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CDM 3 Exam 2 > Lecture 6 - Dermatology 3 > Flashcards

Lecture 6 - Dermatology 3 Flashcards

1
Q

3 types of lice

A

Pediculus = Head and body….2-3mm in size
Phthirus = Crabs = 1mm size

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2
Q

symptoms of lice

A

inflammation and itching
presence of peppery flecks
macular swellings

behind ear good area to look

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3
Q

Lice treatment

A

topical pediculicides are typically preferred

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4
Q

1st line lice Treatment

A

Pyrethrin 0.33% and Permethrin 1%
0.33% > 2yrs, 1% > 2 months
about same cost

put into hair, let sit for about 10 min, remove with special comb

reapply in 7-10 days

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5
Q

2nd line lice treatments

A

topical prescription meds if fail/dont respond to 1st line
typically use Malathion

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6
Q

Malathion 0.5% lotion info

A

apply to dry hair, let air dry and wash off
usually 1 treatment enough, can repeat in 9 days
CI < 24 months old and dont use P.pubis

** Flammable until dry and malodorous **

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7
Q

Benzyl alcohol 5% lotion info

A

can use in infants 6 months or older who OTC dont work
applied to dry hair, rinsed after 10min and repeated after 7 days***

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8
Q

Is permethrin 5% more effective than 1%?

A

nah if failed 1% then probs fail 5%

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9
Q

Spinosad 0.9% suspension info

A

more effective than permethrin
apply to dry hair, rinse after 10min, repeat 7 days if live lice seen
Dont need to Nit comb, but recommended

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10
Q

Ivermectin 0.5% lotion info

A

can use > 6 months or older
apply, and rinse after 10min, single app

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11
Q

Why is Lindane 1% not recommended

A

Adverse drug events

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12
Q

Abametapir (Xeglyze) Lotion info

A

approved for those older than 6 months

apply, rinse after 10min

Can use shampoo anytime after treatment**
more risk of contact dermatitis

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13
Q

Oral lice treatments

A

Bactrim or Ivermectin

Bactrim: CI < 2months, preg/nursing, sulfa allergy
Ivermectin: 1 time dose

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14
Q

Non-pharm lice treatments

A

Petroleum jelly = massage int hair and left overnight, shampoo next morning…repeat 1 week

Cetaphil lotion = apply to hair, dry with hairdryer, leave overnight and shampoo morning, QW X 3wks

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15
Q

Lice exclusion for self-care w/ OTC

A

Hypersensitivity to chrysanthemums, ragweed, pediculicide ingredients
Presence of 2ndary skin infection
Presence of active tumor
2 previous unsuccessful treatment attempts
< 2yrs of age
Lice infestation of eyebrows/eyelid
Pregnancy/breast feeding

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16
Q

Lice counseling points

A

Treat other members
clean all bedding/clothing and high-heat drying
non-washable can be dry-cleaned of sealed bag for few weeks
vacuum
disinfect combs/brushes
teach children to avoid head-to-head contact

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17
Q

Factors that can affect acne

A

Hormone abnormalities or malfunctions
Physical occlusion or damage
Meds

other - Genetics, Climate, Diet, Excessive Sweating

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18
Q

Exclusions to Acne treatment

A

pts w/severe acne Type 3-4
Drug-induced acne
Possibility that its not acne
Acne persists or develops >30yrs old
No improvement after treatment attempt or 6 weeks

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19
Q

Non-pharm acne treatments

A

stress reduction
avoid extreme temps
use nondrying cleansing agents, dont want dry skin
can try comedones extractors

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20
Q

goals of acne therapy

A

reduce excess oil
control bacteria associated with acne
reduce effects of hyperkeratinization
unclog pores

21
Q

what to use on Oily to normal skin?

A

Gels and solutions

22
Q

what to use on normal skin?

A

Gels, solutions, lotions and creams

23
Q

What to use on Normal to dry skin?

A

Lotion and Creams

24
Q

Benzoyl peroxide info

A

no resistance reported
effects seen in ~5 days
comes in bunch of formulations
Fair or moist skin highest risk of irritation
can bleach or discolor fabrics

25
Q

Salicylic acid info

A

repeated use can lead to salicylism
CI in pt who used isotrentinoin within last 6 months

26
Q

Retinoid CI and Warnings

A

CI in retinoid hypersensitivity
avoided in women who are pregnant or breastfeeding
avoid pts with photosensitivity disorder or eczema
safety not established < 12yrs old
use limited by side effects

27
Q

If patients has Fish allergy can you use Retin-A micro?

A

Nah

28
Q

Tretinoin lotion info

A

patients > 9yrs older
Caution: fish allergy
use sunscreen and protective clothing

29
Q

Adapalene info

A

good option for sensitive skin
OTC

30
Q

Tazarotene info

A

more effective than other retinoids but more irritating
Pro drug and synthetic retinoid

31
Q

Topical retinoid general info

A

takes few weeks to see effect, much longer then benzoyl peroxide

32
Q

Dapsone info

A

used in females w/ inflammatory acne

localized discoloration of skin or facial hair * ADR*

33
Q

Clindamcin info

A

preferred macrolide
BPO increases efficacy
* Diarrhea and pseudomembranous colitis can occur from topical use*

34
Q

Why don’t use Erythromycin topical alone?

A

higher risk for resistance

35
Q

Amzeeq info

A

approved for 9yrs or older
used for moderate to severe acne
used once daily, 1hr before bed
$$$$

36
Q

Azelaic Acid

A

useful for noninflammatory and inflammatory acne
can improve acne-induced post-inflammatory hyperpigmentation

not clinically efficacious in treatment of acne

37
Q

Acne tetracyclines

A

Doxy and minocycline

used in moderate to severe who haven’t responded

Limitations: GI upset, photosensitivity, superinfections, hepatotoxicity, intracranial hypertension = rare

** don’t combine with systemic retinoid **

38
Q

when are macrolides used in acne?

A

usually pts who have intolerance or resistant strains to tetracycline

higher rates of bacterial resistance

39
Q

When are oral contraceptives used for acne?

A

usually when also want to use for contraception
Net effect is an anti androgen effect
additional option to give to women taking isotrentinoin

40
Q

Spironolactone for acne

A

pts who haven’t responded
not approved by FDA as anti-androgen agent
can safely use with OCs

41
Q

Isotretinoin info

A

iPLEDGE program
highly effective
use for 15-20wks, then atleast 2 month break
Reserved for severe acne or other forms that have failed treatment

42
Q

iPLEGE requirement

A

females of childbearing age be on 2 forms of BC, 1 month before/after/during treatment

females must have negative pregnancy tests conferred by lab monthly during, 1 month after treatment

pts must access iPLEDGE monthly to document what 2 forms of birth control have been used

43
Q

Primary forms of birth contorl

A

Tying tubes
Vasectomy of partner
IUD
hormones

44
Q

Secondary forms of birth control

A

Latex condom
Diaphragm
Cervical cap
Vag sponge

45
Q

Other iPLEDGE requirements

A

Males also have to register
only registered pharmacy can dispense
have to have yellow approval sticker on RX
can only do 30 DS, no refills

46
Q

1st choice mild acne

A

Topical retinoid or BPO or combo

47
Q

1st choice moderate acne

A

Topical combo BPO + Topical antimicrobial….can also consider adding oral

48
Q

1st choice severe acne

A

Oral antibiotic + topical combo therapy….oral isotretinoin is last line

49
Q

acne monitoring

A

6-8 weeks look for results
treatment can last for 20 weeks before full results are seen

CDM 3 Exam 2 (11 decks)

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