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SBL Exam 2 > L3 - Dermatologic Pharmacology > Flashcards

L3 - Dermatologic Pharmacology Flashcards

1
Q

What are the variables of cutaneous absorption?

A

Regional, concentration gradient, dosing schedule and vehicles/occlusion

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2
Q

How does the regional variable affect cutaneous absorption?

A

E.g. axilla more permeable than the forearm

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3
Q

How does the concentration gradient affect cutaneous absorption?

A

Increased concentration —> increase drug mass/unit time

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4
Q

How does dosing schedule affect cutaneous absorption?

A

Long local t1/2 of skin reservoir may permit 1/day dosing

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5
Q

How do the vehicles/occlusion affect cutaneous absorption?

A

Both can maximize drug penetration

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6
Q

When should you clean your hands?

A 
Before touching a patient 
Before cleaning/aseptic procedures 
After body fluid exposure/risk 
After touching patient 
After touching pt surroundings
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7
Q

Describe some basic hand hygiene

A

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

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8
Q

Describe alcohol based hand disinfection

A

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)

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9
Q

How do gloves provide protection from contaminated material?

A

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

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10
Q

Describe healing by first intention

A 
Inflammatory phase (debridement) 
Proliferative phase (granulation) —> (epithelialization) 
Remodeling phase (apoptosis of excess cells, re-alignment/cross linking of collagen)
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11
Q

Describe healing by second intention

A 
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
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12
Q

In primary closure of surgical wounds in high risk pts poor glycemic control is significantly associated with what?

A

Worse outcomes

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13
Q

Postoperative hyperglycemia is frequent after what kind of surgery?

A

Elective colorectal surgery in non diabetic pts

Even a single post operative elevated glucose value is adversely associated with morbidity and mortality

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14
Q

What can cause a generalized itchy rash?

A

Ring worm (tinea corporus) or nail infection (onchomycosis, tinea unguium)

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15
Q

What can cause an itchy rash on the scalp?

A

Sebhorreic dermatitis or head lice

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16
Q

What can cause an itchy rash of the back?

A

Grover disease (transient acantholytic dermatosis)

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17
Q

What can cause an itchy rash on the hands?

A

Pomphoylx (eczema -> itchy blisters on hands/feet)

Hand dermatitis

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18
Q

What can cause an itchy rash of the genitals?

A

Vulvovaginal candida, pubic lice, lichen sclerosis, jock itch (tinea cruris)

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19
Q

What can cause an itchy rash on the legs?

A

Gravitational eczema

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20
Q

What can cause an itchy rash on the feet?

A

Athletes foot (Tinea pedis)

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21
Q

What can cause neuropathic localized pruritus of the face?

A

Trigeminal trophic syndrome

22
Q

What can cause neuropathic localized pruritus of the arm?

A

Brachioradial pruritus

23
Q

What can cause neuropathic localized pruritus of the back?

A

Brachioradial pruritus

24
Q

What can cause neuropathic localized pruritus of the vulva?

A

Pruritus vulvae

25
Q

What can cause neuropathic localized pruritus of the anus?

A

Pruritus ani

26
Q

What can cause neuropathic localized pruritus of the any dermatome?

A

Herpes zoster (shingles) during recovery phase

27
Q

What are two topical vasoconstrictors used to resolve the redness in rosacea?

A

Brimonidine and oxymetazoline

28
Q

What is brimonidine?

A

Alpha2 adrenergic agonist applied as a topical gel

Vasoconstricts by stimulation post synaptic vascular alpha2 receptors

29
Q

What is oxymetaxoline?

A

Mixed alpha1A/alpha2 adrenergic agonist vasoconstrictor applied as a topical cream

30
Q

What agents can be used to relieve redness in the eyes through vasoconstriction?

A

Naphazoline, tetrahydrozoline, phenylephrine, and oxymetazoline
Eye drops are all adrenergic receptor agonists

31
Q

What are common agents used for killing of ectoparasites?

A

Malathion, permethrin, ivermectin, lindane

32
Q

What is malathion?

A

Topical agent

Organophosphate cholinesterase inhibitor

33
Q

What is permethrin?

A

Topical agent

Binds to insect Na channels and blocks membrane repolarization

34
Q

What is ivermectin?

A

Administered orally
Binds to glutamate gated Cl channels in invertebrates
Hyperpolarizes the nerve and muscle cells

35
Q

What is lindane?

A

Topical agent
Toxicity causes it to be used only after other agents fail
Disrupts GABAergic transmission in insects

36
Q

Which topical therapies are the initial choice for mild to moderate psoriasis?

A

Emollients and corticosteroids

37
Q

Which topical therapies used to treat psoriasis have an unclear mechanism but reduce keratinocytes proliferation?

A

Topical vitamin D analogs such as calcipotriene and calcitriol

38
Q

What is tar?

A

Ancient remedy for psoriasis
Mechanism unknown but has some anti proliferative effects
Largely displaced by less messy/odorous choices but can be a useful adjunct

39
Q

Which topical psoriasis therapy has an unknown mechanism but has anti inflammatory effects?

A

Anthralin

slows something

40
Q

What are some other topical therapies for psoriasis?

A

Tazarotene (retinoid gel)
Calcineurin inhibitors (tacrolimus, pimecrolimus)
Salt water bath (e.g. Dead Sea)

41
Q

What are some drugs that cause skin discoloration?

A

Amiodarone, daunorubicin, gold, methotrexate, psoralens and 5-fluorouracil (patchy dispigmentation)
Minocycline (generalized dyspigmentation)
Iron, silver, hydroquinone and hydroxyurea (discoloration at site of administration)
Bleomycin (flagellate pigmentation)

42
Q

Which drugs can cause discoloration of the eyes?

A

Rifampin turns tears and urine orangish rash
Prostaglandins (e.g. latanoprost) increase iris pigmentation
Minocycline turns sclera blue

43
Q

How are alcohols used as disinfectants?

A

Used for antisepsis, to disinfect surfaces and preservation
However they are flammable
Cannot be used to sterilize

44
Q

How can aldehydes be used as a disinfectant?

A

Used to disinfectant surfaces, sterilize medical instruments, and for preservation
Highly toxic

45
Q

What is an example of a biguanides?

A

Chlorhexidine digluconate

Used for antisepsis, disinfect surfaces and preservation

46
Q

Why should triclosan (a type of bisphenol) be avoided?

A

Commonly used in antiseptic soaps but has toxic effects on the skin and also it accumulates in the environment

47
Q

What kind of a disinfectant is household bleach?

A

Halogen releasing
Can be used for antisepsis and disinfection purposes
Iodine solutions can cause irritation and staining

48
Q

What type of disinfectant is hydrogen peroxide?

A

Peroxygen
Used for disinfection, anti sepsis and sterilization
Peracetic acid is potent and not used for preservation

49
Q

What are phenolics used for?

A

Anti sepsis and preservation
Phenol is no longer used as it is corrosive and carcinogenic
But a number of derivatives are used

50
Q

What are quaternary ammonium salts used for?

A

Disinfection and preservation

Found in Fantastik cleaner

51
Q

Why is it not a good idea to administer amphotericin B intravenously?

A

Serious systemic infections due to adverse effects
Fever/chills, cramps, muscle pain, arrthymia, change in urination, nausea and vomiting
“Amphoterrible” when administered IV

52
Q

Describe the use of topical steroids and their potency

A

Use low potency on face, genitals and skin folds

Elsewhere generally start high potency to gain control and titrate downward for maintenance

SBL Exam 2 (7 decks)

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