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PT III - DEENT > PCOL Acne (Maize) > Flashcards

PCOL Acne (Maize) Flashcards

1
Q

Keratolytics

A

benzoyl peroxide
sulfur
salicylic acid

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2
Q

Benzoyl peroxide products

A

Clearasil, Fostex, Oxy-10

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3
Q

Benzoyl peroxide mechanism of action

A

converted to benzoic acid - a potent oxidizing agent in the skin

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4
Q

Benzoyl peroxide pharmacological effect:

  • ____ keratinocytes
  • increases ____ rate of keratinocytes
  • prevents ____ of follicles
  • antibacterial activity against ____
A
  • loosens
  • turnover
  • closure
  • P. acnes
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5
Q

Benzoyl peroxide side effects

A
  • drying & peeling of skin
  • burning, blistering, scaling, edema
  • no systemic side effects
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6
Q

Sulfur products

A

Fostril, Liquimat, combination products

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7
Q

Sulfur mechanism of action

A

forms hydrogen sulfide when applied to skin

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8
Q

Sulfur pharmacological effect H–S:

  • causes inflammation which promotes ____ and ____ of plugs
  • ____ properties due to inactivation of ____ enzymes
A
  • peeling; unblocking

- antibacterial; bacterial

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9
Q

Sulfur side effects

A

redness, irritation, peeling, odor, comedogenic (acne-producing)

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10
Q

Salicylic acid mechanism of action

A

lowers skin pH, increasing the hydration of keratin, facilitating the loosening and removal of keratinized skin cells

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11
Q

Salicylic acid pharmacological effect:

  • promote shedding of ____ ____
  • effects range from ____ to ____ (dependent on ____)
A
  • stratum corneum

- peeling; desquamation; concentration

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12
Q

Salicylic acid concentrations:

  • for dandruff, acne and psoriasis?
  • for wart and corn removal?
A
  • 3-6% (6% may cause skin damage)

- up to 40%

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13
Q

Salicylic acid side effects

A
  • irritation and inflammation of normal skin

- salicylism

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14
Q

Acne antibiotic drugs:

A

tetracycline, minocycline, doxycycline, clindamycin, erythromycin
metronidazole
azelaic acid

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15
Q

Acne antibiotic mechanism of action (except metronidazole)

A

reduces P. acnes by inhibiting protein synthesis (bacteriostatic) and decreases the percentage of free fatty acids

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16
Q

Tetracycline brand names

A

Achromycin, Sumycin, Topicycline

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17
Q

Tetracycline unique mechanism

A

decreases keratin in the sebaceous pores

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18
Q

Tetracycline side effects (oral)

A

GI: N/V/D

pseudomembraneous colitis

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19
Q

Tetracycline:

  • ____ and ____ are discolored and ____ is impaired in the young (binds to ____; can’t give with milk, antacids, aluminum…)
  • ____ for fair-skinned people
  • increased incidence of ____
  • little use of ____ tetracycline
A
  • bones; teeth; growth; calcium
  • photosensitivity
  • superinfections
  • topical
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20
Q

Monocycline brand name?
Doxycycline brand name?
They may be more efficacious than ____
Side effects?

A
  • Minocin
  • Vibramycin
  • tetracycline
  • ototoxicity and darkening of skin and teeth more than tetracycline
21
Q

Erythromycin brand names

A

E-mycin, Ery-tab, A/T/S, Erycette, T-Stat, Ery-Sol, Benzamycin

22
Q

Erythromycin side effects

  • oral?
  • topical?
A
  • N/V/D, epigastric pain, CYP3A4 inhibition

- burning and drying, especially when combined with benzoyl peroxide

23
Q

Metronidazole brand names

A

Flagyl, Metrogel

24
Q

Metronidazole mechanism of action

A

unknown, but used for acne rosacea instead of acne vulgaris

inhibits growth of Demodex brevis

25
Q

Metronidazole side effects:

  • N/V/D
  • peripheral ____ with prolonged use
  • ____ reaction (headache, copious ____, ____tension, possible death)
  • ____ in animals
  • burning, stinging, drying
A
  • neuropathy
  • disulfuram; vomiting; hypo
  • carcinogenic
  • burning, stinging, drying
26
Q

Azelaic acid brand name

A

Azelex

27
Q

Azelaic acid pharmacological effect

A

antimicrobial action, reduction in the thickness of the stratum corneum, anti-wrinkle

28
Q

Azelaic acid side effects

A
  • pruritis, burning, stinging, tingling

- erythema, dryness, rash

29
Q

Retinoids

A

vitamin A
tretinoin
adapalene
isotretinoin

30
Q

Vitamin A is necessary for cell ____, ____ and ____ of epithelial cells, the ____ system and vision.
Deficiency results in ____ and keratotic skin.
High and low ____ give the same effect on skin, eyes and birth defects.

A

growth; differentiation; homeostasis; reproduction
hyperplastic
doses

31
Q

Tretinoin brand names

A

Retin-A, Renova, Avita, Retin-A Micro

32
Q

Tretinoin and isotretinoin mechanism:

  • Direct?
  • Indirect?
A
  • homo- or hetero-dimer retinoid-receptor complexes bind to RARE and either promote or inhibit protein transcription
  • one receptor complex binds a transcription factor preventing it from binding to TRE on the DNA
33
Q

Tretinoin and adapalene pharmacological effects:

  • Decreases ____, promotes ____, increases the ____ and reduces the ____ of keratinocytes
  • the change in protein transcription has ____ and ____ activity
  • Reduces the thickness of the ____ ____
A
  • proliferation; differentiation; turnover; cohesiveness
  • anti-inflammatory; anti-proliferative
  • stratum corneum
34
Q

Tretinoin side effects

A
  • blistering, peeling, crusting, burning, edema
  • photosensitizing
  • might get worse before it gets better
  • no known systemic side effects
35
Q

Adapalene brand name

A

Differin (topical)

36
Q

Adapalene mechanism of action

A

same as other retinoids except it binds to RAR beta and gamma (leading receptor in skin) receptors only

37
Q

Adapalene side effects

A

erythema, scaling, dryness, pruritis, burning

38
Q

Isotretinoin brand name

A

Accutane (oral)

39
Q

Isotretinoin pharmacological effect:

  • decreases ____ ____ size
  • decreases ____ production
  • reduces ____ by inhibiting ____ release from macrophages
  • reduces ____
A
  • sebaceous gland
  • sebum
  • inflammation; prostaglandin
  • keratinization
40
Q

Isotretinoin common side effects

A
  • Common: inflammation of lips, epitaxis, itching of skin and nose, xerosis, conjunctivitis, xerophthalmia
  • Less common: skin rash, peeling on palms and soles, photosensitization, alopecia, arthralgia
41
Q

Isotretinoin CNS side effects

A
  • persistant headache

- lethargy, fatigue, depression, psychosis, suicidal ideation

42
Q

Isotretinoin ophthalmic effects

A
  • conjunctivitis, blurred/tunnel vision, diplopia,
  • reduction of night vision (rare)
  • optic neuritis, cataracts, papiledema (rare)
43
Q

Isotretinoin effects of blood lipids:

  • increase ____ and plasma ____ levels
  • reduces ____ levels
A
  • triglycerides; cholesterol

- HDL

44
Q

Retinoids are ____ which are signaling molecules that control the ____ pattern of differentiation, making it a ____.

A

morphogens; spatial; teratogenic

45
Q

Push for retinoid removal from market due to

A

birth defects, teen suicide and 50% greater risk of Crohn’s disease

46
Q

Pseudomembranous colitis, a side effect of ____ and ____ (antibiotics), may lead to a ______ caused by C. ______.

A

tetracycline; clindamycin; superinfection; difficile

47
Q

Clindamycin brand names

A

Cleocin, Cleocin T, C/T/S

48
Q

Clindamycin oral side effects:

  • ____ colitis (____infection)
  • N/V/D
  • impaired ____ function
  • ____ (rare)
A
  • pseudomembraneous colitis; super
  • liver
  • neutropenia
49
Q

Clindamycin topical side effects

A
  • dryness or peeling of skin

- contact dermatitis

PT III - DEENT (12 decks)

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