Skin Pharm Flashcards

1
Q

Compare creams and ointments.

A

Creams are more water based:

  • spread easily and well absorbed
  • wash off
  • better for wet skin conditions

Ointments are more oil based:

  • better absorptionof ingredient
  • stays on surface
  • better for dry skin conditions
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2
Q

What are emollients.

List some common ones.

A

form oily layer on top of skin to trap water

(all rather hydrophobic)

  • pertrolatum
  • lanolin
  • mineral oils
  • dimethicone
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3
Q

What are humectants.

List some common ones.

A

draw water into outer skin

(very hydrophilic)

  • glycerin
  • lecithin
  • propylene glycol
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4
Q

What is chlorhexidine?

(what is a general mechanism)

A

broad-spectrum antimicrobial agent;

disrupts membrane lipids -> good against bacteria, enveloped viruses, fungi, and yeasts

only inhibits spores and poorly effective against non-enveloped viruses

used as skin disinfectant

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5
Q

What is becaplermin?

A

platelet growth factor

promotes wound healing in diabetic foot ulcers

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6
Q

What black box warning is associated with becaplermin?

A

increased risk of cancer/worsening of existing cancer (when >3 tubes are used)

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7
Q

What drugs have the suffix “-azole”?

A

antifungal agents (azoles)

inhibit ergosterol synthesis (main fungal membrane component)

topical antifungals fall under the imidazole class

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8
Q

What is miconazole?

(use and mechanism)

A

topical antifungal (imidazole)

inhibits fungal P450 and ergosterol synthesis

used in treating vaginal candidiasis

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9
Q

What is clotirmazole?

(use and mechanism)

A

topical antifungal (imidazole)

inhibits fungal P450 and ergosterol synthesis

used in treating vaginal candidiasis

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10
Q

What is efinaconazole?

(use and mechanism)

A

topical antifungal (imidazole)

inhibits fungal P450 and ergosterol synthesis

used in treating onychomycosis (fungal nail infection)

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11
Q

What is ketoconazole?

(use and mechanism)

A

topical antifungal (imidazole)

inhibits fungal P450 and ergosterol synthesis

used in treating tinea, candiasis, and malessezia (dandruff/serborrheic dermatitis)

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12
Q

What is cicloprox?

(use and mechanism)

A

topical antifungal

(inhibits DNA/RNA synthesis)

dermatophytes (tinea) and yeasts (candida/malassezia)

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13
Q

What is terbinafine?

(use and mechanism)

A

topical antifungal

(inhibits squalene epoxidase)

dermatophytes (tinea) but not yeasts (candida/malessezia)

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14
Q

What is tolaftate?

(use and mechanism)

A

topical antifungal

dermatophytes (tinea) and malessezia but not candida

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15
Q

What is nystatin?

(use and mechanism)

A

topical/oral antifungal (min. GI absorption)

(binds ergosterol, alters membrane permeability)

candida only

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16
Q

What is acyclovir?

(use and mechanism)

A

antiviral

(guanine analog; inhibits viral DNA synthesis)

-herpes (DNA virus)

17
Q

What are topical treatments for pruritis?

A
  • corticosteroids
  • tacrolimus
  • menthol
  • capsaicin
  • salicylic acid
18
Q

What are systemic treatments for pruritis?

A
  • antihistamines
  • antidepressants
  • naltrexone (μ-opioid antagonist)
  • butorphanol (κ-opioid agonist)
  • gabapentin (anticonvulsant)
  • aprepitant (substance P antagonist)
19
Q

What is brimonidine?

(use and mechanism)

A

α2 agonist

(vasoconstriction)

treats erythema of rosacea

20
Q

What is tetrahydrozoline?

(use and mechanism)

A

adrenergic agonist

(vasoconstriction)

treats redness of conjunctivitis

21
Q

What agents are used to treat ectoparasite infections (scabies)?

A
  • malathion (organophosphate)
  • permethrin (Na channel blocker)
  • ivermectin (Cl channel blocker)
  • lindane
22
Q

What drug combination is the first line treatment for acne?

A

Mild acne:

  • topical retinoid (tretinoin)
  • topical antimicrobial/antibiotic

Severe acne:

  • oral retinoid (isotretinoin)
  • oral antibiotic
23
Q

What topical antimicrobials are used in treating acne?

A
  • benzoyl peroxide
  • clindamycin
  • erythromycin
24
Q

What oral antibiotics are used for treating acne?

A
  • tetracycline
  • doxycycline
  • bactrim
25
What is **azaleic acid**?
_alternative_ **acne treatment** **antimicrobial/anticomedone**
26
What are **alternative treatments** for **acne in women**?
- **oral contraceptives** - **spironolactone** (adults with menstrual acne)
27
What **black box warning** is associated with **isotretinoin**?
-**extremely teratogenic**; can not be given during pregnancy and MUST avoid getting pregnant while taking
28
What are **topical therapies** for _mild_ **psoriasis**?
First line: - **emollients** - **corticosteroids** - vitamin D - tacrolimus
29
What are **therapies** for _moderate-severe_ **psoriasis**?
**UVB**: -causes sun burn **PUVA**: - **P**soralen (photosensitizer; **increased risk of melanoma**) - **UVA** - no sunburn
30
What are **systemic therapies** for **psoriasis**?
-**apremilast** (PDE4 inhibitor) Th17 inhibitors - TNFα inhibitors - **ustekinumab** (anti-IL 12/23) - **secukinumab** (anti-IL 17)
31
What pharmacologic therapies are used for **actinic keratosis**?
- **5-flurouracil** (antimetabolite) - **imiquimod** (topical immune regulator; TLR 7) - ingenol mebutate
32
What **pharmacologic therapies** are used for **skin cancers**?
_Basal cell_ and _squamous cell_ carcinomas: - **imiquimod** - **5-flurouracil**
33
What **pharmacologic therapies** are used for _advanced_ **basal cell carcinoma**?
**SHH** pathway inhibitors - **vismo**_degib_**** - **soni**_degib_****
34
What drugs have the suffix "**-degib**"? | (use and mechanism)
**anti-SHH** pathway drugs -\> **basal cell carcinoma** - vismodegib - sonidegib
35
What **pharmacologic therapies** are used for **melanoma**?
Chemotherapeutics: -**decarbazine** (**alkylating agent**) possibly with others **BRAF inhibitors** (with BRAF mutation; 60% of cases): -**vemurafenib**
36
What is **vemurafenib**? | (use and mechanism)
B**_RAF_** inhibitor -\> apoptosis -used in **cancers with BRAF mutations** (including **some melanomas**) suffix of this class is **_raf_**enib
37
What **pharmacologic therapies** are used for **alopecia**?
- **minoxidil** (rogaine); potassium channel opener - **finasteride** (dihydroxytestosterone inhibitor)