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Skin/MSk > Exam 3 dermatological therapeutics > Flashcards

Exam 3 dermatological therapeutics Flashcards

1
Q

What is drug delivery dependent on?

A

Skin type, skin condition, lipid vs. water-based vehicle, charge, concentration gradient

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2
Q

What is the rate limiting step of topical therapy absorption?

A

The stratum corneum

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3
Q

What increases absorption of topical treatments through the skin?

A

Hydration of the skin

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4
Q

What are the actions of corticosteroids?

A

Anti-inflammatory, immunosuppressive, anti-proliferative, vasoconstrictive

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5
Q

What can corticosteroids be used for?

A

eczema, contact dermatitis, psoriasis, itch, lichen planus

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6
Q

What are adverse side effects of corticosteroids

A

Skin atrophy (thinning), striae, acne, suppression of the HPA (hypothalamus, pituitary, adrenal) axis

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7
Q

Explain the levels of corticosteroid strength

A

1 is for very thick skin, 7 is for very thin skin and babies

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8
Q

What are retinoids in terms of their background?

A

vitamin A analoges

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9
Q

How do retinoids work?

A

working through nuclear receptors on DNA causing alteration of gene transcription

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10
Q

What is the action of retinoids?

A

regulate cell growth, inhibit carcinogenesis, alter enzymes involved with cellular differentiation

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11
Q

What can retinoids be used for?

A

acne, psoriasis, cosmetic skin improvement (reduction of fine wrinkles and pigmentation)

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12
Q

What are the side effects of retinoids?

A

dryness, irritation, sun sensitivity

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13
Q

What is calcipotriene

A

Vitamin D analog that acts through DNA receptors to alter skin differentiation

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14
Q

What are the uses for calcipotriene

A

psoriasis (localized), eczema

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15
Q

What are side effects of calcipotriene?

A

irritation, increased serum calcium

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16
Q

What are topical antimicrobials used for?

A

wounds, acne, fungal infections, rosacea

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17
Q

What do non-steroidal anti-inflammatories (topical calcinuerin inhibitors) work through?

A

calcineurin to alter T-cell activation

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18
Q

What are the uses for non-steroidal anti-inflammatories (topical calcinuerin inhibitors)

A

Eczema around the eyes, dermatitis

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19
Q

What sun rays are the best to block for sunscreen?

A

UVA and UVB

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20
Q

What new sunscreens help to block UVA rays?

A

avobenzone/helioplex or mexoryl

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21
Q

What is so special about titanium and zinc oxide for blocking sun rays?

A

they stay on the skin and do not get absorbed so they block longer

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22
Q

How does Imiquimod/aldara cream work?

A

increase local immune activity through toll receptors

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23
Q

What is imiquimod used for?

A

condyloma, actinic keratosis, BCC, common warts, molluscum, in situ cancer

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24
Q

what can topical 5-fluorouracil be used for?

A

actinic damaged skin cells; actinic keratosis,

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25
Q

How does 5-flourouracil work?

A

inhibits thymidylate synthase resulting is reduced DNA synthesis

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26
Q

How do systemic retinoids work?

A

by repairing disordered keratinization

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27
Q

What can systemic retinoids be used for?

A

acne, psoriasis, ichthyosis, Darier’s disease, chemoprophylaxis of skin cancer

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28
Q

What are two systemic retinoids?

A

isotretinoin, acitretin

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29
Q

What are side effects of systemic retinoids?

A

teratogenicity (don’t use during pregnancy), depression, arthralgia, hair loss

30
Q

What labs should be ordered with retinoids?

A

Lipids, LFT, HCG

31
Q

What kind category is dapsone in?

32
Q

What can dapsone be used for

A

Leprosy therapy, dermatitis herpetiformis, linear IgA disease, bullous lupus, Sweet’s syndrome, spider bites

33
Q

How does dapsone work?

A

inhibits myeloperoxidase in PMNs (affects CD11a/CD18)

34
Q

What are the side effects of dapsone?

A

Hemolysis in people with G6PD deficiency

35
Q

What labs should be done before Rx dapsone?

36
Q

What is the action of methotrexate?

A

Dihydrofolate reductase inhibitor that disrupts DNA synthesis to block cell division

37
Q

What can methotrexate be used for?

A

extensive psoriasis, CTCL, lupus

38
Q

Side effects of methotrexate

A

hepatotoxicity, myelosuppression, pneumonitis

39
Q

Labs to order before Rx methotrexate

A

CBC, LFT, Liver biopsy

40
Q

What can biological therapies be used for?

A

psoriasis, psoriatic arthritis and rheumatoid arthritis

41
Q

What proteins do Biological therapies target?

A

TNF and IL12 and IL23

42
Q

What can oral antibiotics be used for?

A

acne, folliculitis, cellulitis, rosacea, wound infection

43
Q

What can anti-vitals be used for?

A

HSV infection, cold sores, zoster

44
Q

What can antifungals be used for

A

Ring worm, athletes foot, infected foot

45
Q

What are some miscellaneous therapies that can be used for different derm disorders?

A

UV light (psoriasis, eczema, inflammatory), Minoxidil, finasteride, Liquid nitrogen (some keratoses)

46
Q

what can UV light therapy be used for?

A

psoriasis, pruritis, eczema, CTCL

47
Q

What is minoxidil used for?

48
Q

What is the action of minoxidil?

A

vasodilation and direct stimulation of hair shaft growth

49
Q

What is finasteride used for?

A

androgenic alopecia

50
Q

What is the action of finasteride?

A

Blocks 5-alpha reductase enzyme in follicles to inhibit the conversion of testosterone to dihydrotestosterone

51
Q

What can liquid nitrogen be used for?

A

Warts, actinic keratoses, skin cancer

52
Q

What are the three cycles of hair cycle?

A

Anagen, catagen, telogen

53
Q

What typically causes scarring alopecia?

54
Q

What causes androgenetic alopecia

A

Genetically determined miniaturization of follicles triggered by androgens

55
Q

What are treatments of androgenetic alopecia?

A

minoxidil, finasteride, hair transplants

56
Q

What causes telogen effluvium

A

Major stressors disrupting growth cycle of hairs causing premature shift to telogen

57
Q

What causes alopecia areata

A

Autoimmune disease where T-cells attack hair bulb

58
Q

What is treatment of alopecia areata?

A

minoxidil, anthralin

59
Q

What does alopecia areata look like?

A

Circular patches on scalp or beard. Totalis= all scalp hair lost. Universalis= all body hair lost. Looks like that basketball player who KG called a cancer patient.

60
Q

What causes secondary alopecia?

A

Chemotherapy, meds, thyroid disease, iron deficiency, nutritional disorders, renal or hepatic failure

61
Q

What usually causes tinea capitis?

A

Trichopyton tonsurans

62
Q

What is the treatment for tinea capitis?

A

Oral Grisofulvin, possibly terbinifine or itraconazole

63
Q

What form of lupus causes hair loss?

A

Discoid lupus of the scalp can destroy hair units

64
Q

Treatment of discoid lupus?

A

hydroxychloroquine

65
Q

What is pediculosis?

A

Head lice and pubic lice

66
Q

What is the treatment for pediculosis?

A

Permethrin, vaseline for eyelids, cetaphil cleansear, Remove nits, wash bedding and clothes

67
Q

What is paranychia?

A

inflammation of the nail folds

68
Q

What causes causes acute paranychia?

A

trauma, bacteria, contact dermatitis, acute eczema flair

69
Q

What causes chronic paranychia?

A

contact dermatitis, eczema, psoriasis, candida

70
Q

What organisms cause onychomycosis (tinea unguium)

A

T. rubrum, T. mentagrophytes

71
Q

How do you treat onychomycosis (tinea unguium)

A

terbinafine, intraconazole, ciclopirox

Skin/MSk (31 decks)

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