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Skin, Blood, Lymph Exam 2 > [PHARM] Dermatologic Pharmacology [Wollff] > Flashcards

[PHARM] Dermatologic Pharmacology [Wollff] Flashcards

1
Q

What are 2 benefits of using ointment vs. cream dermatologic drugs?

A
  • Provide for more complete absorption of the active ingredient
  • Are less likely to cause an allergic rxn than creams, which contain preservatives
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2
Q

Which is better for using on oozing/”wet” skin conditions, creams or ointments?

A

Creams

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3
Q

What is better for using on large areas, creams or ointments?

A

Creams: spread easily, are well-absorbed, and wash off with water

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4
Q

Refers to agents such as glycerin, lecithin and propylene glycol found in moisturizers to draw water into the outer layer of skin

A

Humectants

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5
Q

Broad-spectrum antimicrobial agent widely used in homes and hospitals due to efficacy on skin and oral mucosa with low irritability.

A

Chlorhexidine

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6
Q

To heal best, wounds should be kept clean and ____

A

Moist

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7
Q

Platelet-derived growth factor that promotes the cell proliferation and angiogenesis needed for diabetic ulcer repair; why must it be used cautiously?

A
  • Becaplermin
  • Use of >3 tubes ↑↑↑ risk of malignancy
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8
Q

Antifungal applied topically that penetrates into nails to treat fungal infection?

A

Efinaconazole

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9
Q

Active ingredient of vulvovaginal medications for candidiasis:

A

Clotrimazole or Miconazole

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10
Q

Refers to substances in moisturizers that form an oily layer to trap water in the skin; petrolatum, lanolin and mineral oil are among common examples.

A

Emollients

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11
Q

Name of the agents found in moisturizers that loosen bonds btw top layer of cells helping dead skin cells fall off, leaving skin feeling softer and smoother; common example?

A
  • Horny substance (keratin) softners
  • Urea, alpha hydroxy acids, and allantoin
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12
Q

Which type of radiation is the cause of skin aging and cancer?

A

UVA

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13
Q

Which chemical compound in sunscreen is active in UVA range and is particularly useful for conditions like drug-induced photosensitivity?

A

Dibenzoylmethanes

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14
Q

Control that is now considered a priority for optimal wound closure.

A

Glycemic control

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15
Q

Local vasoconstriction due to blood volume deficit, unrelieved pain, hypothermia, etc., can impair wound healing due to an inadequate amount of this in the tissue:

A

Oxygenation

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16
Q

Important component of wound healing, it conserves the local resources by limiting the need to synthesize proteases; stage when hydrogels are good wound covering.

A

Debridement

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17
Q

Which wound coverings are best for debridement, granulation, and epithelialization stages of wound healing?

A
  • Hydrogels for debridement stage
  • Foam and low-adherence dressings for granulation stage
  • Hydrocolloid and low-adherence dressings for epithelialization stage
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18
Q

Aminoglycoside antibiotic of Neosporin with activity against gram-negative bacteria:

A

Neomycin

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19
Q

Peptide antibiotic with efficacy against gram-negative bacteria including pseudomonas has a detergent-like effect that damages the bacterial cell membrane:

A

Polymixin B

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20
Q

Peptide antibiotic with activity against gram-positive organisms and some anaerobes; only applied topically to limit systemic toxicity, often causes contact dermatitis:

A

Bacitracin

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21
Q

Class of antifungal drugs with a wide range of activity, blocks ergosterol synthesis.

A

Imidazoles

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22
Q

Imidazole antifungal drug applied topically for tx of dermatophytosis, candidiasis, and as shampoo for seborrheic dermatitis; also noteworthy as a classic inhibitor of cytochrome P450:

A

Ketoconazole

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23
Q

Prescription synthetic topical antimycotic agent with broad spectrum of activity against fungal skin infections such as ringworm, athlete’s foot, tinea versicolor, dandruff:

A

Ciclopirox

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24
Q

What is the MOA of Terbinafine and what is it used for?

A
  • Allylmaine, selectively inhibits squalene epoxidase, a key enzyme for synthesis of ergosterol
  • Highly active against dermatophytes; can be used topically or given orally for tx of onychomycosis
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25
Q

Which synthetic antifungal distorts hyphae/stunts mycelial growth and is effective topicaly against various dermatophyt and malessezie infection, but not candida?

A

Tolnaftate

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26
Q

When used to treat thrush, it is held in the mouth before swallowing (has negligible GI absorption)

A

Nystatin

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27
Q

What is the MOA of both Nystatin and Amphotericin B?

A

Binds fungal sterols, alters membrane permeability

28
Q

Antifungal agent with topical effects limited to candida infections, may temporarily stain the skin yellow (also administered IV, etc., for other fungal infections as well including aspergillus and endemic mycosis)

A

Amphotericin B

29
Q

What topical antiviral agent is used for the treatment of recurrent orolabial herpes simplex virus infection in immunocompetent adults

A

Acyclovir

30
Q

Which topical therapy is particularly useful in anogenital pruritus?

A

Calcineurin inhibitors: Tacrolimus

31
Q

Can be useful therapies for pruritus on face associated with CKD and in neuropathic pruritus?

A

Local Anesthetics

32
Q

On which areas of skin should you start with low-potency vs. high-potency glucocorticoids?

A
  • Low-potency on face, genitals, skin fold
  • Elsewhere, generally start high-potency and then titrate downward
33
Q

μ-opioid receptor antagonist that can treat the pruritus associated with CKD and cholestasis.

A

Naltrexone

34
Q

Which antiepileptic drug is useful in tx neuropathic pain and itching; what are 2 AE’s?

A
  • Gabapentin
  • May cause drowsiness and weight gain
35
Q

α2-agonist administered topically as a gel to treat rosacea

A

Brimonidine

36
Q

α-adrenergic agonist in Visine known for its ability to “get the red out”:

A

Tetrahydrozoline

37
Q

Organophosphate anticholinesterase insecticide kills ectoparasites

A

Malathion

38
Q

Synthetic insecticide similar to that of chrysanthemums, ectoparasite therapy (Nix) that binds to insect Na+ channels and prevents membrane repolarization

A

Permethrin

39
Q

Orally administered insecticide to treat ectoparasites, binds glutamate-activated Cl- channels in invertebrates, hyperpolarizes the nerve and muscle cells

A

Ivermectin

40
Q

Late choice for treating ectoparasites, topical agent works by disrupting GABAergic transmission in insects

A

Lindane

41
Q

Topical retinoid administered for the treatment of acne, alters gene expression to normalize keratinization, decrease keratinocyte cohesiveness and reduce microcomedone formation

A

Tretinoin

42
Q

Topical antimicrobial agent commonly used to treat acne; local skin irritant and may bleach hair or clothing

A

Benzoyl Peroxide

43
Q

Antibiotic that works similar to macrolides kills anaerobes, useful for range of infections including topical treatment of acne and for osteomyelitis; associated with increased risk of C. difficile

A

Clindamycin

44
Q

Macrolide antibiotic, among uses is for topical or systemic treatment of acne; among the well-known cytochrome P450 inhibitors to remember.

A

Erythromycin

45
Q

Component of plant defenses against bacteria, active against P. acne and also treats post-inflammatory hyperpigmentation

A

Azelaic acid

46
Q

Tetracycline used to treat acne, noteworthy for its ability to cause dark pigmentation in skin and sclera

A

Minocycline

47
Q

K+-sparing diuretic with partial agonist properties at androgen receptors that can make it useful for treating menstrual cycle linked acne or male pattern baldness in adult women

A

Spironolactone

48
Q

What are some of the AE’s of spironolactone and who is is contraindicated for?

A
  • Contraindicated in pregnancy
  • Menstrual irregularity + breast tenderness
  • Minor GI sx’s
  • Orthostatic hypotension
  • Hyperkalemia + dizziness + HA’s + fatigue
49
Q

Retinoid administered orally for treatment of severe acne, powerful teratogen that mandates participation by young females in the iPledge program

A

Oral isotretinoin

50
Q

Photosensitizer administered in conjunction with UVA treatment of psoriasis

A

Psoralen

51
Q

Orally active PDE4 inhibitor, used in moderate-to- severe plaque psoriasis and psoriatic arthritis

A

Apremilast

52
Q

What are the downstream effects of the orally active PDE4 inhibitor, Apremilast?

A
  • ↓ nitric oxide synthase, TNF-α, IL-23
  • ↑ IL-10
53
Q

What is the most common AE associated with the PDE4 inhibitor, Apremilast, used for moderate to severe plaque psoriasis?

A

Severe diarrhea

54
Q

Monoclonal antibody against IL-12 and IL-23, a biologic agent used to treat plaque psoriasis, psoriatic arthritis, and Chron disease

A

Ustekinumab

55
Q

Ustekinumab is generally well-tolerated but carries what risk?

A
  • ↑ risk for infections
  • May ↑ risk for SCC’s
56
Q

Biologic DMARD directed against IL-17a, used to treat psoriasis and psoriatic arthritis and, for some, works much better than anti-TNF therapies

A

Secukinumab

57
Q

Topical immune response modifier used to treat actinic keratoses and basal or squamous cell carcinomas; also used to treat genital warts

A

Imiquimod

58
Q

Treatment for actinic keratoses derived from Euphorbia peplus sap, causes chemoablation with neutrophil-mediated antibody dependent cellular cytotoxicity eliminating remaining tumor cells

A

Ingenol Mebutate

59
Q

Effective topical therapy for actinic keratoses, causes fast- proliferating dysplastic cells to die a thymidine-less death; necrosis/erosion gives way to re-epithelialization over several weeks

A

5-fluorouracil

60
Q

What are 2 oral hedgehog signaling pathway inhibitor used to treat advanced basal cell carcinoma

A

Vismodegib or Sonidegib

61
Q

FDA-approved conventional therapy for melanoma:

A

Dacarbazine

62
Q

Inhibits the mutated BRAF V600D MAP kinase found in ~60% of melanomas resulting in apoptosis

A

Vemurafenib

63
Q

What is the MOA of Minoxidil and what is it used for?

A
  • Potent vasodilator due to hyperpolarization via activation of K+ channels
  • Promotes hair growth by increasing the duration of anagen (growth phase), shortening telogen (rest phase), and enlarging miniaturized follicles
  • 1st-line for female pattern hair loss and also used for male pattern baldness
64
Q

Blocks the conversion of testosterone to more potent androgen dihydrotestosterone, among its uses is to treat male pattern baldness in men and second-line agent for this in women

A

Finasteride

65
Q

Treatment for alopecia, it is a contact allergen applied to cause dermatitis, which can be followed by hair growth

A

DPCP

Skin, Blood, Lymph Exam 2 (6 decks)

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