Pharm 27 Objectives Flashcards
What are some general principles of topical drug therapy?
- Avoids systemic absorption of agents
- Use an appropriate vehicle
- Apply a WET dressing with evaporate to an oozing/weeping lesion to dry it
- To moisturize a dry lesion, trap moisture with occlusive agents
What are some general principles of transdermal drug therapy?
Achievement of systemic concentrations due to controlled delivery of drug
Avoids “first pass” effect from the liver
Best for small, highly lipid-soluble molecules
Dose of drug is determined by surface are covered
Delay between start and stop of dosing
Types of patches differ
Patches can have 10-95% of drug left inside after removal
What vehicle do you select that are drying and will enhance evaporation from the skin?
Solutions (wet dressing and suspensions) Sprays (aerosols and aqueous sprays) Lotions Gels Powders
What vehicle do you select that are moisturizing and will trap water in the stratum corneum
Creams
Ointments
Ointment bases
What is the rank of vehicles from most moisturizing to least moisturizing?
Occlusive dressing Ointment Cream Lotion Gel Spray Solution
What will occur if you select the wrong vehicle (wetting vs non-wetting dressing)?
It can hamper wound healing
What is an example of low potency topical corticosteroid medication?
Hydrocortisone (1% or 2.5%)
What is an example of medium potency topical corticosteroid medication?
Triamcinolone (0.1%)
What is an example of high potency topical corticosteroid medication?
Flucinonide (0.05%)
What is an example of very high potency topical corticosteroid medication?
Clobetasol (0.05%)
Why can Tiamcinolone be in the medium and high potency class?
Different % of the drug (0.025%, 0.1% and 0.5%)
What are the therapeutic uses for topical corticosteroids?
Relieves inflammation and itching
- Contact dermatitis
- Eczema
- Psoriasis
What are some ASEs of topical corticosteroids?
Atrophy/thinning of skin
Telangiectasias
Striae (striped skin)
HPA axis suppression from systemic absorption
What is Telangiectasia which are an ASEs to topical corticosteroids?
Dilated capillaries, red, elevated, wart-like spots
How does HPA axis suppression occur with the use of topical corticosteroids?
Applying high potency agents over time
Applying moderate-high potency agents over broken skin
What are contraindications of topical corticosteroids?
Skin infections
Applying to broken skin (causes systemic absorption)
What is the therapeutic use of Nystatin?
Yeast infections
- diaper dermatitis
What is the therapeutic use of Clotrimazole?
Tinea versicolor
What is the therapeutic use of Terbinafine?
Tinea Pedis
MOA of benzoyl peroxide?
Drying and may increase cell turnover
ASEs of benzoyl peroxide?
Local irritations and bleaches clothing/bed sheets
How do you reduce irritation caused by benzoyl peroxide?
Start by diluting it with water, then work up to full strength
Clinical use of benzoyl peroxide?
Acne
MOA of salicylic acid?
Desquamates stratum corneum by dissolving cement holding epithelial cells together
-Softens and discourages growth of calluses
Clinical uses of salicylic acid?
Acne Seborrheic derm Psoriasis of body and scalp Dandruff Wart removal Hyperkeratotic skin disorders
ASEs of salicylic acid?
Skin peeling
Contraindications of salicylic acid?
Avoid using on irritated, broken or infected skin, use appropriate product (use only as concentrated as necessary)
MOA of topical retinoids (adapalene, tretinoin, etc)?
Modulator of cellular differentiation, keratinization, and inflammatory processes
Clinical use of topical retinoids (adapalene, tretinoin, etc)?
Acne
ASEs of topical retinoids (adapalene, tretinoin, etc)?
Very irritating (adapalene is less irritating)
Photosensitivity
What are some special monitoring parameters of topical retinoids (adapalene, tretinoin, etc)?
Can be used with topical antibiotics, but need to watch for irritation
Use sunscreen when using retinoids
Clinical use of azelaic acid?
Inflammatory acne (BID up to 6 mos or longer)
Inflammatory lesions of rosacea
ASEs of azelaic acid?
Skin irritation
Lightening of skin