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1. Dermatology > Pharmacology > Flashcards

Pharmacology Flashcards

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Dermatology Board Prep flashcards
1
Q

Topical skin medications come in what (7) forms?

A
  1. Ointment
  2. Cream
  3. Lotion
  4. Solution
  5. Gel
  6. Foam
  7. Powder
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2
Q

Skin absorption is a passive process primarily through ____________ route. Secondary routes are transcellular and follicular.

A

intercellular

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3
Q

What is the rate-limiting step in cutaneous drug absorption?

A

Stratum corneum layer of the skin that is thick and consists of dead cells.

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4
Q

How are drugs that penetrated the skin distributed?

A
  • blood vessels
  • lymphatic system
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5
Q

What are three characteristics of an “ideal” topical drug?

A
  • low molecular mass
  • adequate solubility in both oil and water
  • ability of the drug to “detach” from its vehicle/medium
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6
Q

We categorize some topicals by potency to determine dosing. ________ is determined by clinical endpoint.

A

Effectiveness

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7
Q

Which topical agent is occlusive and what does it mean?

A

Ointments and occlusive bandages/wraps. Occlusive agents are usually oily substances that work by coating the stratum corneum as well as the decreasing transepidermal water loss.

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8
Q

How does propylene glycol affect absorption of topical drugs?

A

Increases the hydration of stratum corneum and enhances desqamation (shedding the outermost layer). Very effective in disorders with retention hyperkeratosis (abnormality of routine skin desquamation).

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9
Q

Why some topical drugs are the most effective in use right after the shower?

A

The skin is at its best hydration after a shower.

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10
Q

Body location, surface-to-mass ratio, heat, electric current, microneedling and laser are all factors that

A

Affect absorption of topical drugs.

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11
Q

Correct diagnosis, moisture level of the lesion, type of medication and the method of its delivery are factors that affect

A

effectiveness of the drug.

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12
Q

Some rare potentially life-threatening hypersensitivities to OTC acne products are caused by what ingredients?

A

Benzoyl peroxide and salicylic acid. FDA recommendation is to limit the use to small affected areas for 3 days to test for hypersensitivity.

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13
Q

What is an excipients in the medication?

A

An inactive substance that serves as the vehicle or medium for a drug or other active substance.

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14
Q

When choosing the quantity of topical drugs, 1 palm equals to? What are FTUs?

A

1 palm equals to 1% of body surface area. FTU - fingertip unit that equals to 500mg of product.

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15
Q

What are the main functions of topical corticosteroids?

Generally

A

Modulates the production of various proteins by inducing or inhibiting gene transcription
Anti-inflammatory and immunosuppressive
- Inhibit inflammatory processes, neutrophil and monocyte recruitment
Antimitotic
- affect cell differentiation
Vasoconstrictive

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16
Q

What are the general principles in selecting the potency of corticosteroids in treatment?

A

Super high Potency:
* Severe Dermatoses - psoriasis, severe atopic dermatitis, severe contact dermatitis
* only for non-facial/non-intertriginous

Medium-High Potency:
* Mild to moderate - non-facial/non-intertriginous

Low-Potency:
* Eyelid and genital dermatoses for limited time periods
* Large body areas

17
Q

What are the rules in administering topical corticosteroids?

Daily use and limitations

A
  • Rubbing creams and ointments
  • typically twice daily (increased frequency does not improve the effect); high potency ones may be used only once daily
  • low-to-high potency limit to 3 months continuous use
  • ultra-high potency limit to 3 weeks continuous use
18
Q

What are some advice in using topical corticosteroids?

6

A
  • Ointments have better absorption than creams but poorer adherence
    Can alternate w/ creams for convenience
  • Application post-shower/bath increases absorption
  • Inflammation increases absorption
  • Avoid fluorinated formulations on the face (rosacea/perioral dermatitis)
  • Avoid ointments in hairy areas or intertriginous areas
  • Taper higher potency steroids
19
Q

Name one corticosteroid drug for every potency.

A
20
Q

What are the drugs used in fighting inflammation?

5

A
  1. Oral Isotretinoin (retinoid, inhibits sebaceous gland function and keratinization)
  2. Oral tetracyclines (keeps bacteria in check)
    3.Topical Retinoids
    4.Azlelaic Acid (neutralizes free radicals)
    5.Topical Dapsone (inhibits production of reactive oxygen species)
21
Q

What are the drugs used in targeting Cutibacterium Acnes?

3

A
  1. Benzoyl Peroxide (disrupts vital cell components)
  2. Topical and Oral antibiotics
  3. Azelaic Acid (inhibits protein synthesis)
22
Q

What are the drugs used in counteracting increased sebum production?

4

A
  1. Oral Isotretinoin
  2. Oral contraceptives
  3. Spironolactone
  4. Clascoterone
23
Q

Which drugs target follicular hyperprolifetation and abnormal desquamation?

A
  1. Topical Retinoids
  2. Oral Isotretinoin
  3. Azelaic Acid
  4. Salicylic Acid
24
Q

What are retinoids?
How do they work?
What are they used for?

A
  1. Biologically they have similar activity to vitamin A. They bind to retinoid receptors, bind DNA sequences and activate gene transcriptions. The product of this transcription has a pharmacological effect.
  2. Reduce inflammation. Systemic ones also reduce sebum production. Reduce Cutibacterium Acne. Increase collagen production. Reduce epidermal hyperplasia and pigmentation by accelerating epicermal cell turnover.
  3. Both inflammatory and noninflammatory acne.
25
Q

What are 3 main topical acne/rosacea medications? Generic names.

A
  • Benzoyl Peroxide
  • Salicylic Acid
  • Azelaic Acid
26
Q

What are two vitamin D analogs used in derm and what are they used for? What are 3 warnings when using it.

A
  • Calcipotriene (Dovonex, Sorilux)
  • Calcitriol (Vectical)

They are used to treat psoriasis.
- Hypercalcemia and hypercalciuria
- irritation and mild photosensitivity
- Keep away from dogs

27
Q

What is Methotrexate used for? What are the precautions (6) when using it?

A
  • Absolutely avoid when pregnant
  • Hepatotoxicity
  • Affects CNS
  • Pancytopenia
  • Rash
  • GI effects
28
Q

What are three topical antibiotics commonly used in dermatology?

Geenric and trade

A
  1. Clindamycin topical gel (Cleocin T)
  2. Mupirocin ointment (Bactroban)
  3. Metronidazole gel (Metrogel)
29
Q

What are the precautions/warnings for using Clindamycin?

A
  • avoid eyes
  • may cause erythema, burning, peeling, oiling or itching
  • can cause C. Diff-associated diarrhea
30
Q

Bactroban ointment can cause generalized rash, angioedema or even anaphylaxis. What are some more common adverse effects?

What is the generic name of bactroban?

A
  • dryness
  • burning
  • erythema
  • stinging
  • tenderness

Mupirocin

31
Q
A

1. Dermatology (7 decks)

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