Pharm 3 Topical Agents pt4

Question 1

What causes scabies to itch?

Answer 1

It is the fecal matter that causes the itching

Question 2

What is scabies’ characteristic rash?

Answer 2

characteristic rash of localized burrows in the finger webs, on the flexor aspects of the wrists and penis
Using gloves and a magnifying glass, look for the dark point at the end of the burrow (the mite)

Question 3

What is a vital thing to do if someone has scabies/pediculosis?

Answer 3

Scrupulous cleaning of the environment, including any infected brushes, combs, clothing, linens and contact surfaces is vital

Question 4

Prototypical Scabicide/Pediculide
Example
Indication
How’s it work?

Answer 4

Example: Permethrin (Elimite)
Indication: a synthetic pyrethroid indicated for the use against lice, mites, ticks, fleas
Causes paralysis of the pests

Question 5

Scabicide/Pediculide Administration

Answer 5

massage into skin from head to soles of feet. LEAVE ON FOR 8-14 HOURS AND WASH OFF COMPLETELY

Question 6

Scabicide/Pediculide Cautions

Answer 6

Contraindicated in patients w/ hypersensitivity to synthetic pyrethrin or CHRYSANTHEMUMS

Question 7

Otic preparations fall into one of six categories (or some combination of those categories):

Answer 7

Antibacterials
Antifungals
Steroids
Astringents
Analgesics/anesthetics
Wax softeners

Question 8

Otic Antibiotic Preparations
Example
Indication
Cautions/contraindications

Answer 8

Example: Oflaxacin otic (Floxin otic)
Indication: susceptible bacterial infections of the external auditory canal, especially acute otitis externa
Cautions/contraindications: Pregnancy Category C, hypersensitivity to quinolones. Probably wouldn’t use this in a pregnant patient.

Question 9

Antifungal/Astringent Combination
Examples (2)
Indication
Contraindication

Answer 9

It’s very rare to get a fungal infection in the ear.
Example: Acetic acid, propylene glycol diacetate (Volsol)
Indication: superficial fungal infections of the external auditory canal
Contraindications: perforated TM

Question 10

Antibiotic/Steroid Otic Preparations
Examples (3)
Indication
Contraindications/precautions

Answer 10

Example: Polymyxin B sulfate, neomycin, hydrocortisone (Cortisporin otic) solution and suspension
Indication: susceptible superficial infections of the external auditory canal, esp. otitis externa
Contraindications/precautions: cutaneous viral infections, esp. herpes simplex, varicella zoster, perforated TM (with solution only)- (you can use suspension still).

Question 11

Otic Analgesic/Anesthetic
Example
Indication
Contraindication

Answer 11

Example: Antipyrine with benzocaine in glycerine (Auralgan)
Indications: analgesia in acute otalgia, especially otitis media
Contraindications: perforated TM

Question 12

Otic Preparations: Wax Softener
Example
Indication
Contraindication’

Answer 12

Example: Carbamide peroxide 6.5% (Debrox)
Indicated for softening and removal of impacted cerumen
Contraindicated with perforated tympanic membranes

Question 13

What works equally effectively as a wax softener as Carbamide peroxide (Debrox)?

Answer 13

Hydrogen peroxide works equally effectively.

Question 14

4 categories of intra-oral preparations

Answer 14

Antifungals
Antivirals
Gingivitis and prophylaxis
Palliative combinations

Question 15

Intra-oral Antifungal Preparations
Example
Indication

Answer 15

Example: Nystatin (Mycostatin)
Indication: oral candidiasis (thrush) and prophylaxis in profoundly immunocompromised patients

Question 16

Who gets Thrush? (2)

What’s a medication for it?

Answer 16

Profoundly immunocompromised: A patient the day after receiving chemo.
Thrush is seen in HIV, Diabetics, ppl who take corticosteroids who don’t rinse their mouth out afterwards, and KIDS.
Tx: Nystatin

Question 17

Intra-oral Preparations
Example
indication
How to apply

Answer 17

Example: Pencyclovir (Denavir)
Indication: herpes labialis
Apply sparingly using a Q-tip to affected area every 2 hours while awake for 4 days

Question 18

What’s a drug for Gingivitis, if a patient is mentally challenged to the point where they have poor hygine..or the elderly.

Answer 18

Chlorhexidine (Peridex)

Question 19

“Magic Mouthwash”
What is it? (3 parts)
Indication?

Answer 19

equal parts Benadryl, Maalox, and viscous Lidocaine
Maalox has soothing qualities
Viscous Lidocaine: a topical anesthetic
Indication: analgesia for intra- and peri-oral lesions, esp. gingival stomatitis

Question 20

3 categories of vaginal preparations

Answer 20

Antifungals
Antibiotics
Antiprotazoals

Question 21

Vaginal Antifungal Preparations
Example
What forms it’s available in (2)
Indication

Answer 21

Example: Clotrimazole (Gyne-lotrimin)
Available in creams and suppository
Indication: susceptible vaginal fungal infections caused by Candida albicans and non—albican infections

Question 22

What drug is meant for pregnant women who have BV?

Answer 22

Clindamycin phosphate (Cleocin cream 2%)

Question 23

Vaginal Antibiotic Preparations
Example
Indication

Answer 23

Example: Clindamycin phosphate (Cleocin cream 2%)

This is for women who have BV when they’re pregnant.

Question 24

Vaginal Antiprotozoal Preparations
Example
Indication

Answer 24

Example: metronidazole (MetroGel vaginal gel 0.75%)

Used for pregnant women with trichomonas.

Question 25

3 vaginal preparation pearls

Answer 25

Treat all partners as well as your patient
Refrain from all forms of intercourse until completing entire course of medication and patient has recheck examination
Consider DM, HIV in patients with recurrent Candida infections