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SP1 Pharmacology > Lecture 17 3/27/24 > Flashcards

Lecture 17 3/27/24 Flashcards

1
Q

What are the potential uses for topical therapy?

A

-focal lesions
-adjunct to systemic therapy
-decrease bacterial resistance
-treat ectoparasites
-management of chronic/recurrent skin diseases

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2
Q

What are the advantages of topical therapy?

A

-reduction in systemic drug absorption and adverse reactions
-decreased risk of antibiotic resistance
-useful in bacterial resistant pyoderma
-adjunctive and synergistic effects in overall management of skin disease
-often less expensive and may not require a prescription
-empowers owner to participate in treatment

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3
Q

What are the disadvantages of topical therapy?

A

-more time consuming and labor intensive
-messier, with potential odors or residues
-localized adverse reactions
-client education and compliance can be harder to achieve

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4
Q

What are the limitations of topical therapy?

A

-long coat breeds: often need to trim for treatment to be effective
-cats: self-grooming limits which products can be used and if they will be efficacious
-owners: topicals are only as effective as the owner

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5
Q

What are the three mechanisms of transepidermal delivery?

A

-intracellular; penetrates keratinocyte
-intercellular; pass through or dissolve in lipid bilayer matrix
-transappendageal; enters follicles and/or glands

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6
Q

How does thickness of the stratum corneum impact absorption?

A

increased thickness of the stratum corneum will decrease absorption

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7
Q

How does absorption differ between acute and chronic lesions?

A

-acute lesions and inflammation increase absorption
-chronic lesions decrease absorption

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8
Q

How does total surface area impact absorption?

A

having a product on more skin provides potential increased absorption and greater systemic effect

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9
Q

What determines diffusion across the barrier?

A

-active ingredient
-vehicle

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10
Q

What is the role of the vehicle?

A

-facilitate application and absorption
-CANNOT force penetration if active ingredient is incapable of penetrating on its own

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11
Q

What must be considered when selecting a vehicle?

A

-ability of vehicle to hydrate stratum corneum
-occlusive vehicles increase absorption
-stability of the drug in the vehicle
-interactions between vehicle, active ingredient, and stratum corneum

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12
Q

Which factors impact the ability of an active ingredient to diffuse across the barrier?

A

-concentration and solubility
-rate of release from vehicle
-diffusion coefficient
-size of molecule
-pH
-temperature and hydration

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13
Q

What are the characteristics of acute lesions and product choice?

A

-erythematous, erosive, often exudative
-do not use occlusive vehicle; would seal infection
-do not use alcohol-containing products
-good for lotions

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14
Q

How do subacute lesions appear?

A

-erythematous
-inflamed
-not exudative

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15
Q

What are the characteristics of chronic lesions and product choice?

A

-thickened with excess stratum corneum
-do not use lotions; too drying

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16
Q

How should the patient be prepped prior to topical treatment?

A

clipped and cleaned

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17
Q

What are the characteristics of water based vehicles?

A

-include shampoo, sprays, and mousses
-contact time of 10 min.
-can be adjunct or sole therapy
-hydrating at correct time
-dehydrating/macerating with prolonged contact

18
Q

What are the characteristics of lotion vehicles?

A

-can be a solution (ingredient does not settle out) or suspension (requires shaking)
-can be drying
-not recommended for chronic lesions

19
Q

What are the characteristics of emulsion vehicles?

A

-oil in water
-low owner compliance due to greasiness of dogs after treatment

20
Q

What are the characteristics of gel/cream/ointment vehicles?

A

-occlusive
-used for chronic lesions
-not recommended for acute lesions

21
Q

What are the characteristics of powder vehicles?

A

-messy
-possibly used for ectoparasites
-poor absorption of most drugs except glucocorticoids

22
Q

What are the characteristics of propylene glycol on its own?

A

-anti-bacterial
-anti-fungal

23
Q

What are the characteristics of propylene glycol as a vehicle?

A

-enhances absorption
-keratolytic
-hygroscopic
-most common cause of contact reactions

24
Q

What are the characteristics of DMSO on its own?

A

-anti-ischemic
-anti-inflammatory
-analgesic
-anti-bacterial, fungal, viral
-decreases fibroplasia

25
Q

What are the characteristics of DMSO as a vehicle?

A

-freely miscible within lipids and water
-bacteriostatic
-hygroscopic
-good penetration
-carrier agent/pulls agent down deeper into skin

26
Q

Which types of topicals are used as anti-pruritics?

A

-anesthetics
-moisturizing agents
-oatmeal
-sensation-altering
-corticosteroids

27
Q

What are the characteristics of corticosteroids?

A

-frequently used for focal pruritus
-typically avoided for pyoderma; if used, not longer than the antibiotics
-increased absorption with ointment vehicles
-steroids in solution contain alcohol and burn; should only be used on strictly pruritic lesions
-only used when necessary and for short periods

28
Q

What are some of the adverse reactions that can occur with corticosteroids?

A

-cutaneous atrophy
-milia
-comedones
-calcinosis cutis
-alopecia

29
Q

Which corticosteroid is best for chronic topical use?

A

hydrocortisone

30
Q

How does an antiseptic differ from a disinfectant?

A

-antiseptic for skin
-disinfectant for non-living surfaces

31
Q

What are the characteristics of 2% chlorhexidine?

A

-most effective and commonly used treatment for pyoderma
-bactericidal; destroys cell membrane
-residual activity for 48 hrs
-possible corneal toxicity and ototoxicity
-effective against resistant bact.

32
Q

What are the characteristics of povidone iodine?

A

-broad spectrum bactericidal
-fungicidal and virucidal
-residual activity up to 4-5 hrs
-not impaired by blood, serum, necrotic debris, pus
-can be drying and irritating
-stains
-safe to the cornea

33
Q

What are the characteristics of hypochlorous acid/bleach?

A

-damages protein structures in bacterial cell membrane
-can be drying if overused
-used in dilutions

34
Q

What are the characteristics of TrisEDTA?

A

-EDTA damages bacterial wall of gram neg. bact., aiding in antibacterial drug penetration
-Tris acts as a buffer to enhance EDTA efficacy
-synergistic for Staph. and Strep. infections

35
Q

Which topical antibiotics are used in vet med?

A

-mupirocin
-nisin
-amikacin
-gentamicin

36
Q

Which topicals are used as antifungals?

A

-creams/lotions/sprays containing azoles, terbinafine, chlorhex., or iodine
-lime sulfur

37
Q

What are the two types of anti-seborrheic agents?

A

-keratolytic/removes stratum corneum
-keratoplastic/normalizes epidermal turnover

38
Q

What are the different keratolytic anti-seborrheic agents?

A

-sulfur/salicylic acid
-coal tar
-selenium sulfide

39
Q

What are the different keratoplastic anti-seborrheic agents?

A

ceramides/fatty acids
-ophytrium
-benzoyl peroxide

40
Q

Which topical treatment can be used for immune-modulation?

A

tacrolimus

SP1 Pharmacology (27 decks)

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