Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dermatology 1 > Pharm: Papulosquamous > Flashcards

Pharm: Papulosquamous Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

What are NSAID pseudoallergic reactions based on?

A

COX-1 inhibiting properties of the NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are NSAID allergic reactions caused by?

A

IgE mediated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the triad of comorbidities that make up the asthma exacerbated respiratory diseases?

A
  • asthma
  • chronic rhinosinusitis w/nasal polyps
  • chronic urticaria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Type 1 pseudoallergic NSAID reaction

- timeline

A

1 - 3 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Type 1 pseudoallergic NSAID reaction

- sx

A 
Mostly Respiratory
• Rhinorrhea
• Nasal congestion
• Periorbital edema and/or injection of the conjunctiva
• Bronchospasm
• Laryngospasm
• +/- Hives and/or angioedema
• severe: flushing, abd pain, diarrhea, hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Type 2 pseudoallergic NSAID reaction

- timeline

A

30-90 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Type 2 pseudoallergic NSAID reaction

- sx

A

mostly cutaneous
• Pts with chronic urticaria
• Develop exacerbation of their hives, sometimes with angioedema
• Occurs after taking COX-1 inhibitors (ASA and some NSAIDs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Type 3 pseudoallergic NSAID reaction

- timeline

A

30 - 90 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Type 3 pseudoallergic NSAID reaction

- sx

A

Mostly Cutaneous
• Pts without chronic urticaria
• Acute urticaria and or angioedema (facial areas, periorbital skin, lips, mouth)
• May have intermittent episodes of unexplained urticaria unrelated to NSAID ingestion
• Likely related to COX-1 mechanisms, can usually tolerate highly selective COX-2 inhibiting NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Type 6 allergic NSAID reaction

- time frame

A

minutes to an hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Type 6 allergic NSAID reaction

- sx

A
  • Severe urticaria and/or angioedema

* Anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Description of a phototoxic skin reaction

A
  • Nonallergic cutaneous reaction
  • Results from direct tissue or cellular damage following UV irradiation of a phototoxic agent that was ingested or applied to the skin
  • The “threshold concentration” of chemical/drug must have been met
  • Severity is proportional to drug dose
  • Looks like exaggerated sunburn, evolve within minutes to hours of sun exposure, restricted to sun exposed skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 4 drugs cause phototoxic skin reactions

A
  • Tetracycline
  • thiazide
  • retinoid
  • NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long does it take for a photoallergic reaction to occur?

A

24-48 hours after sun exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Description of a photoallergic reaction

A
  • Delayed hypersensitivity reaction
  • Same as allergic contact dermatitis to photoallergen
  • Must have had previous exposure to the photoallergen
  • Typically pruritic, eczematous eruptions on sun-exposed areas of skin
  • More often to topical vs. systemic agents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What four agents cause photoallergic reactions?

A
  • sunscreen with PABA
  • topical NSAID
  • sulfonamides
  • thiazides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment for phototoxic reaction to a drug

A
  • DC offending agent ASAP
  • Treat like a sunburn: cool compress, emollient, oral analgesics. Avoid topical anesthetics (possibility of contact allergy)
  • Broad spectrum sunscreen with UVA protection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment for photoallergic reaction to a drug

A
  • DC offending agent ASAP

- Treat like contact allergy: topical corticosteroids to reduce pruritus and inflammatory response.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How to treat pruritus associated with pityriasis rosea?

A
  • medium potent (4,5) corticosteroids

- topical antipruritic lotions containing pramoxine, methol, oral antihistamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pityriasis rosea

- treatment with local anesthetics

A
  • Local anethetics block conduction along axonal membranes to relieve itching and pain
  • Do not use on large surface areas over long period of time
  • Do not use on <2 yo
  • Pramoxine, lidocaine, benzocaine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pityriasis rosea

- treatment with counterirritants

A
  • Camphor and menthol

* antipruritic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is first line treatment for localized cutaneous lichen planus

  • body
  • face/intertriginous skin
A
  • Body: high potency or super high potency topical corticosteroids
  • Face or intertriginous skin: medium to low potency topical steroid
23
Q

What is first line treatment for generalized lichen planus

A
  • Monotherapy with topical corticosteroids not practical

* Topicals used as adjunct to systemic or phototherapy

24
Q

What is second line treatment for lichen planus

A
  • Acitretin (Soriatane)
  • oral retinoid
  • second line d/t ADR, only use if can’t manage with corticosteroids or light therapy
  • can induce remission or produce marked improvement
25
Q

Acitretin (Soriatane) ADR

A
  • Xerosis
  • Alopecia
  • Hypertriglyceridemia
  • Increased liver enzymes
  • Myalgias and arthralgias
  • CNS: hyperesthesias and paresthesias
  • Increased creatinine and phosphokinase
26
Q

Acitretin (Soriatane) and pregnancy

A

CI for three years after discontinuing drug!

27
Q

Role of emollients in psoriasis tx

A
  • Valuable and inexpensive adjuncts to tx
  • Keeps psoriatic skin soft and moist, minimizing sx of itching and tenderness
  • Regular use: decreased itching, reduced scales, enhanced penetration of topical therapies
  • Prevents irritation and potential for subsequent development of new lesions
28
Q

What is considered the cornerstone tx for psoriasis?

A

topical steroids

29
Q

What are vitamin D analogues often used in the tx of psoriasis?

A
  • Calcipotriene

- Calcitriol

30
Q

What role does tar plan in the tx of psoriasis

A
  • Precise MoA unknown, has apparent antiproliferative effect

- Helpful as an adjunct to topical corticosteroids

31
Q

Pt education for the use of tar to treat psoriasis

A
  • Can stain hair, skin, clothing
  • Use at night and wear inexpensive night clothes don’t mind ruining.
  • Unpleasant odor
  • Shampoo – ensure product reaches the scalp, leave in place 5-10 min before rinsing out
32
Q

Topical retinoid used to treat psoriasis

A

Tazarotene (tazorac gel and cream)

33
Q

What is the risk of tazarotene with pregnancy

A
  • category X

- must use effective contraception

34
Q

What is the limitation associated with tazarotene

A

limited to 20% BSA

35
Q

What are the two calcineurin inhibitors?

A
  • tacrolimus

- pimecrolimus

36
Q

What is the role of the two calcineurin inhibitors in the tx of psoriasis?

A
  • well suited for use on facial and intertriginous areas

- reduce the need for topical steroid

37
Q

What is the basic MoA of salicylic acid?

A

keratolytic agent

38
Q

Role of salicylic acid in tx of psoriasis

A
  • Often combined with other topical therapies – corticosteroids and topical immunomodulators
  • Avoid use with children and other salicylates
39
Q

What is the role of anthralin in the treatment of psoriasis

A
  • Effective in thick plaque psoriasis

- Less effective overall than topical vitamin D or potent corticosteroid therapy

40
Q

Pt education for the use of anthralin in the tx of psoriasis

A
  • Not suitable for face, flexures, or genitals
  • Red-brown stain (temp on skin, permanent on clothes)
  • Avoid application to surrounding unaffected skin (can use petrolatum or zinc oxide to surrounding skin to protect)
  • Wash off affected area after desired contact period
41
Q

How to dose anthralin

A

titrated in strength and contact time

42
Q

Nonpharmacologic interventions for treatment of rosacea

A
  • Avoidance of triggers of flushing
  • Gentle skin care
  • Sun-protection:
  • Use of cosmetic products to mask redness: green tint with flesh colored on top
43
Q

What are potential triggers for rosacea flushing

A 
temp extremes 
sunlight
spicy food
alcohol
exercise
acute psych stressors
medications
menopausal hot flashes
etc.
44
Q

Skin care for rosacea

- four categories

A
  • Emollients: frequent skin moisturizing. Repair and maintain cutaneous barrier function
  • Non-soap detergents: beauty bars, mild cleansing bars, many liquid facial cleansers are better than traditional soaps
  • Avoid skin irritating products: toners, astringent, chemical exfoliating agents (alpha hydroxyl acids), manual exfoliation, etc.
  • Broad spectrum sunscreen: daily application of broad spectrum sunscreen min SPF 30
45
Q

What is drug treatment for rosacea-associated facial erythema

A

brimondine (Mirvaso) gel

  • Strongest evidence for efficacy for persistent facial erythema in rosacea
  • Vasoconstrictor
46
Q

What are serious ADR for brimondine (Mirvaso)

A
  • Risk of vascular insufficiency and hypotension: avoid in pts with depression, cerebral or coronary insufficiency, Raynauds, orthostatic hypotension, thromboangiitis obliterans, scleroderma, Sjogren, severe CVD
  • Caution also in pts using anti-hypertensives, cardiac glycosides, CNS depressants, MAOIs
47
Q

3 topical treatments for papulopustular rosacea

A
  • metronidazole
  • azeleic acid
  • ivermectin
48
Q

What is first line oral drug for systemic tx of papulopustular rosacea

A

oral tetracycline

49
Q

What is first line treatment for early phymatous rosacea

A

retinoids

50
Q

define SPF

A

sun protection factor

51
Q

What does broad spectrum mean related to sunscreen

A

Passed test procedures for measuring effectiveness against both UVA and UVB radiation

52
Q

Recommendations for sunscreen:

  • SPF for body
  • SPF for lips
  • Timeframe for application
  • Timeframe for reapplication
A
  • Body: SPF 15+ (Derm recommends SPF 30+)
  • Lips: SPF 30+
  • Apply 15-30 min before sun exposure – doesn’t work instantly
  • Reapply: min every 2 hours, more often if sweating or swimming
53
Q

Recommendations for using sunscreen in an infant

A
  • Small amount of SPF 15+ can be applied to limited areas on <6 months old if no way to avoid sun
  • Zinc oxide and titanium are good options bc don’t chemically bind to the skin, may be less irritating

Dermatology 1 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions