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Pharmacology > Skin Disorders (Exam 2) > Flashcards

Skin Disorders (Exam 2) Flashcards

1
Q

Differentiation

A

Living cells lose nuclei and become flattened cornified cells
Pass through barrier zone

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2
Q

Barrier zone

A

Border zone between epidermal layers and horny later
Epidermal lipids released

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3
Q

How often does the epidermis renew?

A

Every 28 days

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4
Q

5 layers of the epidermis

A

Horny layer
Clear layer
Granular layer
Prickle-cell layer
Basal layer

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5
Q

Keratinocytes

A

Main epidermis cells
Lose nucleus and become corneocytes

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6
Q

Keratin

A

Strong, hydrophobic protein

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7
Q

Stratum corneum (horny layer)

A

Outer protective layer and major barrier to topical drug delivery

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8
Q

What type of drugs are administered through stratum corneum?

A

Small, lipophilic molecules that contain hydrophilic portion

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9
Q

Dermis

A

Hair follicles, sweat glands, nerves, blood vessels
Drugs reach dermis for systemic absorption

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10
Q

Topical Delivery

A

Administration to outer surface for LOCAL effect

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11
Q

Transdermal Delivery

A

Administration through skin for SYSTEMIC effect

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12
Q

Factors that alter systemic drug absorption (3)

A

Heat increases absorption
Children have higher surface area to mass —> greater exposure
Dermatological diseases

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13
Q

Acne vulgaris

A

Skin disorder of the pilosebaceous (hair follicle) units

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14
Q

Noninflammatory Lesions

A

Hair follicle (pore) becomes partially blocked

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15
Q

Closed Comedo

A

Whitehead

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16
Q

Open Comedo

A

Blackhead
Due to oxidation of melanin

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17
Q

Inflammatory Lesions

A

Hair follicle becomes blocked and inflamed
Can lead to scarring and hyperpigmentation

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18
Q

Papules

A

Solid, elevated lesion less than 0.5cm

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19
Q

Pustules

A

Vesicles filled with purulent fluid less than .5 cm

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20
Q

Nodules

A

Painful, firm lesions greater than 0.5cm

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21
Q

Cysts

A

Nodules that harden into larger, pus-filled lesions

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22
Q

Three main factors contributing to acne development?

A

Excessive sebum production
Hyperkeratinization
Bacterial growth

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23
Q

Excessive sebum production

A

Blockage of hair follicle
Androgens and cortisol increase sebum production

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24
Q

Hyperkeratinization

A

Excessive amounts of keratin contributes to cell blockage
Cells become stuck in hair follicle

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25
Q

Cutibacterium acnes

A

Gram positive bacteria that prefers anaerobic environments

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26
Q

How does C. acnes lead to acne?

A

Utilizes triglycerides in sebum as nutrients
Increased sebum production and follicle blockage leads to proliferation
Overgrowth attracts immune cells leading to pus and inflammation

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27
Q

Microcomedo

A

Microscopic plugging of corneocytes
May form weeks before visible lesion

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28
Q

Treatment for mild acne

A

Topical therapy
Lower risk of ADRs

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29
Q

Treatment for moderate to severe acne?

A

Oral therapies with topical

30
Q

Retinoids

A

Derivates of vitamin A

31
Q

Retinoids mechanism of action

A

Agonist at nuclear receptor RAR or RXR and alter transcription

32
Q

Enhanced transcription of epidermal growth factor (HB-EGF)

A

Activates EGF-R which enhances proliferation of basal keratinocytes and promotes shedding of corneocytes

33
Q

Retinoid Effects (3)

A

Enhance collagen production
Reduce inflammation
Reduce sebum and shrink glands

34
Q

What is retinol converted to?

A

“All trans” retinoic acid (ATRA) via oxidation

35
Q

Isotretinoin

A

Stereoisomer of tretinoin
More potent as anti-acne agent
Reduces sebum production

36
Q

Tazarotene

A

Ester prodrug

37
Q

Adapalene

A

Least irritating retinoid

38
Q

Retinoid drug interactions (4)

A

Avoid vitamin A supplements
Light sensitivity
Inactivated by benzoyl peroxide
Isotret with tetracyclines

39
Q

Pharmacokinetic considerations for Retinoids

A

Topicals have low bioavailability
Oral has enhanced bioavailability with high fat meal, high plasma binding to albumin, metabolized by CYP enzymes

40
Q

Topical Retinoid ADRs

A

Dry, red skin, irritation, risk of sunburn due to thinning of stratum corneum

41
Q

Oral isotretinoin ADRs

A

Increased triglycerides/liver enzymes
Myalgia
Depression/suicide
Vision impairment

42
Q

Oral Isotretinoin and pregnancy

A

Strongly teratogenic leads to fetal developmental abnormalities
If pregnant use two birth control and regular pregnancy tests

43
Q

Keratolytics

A

Remove excess stratum corneum and keratin
Can hydrate skin which softens keratin

44
Q

Salicylic acid

A

Most commonly used keratolytic medication, topically

45
Q

Azelaic acid

A

Keratolytic agent that has some antimicrobial effects
Safe for pregnancy

46
Q

Keratolytics mechanism of action

A

Increase solubility/hydrophilicity of stratum corneum leading to desquamation of keratin debris

47
Q

Keratolytic ADRs

A

Erythema, skin peeling, irritation
Salicylic acid toxicity rare but can occur in infants/young children

48
Q

Keratolytic ADRs

A

Erythema, skin peeling, irritation
Salicylic acid toxicity rare but can occur in infants/young children

49
Q

Benzoyl peroxide mechanism of action

A

Prodrug that’s converted t benzoic acid in epidermis and dermis

50
Q

Benzoyl peroxide ADRs

A

Bleaching of fabrics, maybe hair
Skin irritation
Low bioavailability

51
Q

Considerations using benzoyl peroxide

A

Benzoyl peroxide + antibiotic = decreased antibiotic resistance
Inactive some tretinoins

52
Q

Acne Antibiotics (4)

A

Tetracycline- minocycline, doxy
TMP/SMX
Clindamycin (topical)
Dapsone (topical)

53
Q

Considerations using acne antibiotics

A

Topical then oral
Reduction in normal flora and microbial resistance

54
Q

Anti-Androgen Drugs

A

Reduce androgen signaling and effective in treating hormonal acne in females

55
Q

Oral Hormonal Contraceptives

A

Synthetic progesterones found in combination with BC act as antagonists at androgen receptors
Estrogen weakly reduces sebum production

56
Q

Spironolactone

A

Aldosterone receptor antagonist that leads to K+ sparing diuresis
Blocks androgen receptors due to low selectivity

57
Q

UVA Rays

A

Skin aging and wrinkles, skin cancer
Penetrate epidermis and dermis

58
Q

UVB Rays

A

Sunburn and inflammation, DNA damage, skin cancers
Penetrates epidermis

59
Q

Radiation

A

Leads to DNA damage via DNA cross linking (thymine dimers)

60
Q

Inorganic Chemicals in Sunscreen

A

Reflect UV rays

61
Q

Organic Chemicals in Sunscreen

A

Absorb UV rays

62
Q

Broad Spectrum Sunscreen

A

Works against UVA and UVB

63
Q

SPF

A

Fraction of UVB rays that reach the skin
SPF 15 = 1/15 of UVB penetrates

64
Q

Inorganic Sunscreens
Mineral Sunscreen

A

Titanium dioxide and zinc oxide
Protect against both UVA and UVB

65
Q

Organic Sunscreens

A

Protect against UVA, UVB or both depending on chemical

66
Q

Topical Retinoids (3)

A

Tretinoin (Retin-A)
Tazarotene
Adapalene

67
Q

Oral Retinoids (1)

A

Isotretinoin

68
Q

Keratolytics (2)

A

Salicylic Acid
Azelaic Acid

69
Q

Anti-Androgens (2)

A

Hormone Contraceptives
Spironolactone

70
Q

Acne Antibiotics (5)

A

Minocycline
Doxycycline
TMP-SMX
Clindamycin
Dapsone

Pharmacology (18 decks)

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