L3 - Dermatologic Pharmacology Flashcards
What are the variables of cutaneous absorption?
Regional, concentration gradient, dosing schedule and vehicles/occlusion
How does the regional variable affect cutaneous absorption?
E.g. axilla more permeable than the forearm
How does the concentration gradient affect cutaneous absorption?
Increased concentration —> increase drug mass/unit time
How does dosing schedule affect cutaneous absorption?
Long local t1/2 of skin reservoir may permit 1/day dosing
How do the vehicles/occlusion affect cutaneous absorption?
Both can maximize drug penetration
When should you clean your hands?
Before touching a patient Before cleaning/aseptic procedures After body fluid exposure/risk After touching patient After touching pt surroundings
Describe some basic hand hygiene
Should wash for 15-30 seconds with plain soap for hand washing (but this doesn’t reliably prevent microbial transmission)
Frequent hand washing may cause skin damage and irritation
Describe alcohol based hand disinfection
Easier/faster than soap and water
Rapidly effective against gram positive, gram negative and viral pathogens
Not effective against C diff (so must use soap and water)
How do gloves provide protection from contaminated material?
Provide protective barrier from contaminated material reducing chance of transfer of infection from patient to healthcare worker and vice versa
But still need to wash hands since gloves often have small defects or tears that are un apparent + hands become contaminated during removal of gloves
Describe healing by first intention
Inflammatory phase (debridement) Proliferative phase (granulation) —> (epithelialization) Remodeling phase (apoptosis of excess cells, re-alignment/cross linking of collagen)
Describe healing by second intention
Larger scab (clot) Inflammation more intense because there is more necrotic debris, exudate and fibrin to remove Larger amounts of granulation tissue - larger defect Involves wound contraction
In primary closure of surgical wounds in high risk pts poor glycemic control is significantly associated with what?
Worse outcomes
Postoperative hyperglycemia is frequent after what kind of surgery?
Elective colorectal surgery in non diabetic pts
Even a single post operative elevated glucose value is adversely associated with morbidity and mortality
What can cause a generalized itchy rash?
Ring worm (tinea corporus) or nail infection (onchomycosis, tinea unguium)
What can cause an itchy rash on the scalp?
Sebhorreic dermatitis or head lice
What can cause an itchy rash of the back?
Grover disease (transient acantholytic dermatosis)
What can cause an itchy rash on the hands?
Pomphoylx (eczema -> itchy blisters on hands/feet)
Hand dermatitis
What can cause an itchy rash of the genitals?
Vulvovaginal candida, pubic lice, lichen sclerosis, jock itch (tinea cruris)
What can cause an itchy rash on the legs?
Gravitational eczema
What can cause an itchy rash on the feet?
Athletes foot (Tinea pedis)
What can cause neuropathic localized pruritus of the face?
Trigeminal trophic syndrome
What can cause neuropathic localized pruritus of the arm?
Brachioradial pruritus
What can cause neuropathic localized pruritus of the back?
Brachioradial pruritus
What can cause neuropathic localized pruritus of the vulva?
Pruritus vulvae
