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SBL Exam 2 > Skin Pharmacology > Flashcards

Skin Pharmacology Flashcards

1
Q

what factors affect cutaneous absorption?

A

region
concentration gradient
dosing schedule
vehicles/occlusion

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2
Q

when should you use creams?

A

for oozing/wet skin conditions

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3
Q

when should you use ointments?

A

for dry skin conditions

less likely to cause allergic rxn

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4
Q

what are emollients?

A

moisturizers that form an oily layer on top of skin that traps water in the skin

ex: petrolatum, lanolin mineral oil and dimethicone

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5
Q

what are humectants?

A

moisterizers that draw water into the outer layer of skin

ex: glycerin, lecithin, and propylene glycol

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6
Q

what are keratin softeners?

A

moisterizers that loosen the bonds between the top layer of cells to help dead skin cells fall of

helps the skin retain water and gives a smoother feeling

ex: urea, AHAs and allantoin

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7
Q

what does UVB radiation cause?

A

“burn”
erythema/sunburn
skin aging
photocarcinogenesis

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8
Q

what does UVA radiation cause?

A

“aging”
skin aging
cancer

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9
Q

what is glutaraldehyde?

A

a disinfectant that cross-links proteins on the cell envelope of microbes

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10
Q

what is chlorhexidine?

A

a disinfectant and antiseptic that affects the cytoplasmic membrane of microbes

  • safe for skin and oral mucosa due to low irritability
  • broad-spectrum
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11
Q

what are peroxygens?

A

a disinfectant that forms free hydroxl radicals which disrupts thiol groups in enzymes and proteins

ex: hydrogen peroxide

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12
Q

what are halogens?

A

a disinfectant that oxidizes thiol groups of disulfides, sulfoxides or disulfoxides of microbes

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13
Q

what is the protocal for antiseptic wash on wounds?

A

generally not necessary unless the wound is infected since the antiseptic can impede wound healing

*saline debridement is sufficient

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14
Q

what category of patients should be monitored for wound healing?

A

diabetics

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15
Q

what is becaplermin?

A

platelet derived growth factor that promotes cell proliferation and angiogenesis

  • only approved treatment of chronic diabetic food ulcers
  • black box warning for malignancy
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16
Q

what is the general rule for wound dressings?

A

wounds should be kept moist and not exposed to air

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17
Q

what are the components of neosporin?

A

bacitracin: gram +
neomycin: gram -
polymixin B: gram -

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18
Q

what is the MOA of topical imidazoles (antifungals)?

A

block ergosterol synthesis

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19
Q

what does miconazole treat?

A

vulvovaginal candidiasis

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20
Q

what does clotrimazole treat?

A

vulvovaginal candidiasis

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21
Q

what does efinaconazole treat?

A

onychomycosis

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22
Q

what does ketoconazole treat?

A

dermatophytosis
candidiasis
seborrheic dermatitis

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23
Q

ciclopirox

A

broad spectrum topical antifungal

disrupts macromolecular synthesis

treats dermatophytes, candida, and malassezia

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24
Q

terbinafine

A

topical antifungal agent

selectively inhibits squalene epoxidase, a key enzyme for ergosterol synthesis

treats dermatophytes

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25
Q

tolnaftate

A

topical antifungal

unknown MOA

treats dermatophytes and malassezia

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26
Q

nystatin

A

topical antifungal

binds to fungal sterols to alter membrane permeability

treats cutaneous and mucosal candida infection

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27
Q

amphotericin B

A

topical antifungal

binds to fungal sterols to alter membrane permeability

treats cutaneous candida infections

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28
Q

acyclovir

A

topical antiviral agent

synthetic guanine analog

acts on HSV 1 and 2

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29
Q

what are nonpharmacologic treatments for pruritis?

A 
skin moisturization
cool environment
avoidance of skin irritants
stress reduction
physical intervention
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30
Q

topical corticosteroids

A

anti-pruritic treatment to treat underlying skin inflammation

31
Q

what are the topical calcineurin inhibitors? What do they treat?

A

tacrolimus and pimecrolimus

anogenital pruritus

32
Q

doxepin

A

possible H1 antagonist that treats pruritis

33
Q

menthol

A

TRPM8 agonist

provides cooling sensation to soothe pruritis

34
Q

capsaicin

A

TRPV1 agonist

stimulates neurons to release and eventually deplete neuropeptides to induce lasting desensitization

35
Q

salicylic acid

A

COX inhibitor and keratolytic

anti-inflammatory for treatment of acne and dandruff

36
Q

what local anesthetics are useful for pruritis?

A

pramoxine
lidocaine
lidocane and prilocaine mixture

37
Q

what systemic therapies are used to treat pruritis?

A 
antihistamines
antidepressants
opioid receptor antagonists
anticonvulsants (gabapentin)
substance P antagonist
38
Q

brimonidine

A

alpha 2 agonist: vasoconstriction

applied topically to treat rosacea

39
Q

oxymetazoline

A

mixed alpha 1 and alpha 2 agonist: vasoconstriction

applied topically to treat rosacea

40
Q

what drugs can treat red eyes?

A

adrenergic receptor agonists

phenylephrine, naphazoline, and tetrahydrozoline

41
Q

malathion

A

topical organophosphate AchE inhibitor

treats ectoparasites

42
Q

permethrin

A

topical agent that binds to insect Na+ channel to block membrane potential

treats ectoparasites

43
Q

ivermectin

A

oral glutamate-gate Cl- channel agonist to hyperpolarize insect nerve and muscle cells

treats ectoparasites

44
Q

lindane

A

topical agent that disrupts GABAergic transmission in insects

treats ectoparasites

45
Q

what is the preferred treatment for mild comedonal acne?

A

topical retinoid

46
Q

what is the preferred treatment for mild mixed papular/pustular acne?

A

topical retinoid + topical antibiotic

47
Q

what is the preferred treatment for moderate mixed papular/pustular acne?

A

oral antibiotic + topical retinoid +/- benzoyl peroxide

48
Q

what is the preferred treatment for moderate nodular acne?

A

oral antibiotic + topical retinoid + benzoyl peroxide

49
Q

what is the preferred treatment for severe nodular/conglobate acne?

A

oral isotretnoin

50
Q

what are the topical retinoids for acne treatment?

A

tretinoin
adapalene
tazarotene

51
Q

what are the topical antimicrobials for acne treatment?

A 
benzoyl peroxide
clindamycin
erythromycin
dapsone
sulfacetamide
52
Q

azaleic acid

A

a dicarboxylic acid that kills acne bacteria and decreases keratin production

can treat acne and post-inflammatory hyperpigmentation

topical application

53
Q

what oral antibiotics are used for acne treatment?

A 
tetracycline
doxycycline
minocycle
erythromycin
azithromycin
trimethoprim-sulfamethoxazole
54
Q

what hormonal agents are used for acne treatment?

A

oral contraceptives

spironolactone

55
Q

what is the major risk when taking oral isotretinoin?

A

teratogenicity

56
Q

what topical therapies can treat psoriasis?

A 
emollients
corticosteroids
topical vitamin D analogs 
tar
tazarotene
calcineurin inhibitors
anthralin
salt water baths
57
Q

What is the clinical application of UV light therapy?

A

UVB and photochemotherapy (PUVA) can treat moderate to severe psoriasis

58
Q

what systemic therapies can treat psoriasis?

A 
methotrexate
apremilast
retinoids
systemic calcineurin inhibitors
biologic agents (secukinumab and ustekinumab)
59
Q

apremilast

A

PDE4 inhibitor which increases cAMP in cells

reduces inflammatory mediators (NOS, TNFa and IL-23)

increased anti-inflammatory mediators (IL-10)

60
Q

crisaborole

A

PDE4 inhibitor recently approved for topical dermatitis therapy

61
Q

ustekinumab

A

monoclonal Ab that targets proinflammatory cytokines IL-12 and IL-23

treats psoriasis, psoriatic arthritis and Crohn disease

*risk of infection

62
Q

secukinumab

A

monoclonal Ab that targets proinflammatory cytokine IL-17A

treats psoriasis, psoriatic arthritis and ankylosing spondylitis

*risk of infection

63
Q

what are some treatments for actinic keratosis?

A 
liquid nitrogen cryotherapy
surgical removal
pharmacotherapy 
red light therapy
dermabrasion
chemical peels
64
Q

5-fluroruracil

A

topical agent that inhibits thymidylate synthetase to prevent cell proliferation and causes cell death

results in erythema, blistering, necrosis, and then re-epithelialization

treatment for actinic keratosis

65
Q

what topical medications can treat BCC/SCC?

A

imiquimod

5-fluorouracil

66
Q

imiquimod

A

topical immune response modifier that stimulates local cytokine induction

effective therapy for actinic keratosis

67
Q

what is used to treat BCC?

A

vismodegib
sonidegib

*oral SHH signal pathway inhibitors

68
Q

dacarbazine

A

conventional chemotherapy for melanoma

+/- (camustine and tamoxifen) or (cisplatin and vinblastine)

69
Q

vemurafenib

A

MAP kinase pathway inhibitor for BRAF mutation (melanoma)

results in apoptosis

70
Q

what is the preferred treatment method for non-metastatic melanoma?

A

surgical excision

71
Q

minoxidil

A

vasodilates hair follicles due to K+ channel opening

promotes hair growth for male and female pattern baldness

Rogaine

72
Q

finasteride

A

oral inhibitor of DHT production

treats male pattern baldness

73
Q

what anti-androgens can treat female pattern baldness?

A

spironolactone
finasteride
flutamide

74
Q

DPCP (diphenylcyclopropenone)

A

causes contact dermatitis which results in hair growth

treats alopecia areata

SBL Exam 2 (7 decks)

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