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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
Cutibacterium acnes
Gram positive bacteria that prefers anaerobic environments
26
How does C. acnes lead to acne?
Utilizes triglycerides in sebum as nutrients Increased sebum production and follicle blockage leads to proliferation Overgrowth attracts immune cells leading to pus and inflammation
27
Microcomedo
Microscopic plugging of corneocytes May form weeks before visible lesion
28
Treatment for mild acne
Topical therapy Lower risk of ADRs
29
Treatment for moderate to severe acne?
Oral therapies with topical
30
Retinoids
Derivates of vitamin A
31
Retinoids mechanism of action
Agonist at nuclear receptor RAR or RXR and alter transcription
32
Enhanced transcription of epidermal growth factor (HB-EGF)
Activates EGF-R which enhances proliferation of basal keratinocytes and promotes shedding of corneocytes
33
Retinoid Effects (3)
Enhance collagen production Reduce inflammation Reduce sebum and shrink glands
34
What is retinol converted to?
“All trans” retinoic acid (ATRA) via oxidation
35
Isotretinoin
Stereoisomer of tretinoin More potent as anti-acne agent Reduces sebum production
36
Tazarotene
Ester prodrug
37
Adapalene
Least irritating retinoid
38
Retinoid drug interactions (4)
Avoid vitamin A supplements Light sensitivity Inactivated by benzoyl peroxide Isotret with tetracyclines
39
Pharmacokinetic considerations for Retinoids
Topicals have low bioavailability Oral has enhanced bioavailability with high fat meal, high plasma binding to albumin, metabolized by CYP enzymes
40
Topical Retinoid ADRs
Dry, red skin, irritation, risk of sunburn due to thinning of stratum corneum
41
Oral isotretinoin ADRs
Increased triglycerides/liver enzymes Myalgia Depression/suicide Vision impairment
42
Oral Isotretinoin and pregnancy
Strongly teratogenic leads to fetal developmental abnormalities If pregnant use two birth control and regular pregnancy tests
43
Keratolytics
Remove excess stratum corneum and keratin Can hydrate skin which softens keratin
44
Salicylic acid
Most commonly used keratolytic medication, topically
45
Azelaic acid
Keratolytic agent that has some antimicrobial effects Safe for pregnancy
46
Keratolytics mechanism of action
Increase solubility/hydrophilicity of stratum corneum leading to desquamation of keratin debris
47
Keratolytic ADRs
Erythema, skin peeling, irritation Salicylic acid toxicity rare but can occur in infants/young children
48
Keratolytic ADRs
Erythema, skin peeling, irritation Salicylic acid toxicity rare but can occur in infants/young children
49
Benzoyl peroxide mechanism of action
Prodrug that's converted t benzoic acid in epidermis and dermis
50
Benzoyl peroxide ADRs
Bleaching of fabrics, maybe hair Skin irritation Low bioavailability
51
Considerations using benzoyl peroxide
Benzoyl peroxide + antibiotic = decreased antibiotic resistance Inactive some tretinoins
52
Acne Antibiotics (4)
Tetracycline- minocycline, doxy TMP/SMX Clindamycin (topical) Dapsone (topical)
53
Considerations using acne antibiotics
Topical then oral Reduction in normal flora and microbial resistance
54
Anti-Androgen Drugs
Reduce androgen signaling and effective in treating hormonal acne in females
55
Oral Hormonal Contraceptives
Synthetic progesterones found in combination with BC act as antagonists at androgen receptors Estrogen weakly reduces sebum production
56
Spironolactone
Aldosterone receptor antagonist that leads to K+ sparing diuresis Blocks androgen receptors due to low selectivity
57
UVA Rays
Skin aging and wrinkles, skin cancer Penetrate epidermis and dermis
58
UVB Rays
Sunburn and inflammation, DNA damage, skin cancers Penetrates epidermis
59
Radiation
Leads to DNA damage via DNA cross linking (thymine dimers)
60
Inorganic Chemicals in Sunscreen
Reflect UV rays
61
Organic Chemicals in Sunscreen
Absorb UV rays
62
Broad Spectrum Sunscreen
Works against UVA and UVB
63
SPF
Fraction of UVB rays that reach the skin SPF 15 = 1/15 of UVB penetrates
64
Inorganic Sunscreens Mineral Sunscreen
Titanium dioxide and zinc oxide Protect against both UVA and UVB
65
Organic Sunscreens
Protect against UVA, UVB or both depending on chemical
66
Topical Retinoids (3)
Tretinoin (Retin-A) Tazarotene Adapalene
67
Oral Retinoids (1)
Isotretinoin
68
Keratolytics (2)
Salicylic Acid Azelaic Acid
69
Anti-Androgens (2)
Hormone Contraceptives Spironolactone
70
Acne Antibiotics (5)
Minocycline Doxycycline TMP-SMX Clindamycin Dapsone

Pharmacology (18 decks)

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