Integumentary Flashcards by Naomi Roth

What kind of medications are used to treat Poison Ivy?

Calamine lotion, aluminium acetate, colloidal oatmeal baths, topical or oral corticosteroids

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What are Tacrolimus and Pimecrolimus creams?

What are they used for?

They are topical immunosuppressants.

They are used to treat atopic dermatitis (eczema)

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What are side effects of topical immunosuppressants?

What are 2 major risks with taking them?

Redness, burning, itching, increased sensitivity to sunlight.
They increase risk of varicella infections in children, skin cancer, and lymphoma.

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What are topical glucocorticoids?

anti-inflammatory, antipruritic and vasoconstrictive medication used to treat various skin disorders

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Localized adverse effects of topical glucocorticoids?

Major contraindication?

Burning, dryness, irritation, itching

Clients with recurrent systemic fungal, viral or bacterial infections (reduces body’s immune response).

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Systemic adverse effects of extended use of topical glucocorticoids.
What must you monitor?

Growth retardation in children, adrenal suppression, Cushing’s syndrome, glaucoma and cataracts.
Must monitor cortisol levels.

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What are Fluorouracil, Diclofenac sodium, imiquimod 5% cream, Aminolevulinic acid, and Ingenol Mebutate used for?

These are medication used to treat Actinic Keratosis (rough, scaly skin lesions).

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What is Fluorouracil?

How long does it take to work?

A topical medication that affects DNA and RNA synthesis causing a sequence of response that promote healing.
Takes 2-6 weeks to work.

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Adverse Effects of Fluorouracil

Itching, burning, inflammation. rash, and increased sensitivity to light.

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What is Diclofenac Sodium?

How long does it take to work?

A non-steroidal antiinflammatory topical medication.

Takes up to 3 months to take effect.

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Adverse effects of Diclofenac Sodium

Dry skin, itching, redness and rash

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What is Imiquimod 5% cream?

How long does it take to work?

Topical medication that treats both actinic keratosis and venereal warts.
Takes up to 4 months to be effective.

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Adverse effects of Imiquimod cream

Redness, skin swelling, itching, burning, sores, blisters, scabing and crusting of the skin.

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What is Aminolevulinic acid?

How does it work?

Topical medication used in conjunction with phototherapy. Medication is applied and then 14-18hrs later is activated by exposing the medication to a special blue light.

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Adverse effects of Aminolevulinic acid

Burning, stinging, redness, and swelling of the skin. Treated areas are to be kept away from sunlight and bright light.

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What is Ingenol Mebutate?

Medication used to treat actinic keratosis.

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Adverse effects of Ingenol Mebutate

skin reactions, erythema, flaking/scaling, crusting, swelling, postulation, and erosion/ulceration

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What is the difference between organic and inorganic sunscreen?

Organic or chemical suncreen absorbs UV light.

Inorganic or physical sunscreen reflects and scatters UV light

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How long before sun exposure must sunscreen be applied to be most affective?

30 minutes before going out in the sun

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What is Tazarotene?

It is a vitamin A derivative used to treat psoriasis

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Adverse effects of Tazarotene

itching, burning, stinging, dry skin, and redness. May cause sensitivity to sunlight.

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What is Calcipotriene?

An analog of vitamin D used to treat psoriasis

Side effect of Calcipotriene

May cause local irritation

What is coal tar used for and how does this work?

It is used to treat psoriasis. It suppresses DNA synthesis, miotic activity, and cell proliferation.

Adverse effects of coal tar

Irritation, burning, and stinging. Increased risk for cancer in high doses.

What are keratolytics (ex: salicylic acid)?

Medication that softens scales and loosens the horny layer of the skin, resulting in minimal peeling to extensie desquamation.

Side effects of salycilic acid

Can be absorbed systematically, causing dizziness, tinnitus, hyperpnea, and psychological disturbances.

What does sulfur do and what does it treat?

Promotes peeling and drying and is used to treat acne, dandruff, seborrheic dermatitis and psoriasis.

What is methotrexate used to treat and how does it work?

Treats psoriasis by reducing proliferation of epidermal cells

Adverse effects of methotrexate | What must you monitor?

Digestive upset (diarrhea, nausea, etc), ulcerative stomatitis and bone marrow depression. Can also be hepatotoxic so must monitor liver function.

Major contraindication for most systemic skin disorder medications?

MUST NOT BE PREGNANT! | Most of them are teratogenic.

What is Acitretin?

Medication that inhibits keratinization, proliferation and differentiation of cells. Has anti-inflammatory and immunomodulatory action.

Side effects of Acitretin | What must be monitored?

Hair loss, skin peeling, dry skin, rash, pruritis, nail disorders, rhinitis, inflammation of the lips, dry mouth, bone and joint pain. Must monitor liver function, and triglyceride levels.

What is Cyclosporine?

An immunosuppressant that inhibits proliferation of B and T cells

What kind of medications are Adalimumab, Etanercept and Infliximab?

They are tumour-necrosis factor antagonists, they interrupt the inflammatory process of psoriasis.

Adverse effects of tumor necrosis factors

upper respiratory infection, abdominal pain, headache, rash, UTIs

What is Ustekinumab?

A human monoclonal antibody administered by subcutaneous route

Side effects of Ustekinumab

Upper respiratory tract infections, headache, tiredness, redness at injection site, back pain and fatigue.

What is Secukinumab?

It is a human interlukin-17A antagonist. Blocks cytokines to interrupt the inflammatory cycle of psoriasis.

Adverse effects of Secukinumab

Cold symptoms, diarrhea, and upper respiratory infections

What are Benzoyl peroxide, Cindamycin and Dapsone?

They are topical antibiotics that are used to treat acne.

What is Tretinoin? | What is it used for?

A derivative of vitamin A. used to treat acne, as well as fine wrinkles, skin roughness, and hyperpigmentation.

Adverse effects of Tretinoin

blistering, peeling, crusting, burning and swelling of the skin

What is Adapalene?

Similar to Tretinoin (vitamin A derivative) and sensitizes the skin to UV light.

What is Tazarotene? | What is it used for?

It is a derivative of vitamin A. | Used to treat acne, wrinkles and psoriasis.

What is Azelaic acid?

A topical retinoid used to treat acne

What is Isotretinoin? | What is used for?

Derivative of vitamin A. Used to treat severe cystic acne in persons who have not responded to other therapies.

Adverse effects of Isotretinoin | What must you monitor?

Nosebleeds, inflammation of lips or eyes, dryness or itching, stiffness of joints, rash, hair loss. Must monitor triglyceride levels.

What is the special consideration for women taking Isotretinoin?

They MUST partake in the 'iPledge program' which ensures no pregnant woman take the medication or get pregnant while taking it.

What two hormonal medications are prescribed to women to treat acne?

Hormonal birth control and spironolactone

What is Silver Sulfadiazine? | What is it used for?

It is a medication with broad spectrum antibiotic properties. It is used to prevent sepsis in clients with burns

Side effects of Silver Sulfadiazine | What must you monitor?

Rash, itching, blue-green skin discoloration, leukopenia and interstitial nephritis. Must monitor the WBC for leukopenia.

What is Mafenide Acetate? | What is it used for?

Water-soluble cream that is bacteriostatic for both gram negative and gram positive bacteria. Used to treat burns to reduce the bacteria present in avascular tissues.

Adverse effects of Mafenide acetate | What must you monitor?

Local pain, rash, bone marrow depression, hemolytic anemia, metabolic acidosis. Must monitor ABG and electrolytes for acidosis.