Pharm 3 Topical Agents pt3

Question 1

5 categories of Cutaneous Preparations

Answer 1

Steroids
Topical antibiotics
Topical antifungals
Scabicides/pediculides
Topical acne preparations

Question 2

Creams

Base, color, versatility, misc

Answer 2

Mixture of organic oils & water
WHITE, somewhat greasy
Most frequently Rx’d base used on nearly every body surface, esp. useful in intertriginous areas
COSMETICALLY more acceptable; can be drying after prolonged use

Question 3

Ointments

Color, versatility, misc

Answer 3

Translucent, greasy feeling persists
Greater penetration, useful for dryer lesions, enhanced potency
Too occlusive for acute exudative eczematous inflammation

Question 4

Gels

Base, color, misc

Answer 4

Greaseless mixtures of propylene glycol, water, alcohol
Clear w/ a jellylike consistency
Unpleasant, sticky feeling, may be irritating
Alcohol gel feels cool and are drying, useful in acute exudative inflammation (I.e., poison ivy)

Question 5

Solutoins & Lotions

Versatility, Misc

Answer 5

Most useful for scalp because it penetrates the hair shaft

May be drying and irritating when used in intertriginous areas

Question 6

Aerosols are only applied when?

Answer 6

Aerosols are only applied if the patient cannot reach where it must be applied.

Question 7

List the 5 topical preparations from lowest to greatest frequency of application.

Answer 7

Ointments, Gels, Creams, Solutions & Lotions, Aerosols

Question 8

Topical Corticosteroids
Example
Indication
What does it do?

Answer 8

Example: triamcinolone acetonide (Aristocort)
Indicated in corticosteroid-responsive inflammatory and pruritic dermatoses such as psoriasis, eczema, contact dermatitis
Anti-inflammatory effects are produced through vasconstriction of the small vessels in the upper dermis (causes thinning of the skin)

Question 9

Topical corticosteroids have the same pharmacologic effects as:

Answer 9

systemic steroids

Question 10

There are numerous topical coticosteroids available
__ is the most important variable in selecting a topical corticosteroid.
The potency is not determined by its strength but rather by __

Answer 10

Potency; Vasoconstrictor assays

Question 11

The dose of one steroid dose not correlate with the dose of another
T/F?

Answer 11

True

Question 12

Group _ corticosteroids are the most potent and Group _ are the least potent

Answer 12

Group I corticosteroids are the most potent and Group VII are the least potent

Question 13

Rank these by potency (most to least). What are these?
Betamethasone
Hydrocortisone
Triamcinolone

Answer 13

These are Topical steroids.
Betamethasone
Triamcinolone
Hydrocortisone

Question 14

The most common complication of topical steroids is:

Answer 14

suppression of the hypothalamic-pituitary-adrenal axis

Question 15

7 topical antibiotics. (first 2 are most common)

Answer 15

Bacitracin (Bacitracin)
Neomycin sulfate (Neomycin)
Erythromycin (Erygel)
Gentamycin (Gentamicin)
Polymyxin B sulfate (Polymyxin)
Mupirocin (Bactroban)
Silver sulfadiazine (Silvadene)

Question 16

Bacitracin ointment (Bacitracin)
What is it?
Indication
Caveats

Answer 16

a Common topical antibiotic
To prevent an infection. Indicated for prophylaxis of infection in minor wounds, burns and skin abrasions and to aid in healing of susceptible organisms especially streptococci, pneumococci, staphylococci and other gram-positive organisms
Poorly absorbed and allergic sensitivity is rare

Question 17

Best tx for a wound is:

Answer 17

irrigation

Question 18

Mupirocin (Bactroban)
What is it?
Indication

Answer 18

a Common Topical Antibiotics
Indicated for localized treatment of IMPETIGO caused by S. aureus (including MRSA and -lactamase producing strains), S. epidermidis, S. saprophyticus, -hemolytic streptococci, S. pyogenes
Mechanism of action is thru the blocking of protein synthesis of bacteria by binding with the transfer ribonucleic acid (tRNA) synthetase

Question 19

What’s the antibiotic to treat impetigo?

Answer 19

Mupirocin (Bactroban)

Question 20

Silver sulfadiazine (Silvadene)
What is it?
Indication
Precautions

Answer 20

a common topical antibiotic.
Indicated for 2º and 3º burns of the skin
Precautions: may permanently stain some skin, esp on face/hands

Question 21

If someone have a burn on their forearm what drug is used?

What if it’s a burn on the face/hands?

Answer 21

Forearm: Silver sulfadiazine (Silvadene)

Face/hands: Bacitracin

Question 22

Prototypical Topical Antifungal
Example
Indication

Answer 22

Example: Clotrimazole
Indication: treatment of tinea pedis, tinea cruris, tinea corporis, tinea versacolor caused by M. furfur, and candidiasis caused by C albicans

Question 23

___ determines how long we treat with an antifungal.

Answer 23

Where the infection is.