Pharm Derm part I

Question 1

what are the topical antibiotics used for acne

Answer 1

clindamycin
erythromycin
metronidazole

Question 2

what are the topical antifungals

Answer 2

azoles
ciclopirox olamine
allylamines- terbinagine (lamisil)
butenafine
folnaftate
nystatin and amphotericin B

Question 3

what are the oral antifungals

Answer 3

azoles- ketoconazole, itraconazole, fluconazole, voriconazole

Question 4

what are the topical antiviral agents

Answer 4

acyclovir, penciclovir, docosanol

Question 5

what are the immunomodulators used for derm

Answer 5

imiquimod

tacrolimus and pimecrolimus

Question 6

what are the specific acne preparations

Answer 6

retinoic acid and derivatives: retinoic acid, adapalene, tazarotene
isotretinoion (accutane)
benzoyls peroxide

Question 7

what are the drugs used for psoriasis

Answer 7

acitretin, tazarotene, calcipotriene, cyclosprine

TNF inhbitors: etanercept, infliximab, adalimumab

Question 8

what are the anti inflammatory agents used for derm

Answer 8

topical steroids: hydrocortisone, hydrocortisone valerate, triamcinolone, acetonide, betamethasone, others

Question 9

what are the keratolytic and destructive agents used in derm

Answer 9

salicylic acid

fluorouracil

Question 10

what drugs do we use for antipruritic

Answer 10

antihistamine

Question 11

what drugs do we use for trichogenic and antitrichogenic

Answer 11

minoxidil(rogaine)

finasteride (propecia)

Question 12

which layer of skin limits diffusion of compunds

Answer 12

stratum corneum

Question 13

what areas of body are more permeable than the forearm

Answer 13

scrotum, face, axilla and scalp

Question 14

what factor helps increase the amount of drug transfered through skin

Answer 14

increased [ ] will increase the [ ] gradient so more transferred

Question 15

what allows for the once daily application of topical drugs

Answer 15

skin acts as reservoir for many drugs

Question 16

what is an occlusive dressing

Answer 16

application of plastic wrap– holds drug in close contact with skin

Question 17

3 routes which molecules can penetrate skin

Answer 17

intact stratum corneum (rate limit is percutaneous absorption)
sweat ducts
sebaceous follicles

Question 18

steps for percutaneous absorption

Answer 18

make [ ] gradient (force for drug movement across skin)
partition coefficient: release of drug from vehicle
diffusion coefficient: drug diffusion across layers of skin

Question 19

what are factors for rate of absorption

Answer 19

[ ] drug in vehicle, partition coefficient, diffusion coefficient, thickness of stratum corneum

Question 20

preferable characteristics of topical drugs

Answer 20

low molecular mass
adequate solubility in oils/lipids and water
high lipid: water partition coefficient

Question 21

what particles do not cross stratum corneum

Answer 21

water soluble ions and polar molecules

Question 22

what are the vehicles used for topical medications in order of most to least ability to retard evaporation from surface skin

Answer 22

ointments, creams, paste, powders, aerosols, gels, lotions, wet dressings, tinctures

Question 23

best vehicle for acute inflammation with oozing, vesiculation and crusting

Answer 23

drying preparations: tinctures, wet dressings and lotions

Question 24

best vehicle for chronic inflammation with xerosis, scaling and lichenification

Answer 24

creams and ointments

Question 25

transdermal patches are used for what

Answer 25

contraception, smoking cessation, hormone therapy, osteoporosis, hypogonadism, pain relief, motion sickness, local anesthesia and angina pectoris

Question 26

methods to hydrate skin so drug absorbed more

Answer 26

occlusion with impermeable film, application of lipophilic occlusive vehicles like ointments and soaking dry skin before occlusion

Question 27

difference of age when giving topical medications

Answer 27

children have greater SA than to mass ratio. so more systemic effects. decrease dose

Question 28

what is intralesional administration and what is main reason not to use it

Answer 28

direct contact of drug with underlying pathologic process. eliminates first pass watch out for systemic absorption

Question 29

when do you use systemic administration of derm agents

Answer 29

systemic infections, yeast, fungus, bacteria or severe dermatological illness

Question 30

MOA bactitracin and gramicidin

Answer 30

inhibit cell wall synthesis, bind phospholipids and increase permeability of cell wall

Question 31

spectrum bacitracin and gramicidin

Answer 31

gram + and anaerobic cocci: neisseria, tetanus bacilli and diphteria bacilli

Question 32

MOA mupirocin

Answer 32

inhbiits protein synthesis

Question 33

spectrum mupirocin

Answer 33

gram + aerobic bacteria and MRSA | allowed for Tx impetigo

Question 34

MOA polymyxin B sulfate

Answer 34

binds phospholipids and increases permeability of cell wall membrane

Question 35

spectrum polymyxin B sulfate

Answer 35

gram - organisms: P aeruginosa, E coli, Enterobacter, Klebsiella

Question 36

Polymyxin B sulfate toxicity

Answer 36

neurotoxicity and nephrotoxicity

Question 37

MOA neomycin and gentamicin

Answer 37

irreversibly binds 30S subunit and inhibits protein synthesis

Question 38

spectrum neomycin and genta

Answer 38

gram - E coli, Enterobacter, Klebsiella, Proteus, genta: P aeruginosa, staphylococcie, group A beta-hemolytic strep

Question 39

toxicity with neomycin and gentamicin

Answer 39

nephrotoxicity, neurotoxicity and ototoxicity if have renal failure since excreted primarily in urine

Question 40

MOA clindamycin

Answer 40

inhibits protein synthesis binds 50S | works against P acnes

Question 41

MOA erythromycin

Answer 41

inhibits protein synthesis. binds 50S

Question 42

complications of using erythromycin for acne

Answer 42

R to staphylococci, need to discontinue and start systemic

Question 43

MOA metronidazole

Answer 43

interacts with DNA resulting in strand breakage, anti inglammatory effects

Question 44

uses of metronidazole for acne

Answer 44

acne rosacea

Question 45

CI to metronidazole use for acne

Answer 45

during pregnancy or nursing because carcinogenic nature

Question 46

MOA Na sulfacetamide

Answer 46

inhibit P acnes thorugh competetive inhibition and inhibits bacterial folic acid synthesis

Question 47

CI Na sulfacetamide for acne

Answer 47

sensitivity to sulfonamides