Lehne Chapter 105 Flashcards
Topical glucocorticoids (cream, ointment, or gel)
Uses
To relieve inflammation and itching
Drying agent
Adverse effects
Stretch marks
Purpura
Telangiectasia
Hypertrichosis
Possible systemic toxicity
Local reactions
Thinning of the skin
Stretch marks
Purpura
Telangiectasia
Hypertrichosis
Possible systemic toxicity
Adverse effects
Systemic toxicity
More likely with higher doses and long-term therapy
Growth retardation in children
Adrenal suppression
Administration
Apply in a thin film and gently rub into the skin
Do not use occlusive bandages (or tight-fitting diapers and plastic pants)
Keratolytic Agents
Promote shedding of horny layer of the skin
Primary agents and uses
Salicylic acid: Warts, corns
Sulfur: Acne, dandruff, psoriasis, seborrheic dermatitis
Benzoyl peroxide
Treatment for Acne
Nondrug therapy
Cleansing
Drug therapy
Benzoyl peroxide
Antibiotics
Topical: Clindamycin
Oral: Tetracycline antibiotics, isotretinoin, hormonal agents
Retinoids
Tretinoin
Adapalene
Topical Drugs for Acne
Benzoyl peroxide
Clindamycin and erythromycin
Retinoids
Tretinoin
Adapalene
Tazarotene
Azelaic acid
Oral Drugs for Acne
Antibiotics
Agents of choice
Doxycycline [Vibramycin], minocycline [Minocin]
Alternatives (resistance is common)
Tetracycline [Sumycin], erythromycin [Ery-Tab]
Isotretinoin
Used to treat severe nodulocystic acne vulgaris
Teratogenic
Triglyceride levels must be monitored
Adverse effects
Hormonal agents
Spironolactone [Aldactone]
Sunscreens (UVA)
UVA penetrates the epidermis and deep into the dermis
UVA penetrates much deeper than UVB
UVA is the primary cause of immunosuppression, photosensitive drug reactions, and photoaging of the skin
Sunscreens (UVB)
UVB penetrates into the epidermis but goes no deeper
Tanning and sunburn are caused primarily by UVB
Sunscreens (UVA & UVB)
Both UVA and UVB promote damage to DNA, so both can cause premalignant actinic keratoses, basal cell carcinoma, squamous cell carcinoma, and malignant and nonmalignant melanoma
Sunscreens
Impede penetration of UV radiation to viable cells of the skin
Can protect against sunburn, photoaging of the skin, and photosensitivity reactions to certain drugs (for example, tricyclic antidepressants, phenothiazines, sulfonamides, sulfonylureas)
Can also reduce the risk of actinic keratoses, squamous cell carcinoma, and melanoma
Adverse effects
Rules for labeling
Range of UV protection and SPF
Water/sweat resistance
Safe sun exposure
Water and sweat resistance
Adverse effects of sunscreens
Proposed changes regarding sunscreen testing and labeling
UVB rating and labeling
Using a sunscreen effectively
Organic screens
Also known as chemical screens
Absorb UV radiation and then dissipate it as heat
15 of approved sunscreens
Inorganic screens
Also known as physical screens
Scatter UV radiation
Titanium oxide and zinc oxide
Now micronized and clear for applying to skin
Sun Protection Factor (SPF)
SPF is an index of protection against ultraviolet B (UVB) radiation
SPF does not address ultraviolet A (UVA) protection
Methods for obtaining SPF are not precise
Relationship between SPF and protection against sunburn is not linear (SPF 30 is not twice as much protection as SPF 15)
Psoriasis
Red patches with silver scales
Common, chronic inflammatory disorder that follows an erratic course
Initial episode usually develops in early adulthood
Subsequent attacks may occur spontaneously or in response to triggers
Varying degrees of severity
Symptoms result from:
Accelerated maturation of epidermal cells
Excessive activity of inflammatory cells
Treatment for Psoriasis (topical drugs)
Glucocorticoids
Vitamin D analogues: Calcipotrien, calcitriol
Vitamin A derivative: Tazarotene
Anthralin
Tars
Treatment for Psoriasis: Systemic drugs (conventional agents)
Methotrexate
Acitretin
Glucocorticoids
Cyclosporine
Treatment for Psoriasis: Biologic agents
Etanercept
Infliximab
Adalimumab
Ustekinumab
Treatment for Psoriasis: Procedures
Photochemotherapy
Coal tar + ultraviolet B irradiation
Actinic Keratoses (AKs)
Rough, scaly, red or brown papules caused by chronic exposure to sunlight
Half of all skin cancers in the United States begin as AKs
Drugs for AK
Fluorouracil
Diclofenac sodium
Imiquimod
Aminolevulinic acid + blue light
Drugs for Atopic
Dermatitis (Eczema)
Glucocorticoids
Topical immunosuppressants
May cause skin cancer or lymphoma
Tacrolimus
Pimecrolimus
Agents Used to Remove
Venereal Warts
Physical measures
Cryotherapy, electrodesiccation, laser surgery, and conventional surgery
Topical drugs (must be applied by provider)
Podophyllin (must be applied by provider)
Bichloroacetic acid (BCA) and Trichloroacetic acid (TCA)
Topical drugs (can be applied at home)
Imiquimod
Podofilox
Kunecatechins
Common Warts
Verruca vulgaris: Hard, rough, horny papules
Majority of common warts are caused by just three types of human papillomavirus (HPV): HPV-1, HPV-2, and HPV-3
Physical measures for removal
Cryotherapy, electrodesiccation, curettage, and laser therapy
Topical drugs
Salicylic acid, podophyllin, podofilox, imiquimod, trichloroacetic acid, and topical fluorouracil
Antiperspirants
Aluminum chlorohydrate, aluminum chloride, and buffered aluminum sulfate; these agents can reduce the flow of eccrine sweat by 20% to 50%
Deodorants
Carbanilide, triclocarban, and triclosan inhibit growth of the surface bacteria that degrade components of apocrine sweat into malodorous products; they do not suppress sweat formation
Drugs for seborrheic dermatitis and dandruff
Pityrosporum ovale, a microbe in the yeast family
Symptoms respond rapidly to topical treatment with ketoconazole, an antifungal drug with activity against yeast
Drugs for Hair
Treatment of hair loss
Topical minoxidil
Finasteride [Propecia]
Treatment of unwanted facial hair
Eflornithine [Vaniqa]
Impetigo
Most common bacterial infection of the skin: Staphylococcus aureus
Usually seen in children 2 to 5 years of age
Two forms:
Bullous
Nonbullous
Impetigo is treated with antibiotics
Local Anesthetics
Can be applied topically to relieve pain and itching associated with skin disorders
Benzocaine
Lidocaine
Pramoxine
