Skin Pharm Flashcards
Compare creams and ointments.
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
What are emollients.
List some common ones.
form oily layer on top of skin to trap water
(all rather hydrophobic)
- pertrolatum
- lanolin
- mineral oils
- dimethicone
What are humectants.
List some common ones.
draw water into outer skin
(very hydrophilic)
- glycerin
- lecithin
- propylene glycol
What is chlorhexidine?
(what is a general mechanism)
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
What is becaplermin?
platelet growth factor
promotes wound healing in diabetic foot ulcers
What black box warning is associated with becaplermin?
increased risk of cancer/worsening of existing cancer (when >3 tubes are used)
What drugs have the suffix “-azole”?
antifungal agents (azoles)
inhibit ergosterol synthesis (main fungal membrane component)
topical antifungals fall under the imidazole class
What is miconazole?
(use and mechanism)
topical antifungal (imidazole)
inhibits fungal P450 and ergosterol synthesis
used in treating vaginal candidiasis
What is clotirmazole?
(use and mechanism)
topical antifungal (imidazole)
inhibits fungal P450 and ergosterol synthesis
used in treating vaginal candidiasis
What is efinaconazole?
(use and mechanism)
topical antifungal (imidazole)
inhibits fungal P450 and ergosterol synthesis
used in treating onychomycosis (fungal nail infection)
What is ketoconazole?
(use and mechanism)
topical antifungal (imidazole)
inhibits fungal P450 and ergosterol synthesis
used in treating tinea, candiasis, and malessezia (dandruff/serborrheic dermatitis)
What is cicloprox?
(use and mechanism)
topical antifungal
(inhibits DNA/RNA synthesis)
dermatophytes (tinea) and yeasts (candida/malassezia)
What is terbinafine?
(use and mechanism)
topical antifungal
(inhibits squalene epoxidase)
dermatophytes (tinea) but not yeasts (candida/malessezia)
What is tolaftate?
(use and mechanism)
topical antifungal
dermatophytes (tinea) and malessezia but not candida
What is nystatin?
(use and mechanism)
topical/oral antifungal (min. GI absorption)
(binds ergosterol, alters membrane permeability)
candida only
What is acyclovir?
(use and mechanism)
antiviral
(guanine analog; inhibits viral DNA synthesis)
-herpes (DNA virus)
What are topical treatments for pruritis?
- corticosteroids
- tacrolimus
- menthol
- capsaicin
- salicylic acid
What are systemic treatments for pruritis?
- antihistamines
- antidepressants
- naltrexone (μ-opioid antagonist)
- butorphanol (κ-opioid agonist)
- gabapentin (anticonvulsant)
- aprepitant (substance P antagonist)
What is brimonidine?
(use and mechanism)
α2 agonist
(vasoconstriction)
treats erythema of rosacea
What is tetrahydrozoline?
(use and mechanism)
adrenergic agonist
(vasoconstriction)
treats redness of conjunctivitis
What agents are used to treat ectoparasite infections (scabies)?
- malathion (organophosphate)
- permethrin (Na channel blocker)
- ivermectin (Cl channel blocker)
- lindane
What drug combination is the first line treatment for acne?
Mild acne:
- topical retinoid (tretinoin)
- topical antimicrobial/antibiotic
Severe acne:
- oral retinoid (isotretinoin)
- oral antibiotic
What topical antimicrobials are used in treating acne?
- benzoyl peroxide
- clindamycin
- erythromycin
What oral antibiotics are used for treating acne?
- tetracycline
- doxycycline
- bactrim
What is azaleic acid?
alternative acne treatment
antimicrobial/anticomedone
What are alternative treatments for acne in women?
- oral contraceptives
- spironolactone (adults with menstrual acne)
What black box warning is associated with isotretinoin?
-extremely teratogenic; can not be given during pregnancy and MUST avoid getting pregnant while taking
What are topical therapies for mild psoriasis?
First line:
- emollients
- corticosteroids
- vitamin D
- tacrolimus
What are therapies for moderate-severe psoriasis?
UVB:
-causes sun burn
PUVA:
- Psoralen (photosensitizer; increased risk of melanoma)
- UVA
- no sunburn
What are systemic therapies for psoriasis?
-apremilast (PDE4 inhibitor)
Th17 inhibitors
- TNFα inhibitors
- ustekinumab (anti-IL 12/23)
- secukinumab (anti-IL 17)
What pharmacologic therapies are used for actinic keratosis?
- 5-flurouracil (antimetabolite)
- imiquimod (topical immune regulator; TLR 7)
- ingenol mebutate
What pharmacologic therapies are used for skin cancers?
Basal cell and squamous cell carcinomas:
- imiquimod
- 5-flurouracil
What pharmacologic therapies are used for advanced basal cell carcinoma?
SHH pathway inhibitors
- vismodegib**
- sonidegib**
What drugs have the suffix “-degib”?
(use and mechanism)
anti-SHH pathway drugs -> basal cell carcinoma
- vismodegib
- sonidegib
What pharmacologic therapies are used for melanoma?
Chemotherapeutics:
-decarbazine (alkylating agent) possibly with others
BRAF inhibitors (with BRAF mutation; 60% of cases):
-vemurafenib
What is vemurafenib?
(use and mechanism)
BRAF inhibitor -> apoptosis
-used in cancers with BRAF mutations (including some melanomas)
suffix of this class is rafenib
What pharmacologic therapies are used for alopecia?
- minoxidil (rogaine); potassium channel opener
- finasteride (dihydroxytestosterone inhibitor)
