting to treat a mild comedonal acne what is your 1st choice

A

Topical Retinoid

123
Q

When wanting to treat Mild mixed papular/pustular acne what is your 1st choice

A

1) Topical Retinoid + Topical Antimicrobial

124
Q

When wanting to treat moderate mixed papular and pustular ance what is the 1st choice

A

1) Topical Retinoid + Oral Antibiotic

2) +/- BPO

125
Q

When wanting to treat moderate nodular acne what is your 1st choice

A

1) Oral Antibiotic
2) Topical retinoid
3) BPO

126
Q

When Treating Severe Nodular/Conglobate acne what is your 1st choice

A

Oral Isotretinoin

127
Q

What is the first choice of topical antimicrobials

A

Benzoyl Peroxide

128
Q

What is the first choice in terms of oral antibiotics

A

Tetracyclin and its family

129
Q

How would you treat Hypertropic Actinic Keratosis?

A

Topical 5-flurouracil

130
Q

List the 4 other agents other than Topical 5-flurouracil that can treat Hypertropic Actinic Keratosis

A

1) Imiquimod
2) Ingenol mebutate
3) Topical Diclofenac
4) Retinoids

131
Q

Topical diclofenac is a __

132
Q

Melanoma Treat consists of ____ (3x)

A

1) Surgical
2) Chemo
3) MAP Kinase Pathway Inhibitor

133
Q

Dacarbazine is a chemo agent that treats ____

134
Q

What chemo agent treats melanoma

A

Dacarbazine

135
Q

What is the MAP Kinase Pathway inhibitor that inhibits the mutated BRAF gene in melanoma

A

Vemurafenib

136
Q

Vemurafenib is a ___ kinase pathway inhibitor that inhibits mutated ____ gene in Melanoma

A

1) MAP

2) BRAF

137
Q

For advance BCC physicians use __ or ___ for treatment

A

1) Vismodegib

2) Sonidegib

138
Q

MOA of Vismodegib and Sonidegib is

A

1) Oral hedgehog signaling pathway inhibitors

139
Q

What are the topical meds that treat BCC and SCC

A

1) Imiquinimod

2) 5-Fluorouical

140
Q

What is the MOA for Imiquimod

A

Immune response modifier (triggers toll like receptors) –> Inflammatory cell infiltration

141
Q

Male Pattern Baldness 1st line of defense is

142
Q

MOA of Minoxidil

A

1) Vasodilates due to K+ channel opening
- Increases duration of anagen (growth phase)
- Shortening Telogen (rest phase
- Leads to enlargement of follicle

143
Q

Alterantive treatment for Male pattern baldness is _______

A

Finasteride

144
Q

MOA of Finasteride

A

Inhibits dihydrotestosterone (DHT) production –> increase hair count

145
Q

Which treatment of male pattern baldness can cause sexual dysfunction

A

Finasteride

146
Q

List the two agents that can treat Male pattern baldness

A

Minoxidil

Finasteride

147
Q

What is the first line for female hair loss

148
Q

What is the second line of defense for female hair loss if Minoxidil fails

A

Anti-Androgens

149
Q

List the Anti-Androgens that can treat female baldness

A

1) Spironolactone ( androgen partial agonist)
2) Finasteride (block dihydrotesttosterone syn)
3) Flutamide (androgen antagonist)

150
Q

____ is chronic relapsing immune-medatiated inflammatory disorder affecting hair follicle

A

Alopecia Areata

151
Q

List the treatments for Alopecia Areata

A

1) Corticosteroids

2) Topical Immunotherapy (Diphenylcyclopropenone) (DPCP)

SBL (8 decks)

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