Pharm 2-2 Flashcards
1
Q
What are the 1st Generation Antihistamines?
A
Dr Pepper, Cycho Chic Hit Me Bro Diphenhydramine- OTC sleep, Preg Cat B Promethazine- NV Cyproheptadine- SSyndrome Chlorpheniramine- ACOG Cat B Hydroxyzine- hives Meclizine- vertigo Brompheniramine
2
Q
What are the 2nd Generation Antihistamines?
A
Dos Foxy Ladies Love Construction Desloratadine Fexofenadine Loratadine- non-sedating pregnancy-B Levocetirizine Cetirizine- low sedating, pregnancy-B
3
Q
What are the Intranasal 2nd Generation Antihistamines
A
A-Ohhh
Azelastine- systemic absorption, crosses BBB
Olopatadine- H1 selective, fewer s/e
4
Q
What are the Decongestants
A
POP
Phenylephrine- 4hrs,
5
Q
What are the 3 Decongestant Alternatives?
A
IN Case
Intranasal Saline
Nasal strips
Coricidin- Chlorpheniramine is typical ingredient, abuse potential
6
Q
What is the name of the Leukotriene Antagonist
A
Montelukast
Inhibits cysteinyl leukotriene on target cells
Comparable to anti-histamines, less than INS; Pregnancy Cat B
S/e= HA, Mood/SIs
7
Q
What are the names of the Intranasal Steroids
A
Moms Fat Belly Tried Flinging Boogers Far Mometasone Fluticasone Pro. Budesonide- preferred INS in pregnancy Triamcinolone Flunisolide- Dec growth velocity Beclomethasone- Dec growth velocity Fluticasone Fur.
8
Q
What is the name of the Intranasal Steroid combo?
What is the name of the Anticholinergic med used for congestion and the MOA, Use and Adverse
A
Azelastine and Fluticasone propiona
Ipratropium
Muscarinic antagonist to decrease secretions
Pregnancy B and relief of rhinorrhea from common cold in PTs +5y/o
Epistaxis, dry mouth/nose
9
Q
What is the name of the spray form of Mast Cell Stabilizer?
What is the name of the ocular form of Mast Cell Stabilizer?
Due to their slow onset, what step is taken to speed up relief?
A
Cromolyn Sodium
Prevents release of histamine and leukotrienes, best as preventative measure and preferred DOC for pregnancy rhinorrhea and sneezing
Cromolyn
Lodoxamide
Nedocromil
Taken w/ ocular anti-histamine
10
Q
What are the names of the 2 non-selective ocular anti-histamines
What are the names of the 2 selective ocular anti-histamines?
A
Azelastine
Levocabastine
Ketotifen
Olopatadine
11
Q
What are the names of the 3 ocular decongestants?
A
NOT
Naphazoline
Oxymetazoline
Tetrahydrozoline
12
Q
What is the name of the ocular NSAID?
What is the name of the ocular steroid?
A
Ketoralac
Loteprednol
13
Q
How do NSAIDs/ASA inihibit prostaglandin, Thromboxane, or Prostacyclin formation?
Where/how do corticosteroids exert their effect?
A
Stops cyclo-oxygenase
Prevent phospholipase from converting into arachidonic acid
14
Q
How is Allergic Rhinitis: Intermittents Sxs managed?
A
1- Avoidance
2- PIdL (PO Anti-hist, InNasal Anti-hist +/- decon, LTRA)
3- PIaLInMast
15
Q
How is Allergic Rhinitis Persistent Sxs managed?
A
1- Avoidance
2- PIaLInMast
3- INS; PO Ant/LTRA; Rhino= Ipra; Block= PO D/CCS burst
16
Q
How is allergic conjunctivitis treated?
A
1- Avoidance
2- PO/Ocular anti-histamine, artificial tears, cold compress
3- DAMN (D-redness;N-itch)
4- ocular steroids and referral
17
Q
What are the 4 characteristics Sxs of Allergic Rhinitis
What are the two forms of Allergic Rhinitis?
A
CRIS
Congestion, Rhinorrhea, Itching, Sneezing
Acute- HOID
Hormones, Object, Infection, Drugs
Chronic- Allergic: Intermittent/Persistent
Nonallergic: NARES, anatomic
18
Q
Which immunoglobulin drives allergic rhinitis cases and what are the 5 main triggers of it?
Most of these PTs will also have what issues?
A
IgE; DIMMP
Dander, Insects, Mold, Mites, Pollen
40%- asthma
80%- chronic sinusitis
19
Q
What are the Sxs of the Early Phase Reactants?
What are the Sxs of the Late Phase Reactants?
A
Congestion, Rhinorrhea, Pruritis, Sneezes
Congestion, Sneezes, Rhinorrhea
20
Q
What are 4 exterior Sxs that could be seen on a PE for a PT with Allergic Rhinitis
Criteria for intermittent and persistent Sxs?
A
Shiners, Allergic salute, Nasal creases, Dennie Morgan lines
Intermittent: <4 days/wk, <4 wks
Persistent: 4 or more days/wk for 4 or more wks
21
Q
Criteria for mild and mod/severe Sxs of Allergic Rhinitis
What are the four treatment fgoals for Allergic Rhinitis?
A
Mild- normal sleep; no trouble w/ Sxs, sleep, work
Mod/Sev- issues w/ sleep, life, work, Sxs
Improve QoL
Reduce Sxs
Prevent long term complications
Avoid adverse medication s/e
22
Q
Anti-histamine use is contraindicated in ? PT populations?
Decongestants are AKA ?
A
Glaucoma, BPH
Sympathomimetics
23
Q
Caution needs to be exercised when using decongestants w PTs that have what adrenergic stimulation sensitive conditions?
What drug is preferred because of this precaution?
A
D HN BCT
CAD, HTN, Thyroid Dz, DM, NA Glaucoma, BPH
PO Phenylephrine > Pseudoephedrine due to decrease CV s/e
24
Q
Since INS are the most effective drugs for relieving CRIS, what steps are taken during dosing to ensure max relief?
A
Clear nasals w/ saline/decongestant first
Avoid blowing nose x 10m
25
What is the triad of allergic conjunctivitis
What non-pharm steps can be taken to relieve Sxs?
Itching, Redness, Chemosis
Cold compress- itching
Tears- dilutes/flushes eyes
26
What are the adverse effects of Ocular steroids?
Why is Loteprednol unique?
Cataracts, Inc IOP, Inc risk of Infxn
Only ocular steroid approved for use in seasonal allergic conjunctivitis; Lacks ketone on C-20 allowing for rapid conversion to metabolite and decreased absorption
27
What are the steps of administerring eye drops?
Wash hands
Tilt back, pull down w/ index to form pocket
Hold dropper close to eye and brace
Squeeze drop into lower lid
Hold eye closed x 2-3min w/ head down
Place finger near duct and apply pressure to minimize systemic absorption
Wipe excess w/ tissue
Wait 5min before applying second drop to same eye
28
What is the function of Glucocorticoids and what is the major one?
What are the two functions of Mineralcorticoid and what is the major one?
G- effects metabolism and immune function
Cortisol (hydrocortisone) w/ some mineralcorticoid effects
M- sodium retaining activity and feedback regulation of pituitary corticotropin
Aldosterone
29
What are the 3 layers of the adrenal cortex and the major compound made there?
What hormone controls the secretion of the inner and part of the outter layers of the adrenal cortex?
What is the negative feedback inhibitor of this process?
Outter- Glomerulosa: Aldosterone
Middle- Fascicuata: Cortisol
Inner- Reticularis: Adrenal androgens
ACTH from anterior pituitary
Glucocorticoids inhibit ACTH and CRH
30
What controls aldosterones presence and effects in the body?
What is the forward process of the HPA axis and where is the negative feedback process seen?
Angiotensin II
Hypothalamus - CRH - Ant Pituitary - ACTH - Adrenal Cortex - CORT
CORT inhibits Ant Pituitary and Hypothalamus
31
Which glucocorticoid follows a normal circadian rhythm?
What does this timing mean for dosing?
ACTH- peaks in AM and post-meals
Systemic glucorticoids are dosed in the AM and w/ meals
32
How much cortisol is secreted by a non-stressed adult per day?
What causes these levels to be increased?
10-20mg w/ T1/2 60-90min
Hydrocortisone administered in large amounts, stress, hypothyroid or active liver dz
33
90% of corticosteroids are bound to ?
What causes this transporter to be increased or decreased?
Corticosteroid binding globulin
Estrogen/pregnancy= increased
Hypothyroidism, protein deficiency= decreased
34
MOA of Glucocorticoids
What effect do they have on metabolism, hematopoietic and anti-inflammation
Bind to receptors in cytoplasms; 20% of gene regulation is due to glucocorticoids
Increases lipolysis to create hyperglycemia
Causes WBC migration to lymph tissue
Blocks release of arachidonic acid to reduce progstaglandins and leukotrienes
35
What glucocorticoid is used for Addison's Dz
What glucocorticoid is used for Asthma
Hydrocortisone (and Fludrocortisone if mineracorticoid activity is needed)
Prednisone, Prednisolone- less mineral activity
36
What glucocorticoid is used for acceleration of lung maturation
What glucocorticoid is used for COPD
Dexamethasone or Metamethasome IM
Methylprednisolone, Prednisone
37
What glucocorticoid is used for CT/Rheumatic d/os
What glucocorticoid is used for post-op/chemo N/V
Prednisone- well absorbed and cheap; can substitute w/ Methylprednisolone or Prednisolone
Dexamethasone IV- most commonly used/studied
38
What glucocorticoid is used for poison oak/ivy/sumac
What drug interactions does glucocorticoids have?
Prednisone- do not use pre-packaged corticosteroids
CYP450 inducers- increase metabolism and decreased efficacy
OCP, Itraconazole, Macrolides- decreased clearance
K-depleting drugs/diuretic- increased risk of hypokalemia
39
What are the adverse effects of inhales glucocorticoids?
When d/c these meds, how long of a taper period is needed?
Thrush, Dysphonia, Dry mouth
Growth suppression
Use longer than 2wks= 5-20% per 1-2wks (inc dose if Flu Sxs/Dz flare occurs)
Switch to Prednisone
Consolidate daily doses to single morning dose
Consider cortisol therapy prior to d/c
40
What are the short term s/e of glucocorticoid usage?
Suppression of the HTA by these meds is unlikely if they were taken for what time frame?
HPA suppression is likely if taken for ?
Unknown risks if meds are taken for ?
Weight gain, Hyperglycemia, Acne, Moods
<3wks or every other day dosing
>20mg of prenisone or equivalent >3wks
5mg or more of prednisone or equivalent at bed >3wks
Any PT w/ Cushingoid appearance
10-20mg of prednisone equivalent for >3wks
41
When are topical glucocorticoids used?
When are they contraindicated?
DOC for dermal flares- Allergic contact dermatitis, Atopic eczema, Seborrheic dermatitis
Acne vulgaris, Rosacea, Warts, Fungal infections, Ulcers
42
What are the Very High, High, Medium and Low potency glucocorticoids
Very- Betameth dipro 0.05% ointment/gel
High- Betameth dipro 0.05% lotion/cream
Med- Betameth dipro 0.05% lotion/cream
Low- Desonide, Hydrocortisone/acetate
43
Pros/Cons of topical ointments, creams, lotion/gel, and foam/shampoos
Oint- more lube/occlusion= improves absorption, most useful for dry/thick hyperkeratotic lesions, NOT for hairy areas
Cream- PT preference, disappearances in skin, less potent than ointment, best for acute exudtative inflammation
Lotion/Gel- lowest grease/occlusion of all topicals, best for hairy areas, good for poison ivy
Foam/Shampoo- scalp/hairy areas but more $
44
What are the potency ranges for glucocorticoids
1 Very High, don't d/c abruptly (Clobetasol)
2 High, avoid occlusive dressings (Fluocinonide)
3-5 Med, large surface areas/non-face, less than 3mon (Triamcinolone)
6-7 Low, Kids, Pregnant, Old w/ large areas in sensitive parts (Hydrocortisone)
45
How are glucocorticoid dosages measured out?
Finger tip= 500mg/0.5g and covers both sides of adult hand w/ fingers closed
46
Clinical use of Cortisone
Clinical use of Hydrocortisone
Primary/Secondary adrenal cortical insufficiency (Addisons)
Addison's, UC, Asthma, Joint injections
47
What is the most prescribed oral med for short term therapy for inflammatory d/os?
What are 6 intermediate acting PO Glucocorticoids?
Prednisone
Prednisone, Prednisolone, Methyprednisolone, Methylpred Acetate, Methylpred Soduim Succinate, Triamcinolone
48
What is the long acting PO Glucocorticoid
What is the corticosteroid antagonist and what is the MOA, Use and Adverse facts of it
Dexamethasone
Resp/Derm/GI/Eye Dzs
Ketoconazole
Inhibits adrenal gonadal synthesis and dec synthesis of corticosteroids
Cushings Dz if surgery isn't possible
Adrenal suppression, Gynecomastia, Inc cholesterol, Hypo thyroid
49
What is the MOA and Use for Aldosterone
When treating Addison's Dz, what can Cortisol and Aldosterone deficiency be supplemented with?
Na, BiCarb and Water reabsorption in CD/DT
Addison Dz
Hydrocortisone and Fludrocortisone
50
What is the MOA and Use of Fludrocortison
MOA and Use of Spironolactone and Eplerenone
Exogenous, 15x the glucocorticoid activity than hydrocortisone
Used to replace aldosterone in Addison's Dz
Aldosterone antagonist
CHF diuretic, Tx of hyperaldosteronism (primary)
51
What are the 5 risks for osteoporosis?
```
Low Estrogen
Age= red Ca reabsorption
Ca deficiency
Vit D deficiency
Inc PTH from adenoma or Vit D deficiency
```
52
What are the 5 classes of drugs and names used for osteoporosis
```
Bisphosphonates- RAIZ
SERMS- Raloxifene, Conjugated estrogen/bazedoxifene
PTH- Teriparatide
Calcitonin- salmon nasal spray
Denosumab- full human monoclonal Ab
```
53
How much Ca and Vit D are needed each day?
What is D3, D2, Calcidiol, Calcitriol
Ca- 1200mg
Vit D- 800IU
D3- cholecalciferol
D2- ergocalciferol
diol- liver to kidney
triol- kidney to gut/bone
54
What is the first line class of drug for treating osteoporosis and Paget's dz
This type of therapy is recommended to last for 5yrs, but can be extended if a PTs T score is below ?
Bisphosphonates- reduce vertebral and non-vertebral Fx, except- Ibandronate- only vertebral Fx
-3.5, extend to 10yrs
55
When is Estrogen replacement therapy contraindicated
SrCr <30
56
MOA, Use, and C/C of ERT
Inhibits resorption and promotes bone formation
Started during menopause
Lowest dose for Tx of Vasomotor Sxs
VTE
Pregnant/on hormones
Breast/ednometrial CA
UnDx genital bleeding
57
MOA, Use, Adverse, and C/C of Bisphoosphonates
Dec -clast activity to inc bone density and prevent Fxs
1st line for PTs w/ osteoporosis and Paget's Dz
GI, Jaw Necrosis, Atypical Fxs, Esophageal CA
SrCR <30ml/min
30 min wait w/ 8oz H2O
1hr if on Ibandronate (only for spine Fxs)
58
What are the two most common conditions that fall under COPD
Chronic bronchitis- excess mucus secretion for most days for 3mon for more than 3yrs
Emphysema- abnormal enlargement of bronchiole air spaces
59
Facts of COPD
Facts of Emphysema
C- clinical Dx of daily productive cough
Over weight, cyanotic, Inc Hgb, rhonchi/wheezing and peripheral edema
E- pathological Dx of permanent enlargement/destruction of air spaces
Older/thin, dyspnea, quiet chest, flat diaphragm on x-ray
60
COPD is an imbalance of what 3 things that involve what cells?
Inflammatory- neutrophils, macrophages, CD8/TNF-a, IL-8, LT-B4
Protease imbalance
Oxidative stress- inc markers= hydrogen peroxide and NO
61
What type of blood gas irregularity is seen in COPD
Hypoxemia- dec pO2, low V/Q ratio, hypercapnia, normal pH
```
V= lung ventilation
Q= perfusion
```
62
Define COPD Gold levels
Mild= 80% or higher
Mod= 50-80%
Sev= 30-50%
Very Sev= <30% or FEV1 <50% w/ chronic respiratory failure
63
What are the Sxs of the four COPD Gold levels
What are the indications/reasons to admit a PT with COPD?
```
1= chronic cough/sputum
2= SOB w/ exertion
3= reduced exercise tolerance
4= failure, edema, inc JVP
```
```
High risk comorbidity (pneumonia, arrhythmia, CHF, DM, RF, HF)
Poor OutPT response
Worsening dyspnea
Can't eat/sleep
Hypoxemia/Hypercapnia
AMS
Uncertain Dx
```
64
How often should COPD PTs exercise?
How much supplemental O2 can be used?
3-7x/wk @ 70% of max
1-2L/min
>15hrs/day increases PT survival
65
COPD Pts can get what 2 vaccinations?
What are the steps to COPD management?
Influenza and Penumococcal
```
SABA/SAMA
LABA/LAMA
LABA/LAMA combo
Inhaled CCS in severe Dzs
Roflumist- FEV1<50%
```
66
What do A-D COPD severity categories get for meds?
```
A= any
B= LAMA or LABA
C= LAMA
D= LAMA or LABA
```
67
What drug class is central to symptomatic management of COPD?
What 4 does this include?
Bronchodilators
B2 agonists
Anticholinergics
Theophylline
Combo therapy
68
What are the 3 SABAs?
What are the 4 LABAs?
Levalbuterol, Albuterol, Terbutaline
Salmeterol, Olodaterol, Formoterol, Arformoterol
69
What are the 2 ultra-long acting B2 agonists?
What is the SAMA?
What are the four LAMAs?
Indacaterol and Indacaterol/Glycopyrrolate
Ipratropium Bromide
Glycopyrronium bromide, Aclidinium bromide, Umedclidinium, Tiotropium
70
Inhaled corticosteroids improve what 3 things in COPD PTs?
What are the risks of these drugs?
Sxs, Function, QoL
Pneumonia, Thrush, Exacerbation induced withdrawal, NO modification of FEV1 decline
Do NOT decrease mortality
71
What are the benefits of using inhaled CCS and LABAs together?\
What is a drawback/risk of this combo?
What med as an additive is even additionally beneficial?
More effective
Improved lung function and health
Reduced exacerbation
Pneumonia
Tiotropium
72
If PT taking inhaled CCS develops Candidiasis infection, how are they treated?
What are the 4 inhaled CCS combos that can be used?
Treat w/ appropriate anti-fungal while continuing therapy w/ inhaler
Formoterol/Budesonide
Formoterol/Mometasone
Salmeterol/Fluticasone
Vilanterol/Fluticasone
73
What are the two Methylxanthines used for COPD?
What is the PDE-4 inhibitor used in COPD?
Aminophylline and Theophylline
Roflumilast
74
COPD PTs can get what two vaccines and how often?
What type of ABX can they receive?
Influenza- annually
Pneumococcal- at Dx and 65 or older if last vaccine was more than 5yrs ago
Macrolides- Azithromyin and Azithromycin
75
What drives COPD PTs need to breathe?
What caution needs to be taken when correcting and what needs to be monitored?
Low O2
Normal PT is elevated CO2
Inc O2 can induce respiratory distress and failure, pCO2 and ABG
76
What COPD PTs are not candidates for NPPV treatments?
What type of bronchodilator is typically avoided in COPD PTs but can be used as an alternative?
AMS, pH<7.25, Respiratory arrest, CV instability
Theophylline
77
What 3 drugs are used for COPD exacerbations?
If one of these is used for _ days, taper is needed?
Bronchodilator- SABA
CCS- Prednisone or IV equivalent if NPO
ABX- if 2 of 3 cardinal Sxs are present (Dyspnea, Sputum Volume/Purulence) x 7-10 days
CCS use for 14 days or longer to prevent HPA axis suppression
78
Define an Uncomplicated COPD Exacerbation and how is it Tx
<4 exacerbations/year
FEV1>50%
Macrolide, Cephalosporin, Doxy
79
Define a Complicated COPD exacerbation and how is it treated?
65 or older
>4 exacerbations/year
FEV1 <50 but >35%
Amoxocillin, Fluroquinolone
80
Define a complicated COPD exacerbation with risk of Pseudomonas infxn
```
Chronic bronchial sepsis
Need for chronic CCS
Nursing home resident
> 4 exacerbations/year
FEV1 >35%
```
IV therapy w/ B lactamase resistant penicillin
81
Acute asthma management in PTs 12y/o or older
What 3 drugs can be used prior to exercise to prevent asthma
Inhaled B-agonists: albuterol or Levalbuterol PRN
Inhaled B-agonist, Montelukast, Nedocromil
82
How are persistent asthma cases handled?
```
Inhaled CCS is first line
Combo:
Formoterol/Budesonide
Fluticasone/Salmeterol
Mometasone/Formoterol
```
83
Recommended long term control for asthma levels 1-6
1- none
2- low dose ICS
3- low dose ICS + LABA or med ICS alone
4- med dose ICS and LABA
5- High ICS and LABA, consider Omalizumab for PTs w/ allergic asthma
6- High dose ICS plus LABA plus systemic ICS and consider Omalizumab
84
How is EIB managed?
SABA 15m prior and are DOC
LABA and Formoterol 30-60min prior
Leukotriene modifiers (Zileuton) used daily but not PRN
85
Use of a SABA more than ?days/wk indicate inadequate control and need for step up treatement
What drug is the first line anti-inflammatory therapy for mild-severe persistent asthma in adults and kids?
> 2 days/wk
Inhaled CCS and the preferred anti inflammatory in chronic asthma
86
What are the 2 most frequently used PO corticosteroids
Which one is given in IV form for PTs that are NPO
Prednisone and Prednisolone
Methylprednisolone
87
When are systemic CCS used?
What 3 drugs can be used?
Mod-severe exacerbation, to prevent progression
Methylprednisolone
Prednisolone
Prednisone
88
What are the adverse effects of using systemic CCS'?
What is the combo of CCS/LABA used for?
Inc appetite/fluid retention, HTN, Mood change
Long term prevention/suppression of Sxs and reversal of inflammation
Reduces need for PO CCS
89
What are the 4 forms of CCS/LABA combos?
Fluticasone/Salmeterol
Budesonide/Formoterol
Mometasone/Formoterol
Flucicasone/Vilanterol
90
Mild Asthma exacerbation and Tx
Moderate asthma exacerbation and Tx
Dyspnea w/ activity
SABA or short use of OCS
Dyspnea interferes w/ normal activity
Dr office/ED for SABA and OCS Tx
91
Severe Asthma exacerbation and Tx
Life threatenting asthma exacerbation and Tx
Dyspnea at rest
ED visit for SABA and OCS
Too dyspneic to speak
IV CCS and little help from SABAs
92
Asthma has what cells more present and predominant?
CD4, Inc ration of CD4/CD8, Eosinophils, Mast cells, Neutrophils in severe asthma, IL3-5
CD8, Dec ration of CD4/CD8, Neutrophils, Machophages, Eosinophils during exacerbation IL-8 and IL-1
93
What are the 5 A's of tobacco cessation?
How long can nicotine gum be used?
Ask, Advise, Assess, Assist, Arrange
12wks
94
UV light is needed to activate for form of Vit D?
What are the 4 RF for osteoporosis
Cholecalciferol Vit D3
```
Low Estrogen
Inc age= dec Ca absorption
Ca deficiency
Vit D deficiency
Inc PTH secretion from adenoma/Vit D deficiency
```
95
Major barrier layer of the skin is the ? layer
Passage through the ? layer is the rate limiting step of percutaneous absorption?
Corneum- outtermost made of dead corneyocytes (terminally differentiated keratinocytes)
Stratum- may act as reservoir and lengthen half life
96
Skin permeability is inversely proportional to ?
Most derm dzs have a dysfunction in ? layer
Thickness of Corneum
Corneum
97
What can be done prior to applying skin meds that will increase it's absorption abilities?
What is an ideal topical agent?
Soak in water
Low molecular weight <600Da and soluble in water and oil
98
What are ointments best used for?
Protects skin while penetrating chronic/thick walled lesions
| Hydrocortisone ointment for scaling on non-hairy skin
99
What are gels best used for?
Drying effect due to water/alcohol content
Least occlusive and quick drying
Acne, Exudative inflammation/oozing on scalp/hair
Testosterone 1%
100
What are creams best used for?
Less greasy and vanish w/ rubbing
Acute exudative inflammation intertriginous areas w/ good corneum penetration
Hydrocortisone cream
101
What are lotions best for?
What are aerosols best for?
Exudative lesions on hairy areas
Scalp and hair areas w/out need for contact (Miconazole)
102
What are tinctures best for?
What are foams best for?
Scalp/hair areas (Benzoin, Podophyllum, Minocazole)
Spread easily through scalp/hairy areas (Rogaine)
103
What are pastes best for?
What are powders best for?
What are wet preparations best for?
Chronic inflammation w/ xerosis, scaling/ not for weeping/hairy areas (Anthralin Paste)
Wet skin Dzs and reduce friction (Tinactin)
Acute inflammation w/ oozing and vesiculation lesions (NS, Acetic Acid, Domeboro)
104
What is the most common derm condition in clinic?
What are the 3 phases?
Contact dermatitis
Irritant: acid/soap
Allergic: poison ivy
Acute- blisters/weeping skin
Sub-acute- crust/scab
Chronic- dried and thickened lesions
105
What meds are avoided in contact dermatitis Tx?
What 3 can be used for mild cases?
Ointment, anesthetics, anti-histamines, calamine
Wet dressing
Astringents- Aluminum Acetate
Colloidal oatmeal bath
106
How is moderate contact dermatitis treated?
How are severe cases Tx?
Counterirritant- Camphor/Methanol
Topical anti-histamine- Diphenhydramine
Topical steroid
Systemic corticosteroids- Prednisone 40mg 4-6days
107
How is Seborrheic dermatitis treated
Shampoos w/ any of these ingredients:
Antigungal- ketoconazole
Antiproliferative- Coal tar, Selenium sulfide, Zinc pyrithione
108
What is the IgE mediated skin response and how is it treated
```
Atopic Dermatitis
Inc skin hydration
Corticosteroids
TIMS
Systemic therapy- PO antihistamines
```
109
TIMs MOA and names
What are they used for
Inhibit T cell activation
Pimecrolimus
Tacrolimus
Atopic dermatitis and chronic inflammatory skin dz
Alternative to topical steroids
110
What is the FIRST line choice for atopic dermatitis and psoriasis of the face, flexural or genital areas?
What caution needs to be taken with these drugs?
TIMS
UV exposure
Lymphoma and skin CA
111
How is impetigo treated
Mupirocin
| Systemic ABX- Dicloxacillin/Cephalexin
112
Stopped on Slide
24 Derm
