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Year 2 Clinical > Skin Therapeutics/Topicals > Flashcards

Skin Therapeutics/Topicals Flashcards

1
Q

Advantages of topical treatments?

A

Direct application

Reduced systemic effects

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2
Q

Disadvantages of topical treatments?

A

Time-consuming
Correct dosage can be difficult
Messiness

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3
Q

Different bases/vehicles that drugs are dissolved in?

A 
Gels
Creams
Ointments
Pastes
Lotions
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4
Q

What are creams and what do they contain?

A

Semi-solid emulsions of water that contain emulsifier and preservative

They have a high water content

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5
Q

Advantages of creams?

A

Cooling and moisturise

Non-greasy

Easy to apply

Cosmetically acceptable

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6
Q

What are ointments and what do they contain?

A

Semi-solid grease/oil (soft paraffin)

NO PRESERVATIVE

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7
Q

Advantages of ointments?

A

Occlusive and emollient

Restrict trans-epidermal water loss

Greasy - less cosmetically attractive

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8
Q

What are lotions and their main uses?

A

Liquid formulations that are suspensions/solutions of medication in water, alcohol or other liquids

Treatment of the scalp and hair-bearing areas

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9
Q

What are gels and their main uses?

A

Thickened aqueous solutions; they are semi-solids that contain high molecular weight solids

They can be used to treat the scalp, hair-bearing areas and the face

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10
Q

What are pastes and their main uses?

A

Semi-solids that contain finely powdered material, e.g: ZNO

They are often used in cooling, drying and soothing bandages

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11
Q

What are the advantages of pastes?

A

Protective, occlusive and hydrating

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12
Q

What are the disadvantages of pastes?

A

Stiff, greasy and difficult to apply

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13
Q

What are the TYPES of topical therapies (not the base/vehicle)?

A 
Emollients
Topical steroids
Anti-infective agents (antiseptics, antibiotics, 
antivirals, antifungals)
Anti-pruritics
Keratolytics
Psoriasis therapies
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14
Q

Functions and uses of emollients?

A

Enhance rehydration of the epidermis and are used for all dry/scaly conditions, esp. eczema; they can also be used as soap substitutes

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15
Q

Prescribing emollients?

A

Prescribe 300-500g weekly; these require frequent application

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16
Q

Difference between non-proprietary and proprietary emollients?

A

Non-proprietary (no trade name), e.g: soft paraffin, emulsifying ointment - these are cheaper

Proprietary (trademark name) - more expensive but more cosmetically acceptable (COMPLIANCE is higher)

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17
Q

When is wet wrap therapy used?

A

Used for very dry (xerotic) skin, however they are difficult and time-consuming to apply

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18
Q

3 modes of action of corticosteroids?

A

Vasoconstrictive
Anti-inflammatory
Anti-proliferative

19
Q 
Examples of topical steroids progressing from:
Mild
Moderate
Potent
Very potent
?
A

Mild - hydrocortisone (1%)

Moderate - Modrasone, Clobetasone, Butyrate (0.05%)

Potent - mometasone, betamethasone, Valerate (0.1%)

Very potent - Clobetasol, Proprionate (0.05%)

From mild to very potent, there is increasing anti-inflammatory and immunosuppressant effect

20
Q

Conditions where topical corticosteroids are used?

A

Eczema (dermatitis)

Psoriasis

Other non-infective inflammatory dermatoses, e.g: lichen planus

Keloid scars (usually intralesional)

21
Q

How to roughly estimate the topical steroid amount to apply?

A

1 application to the whole body of an adult should be 20-30g

1 fingertip unit = 1/2g

Thus, the correct amount should cover 2 hand areas

22
Q

Side effects of topical steroids?

A

Thinning of the skin, purpura and stretch marks

Steroid rosacea

Fixed telangectasia

Perioral dermatitis

May worsen/mask infections

SYSTEMIC ABSORPTION

Tachyphylaxis (decrease in response to anti-inflammatory effects)

Rebound flare of disease, esp. in psoriasis

23
Q

Examples of antiseptics applied topically?

A

Povidone iodine
Chlorhexidine
Hydrogen peroxide

24
Q

Clinical uses of antiseptics?

A

Recurrent infections
Antibiotic resistance
Wound irrigation

25
Q

What topical antibiotics are used for acne?

A

Clindamycin

Erythromycin, tetracycline

26
Q

What topical antibiotics are used for rosacea?

A

Metronidazole

27
Q

What topical antibiotics are used for impetigo?

A

Mupirocin, fusidic acid

28
Q

What topical antibiotics are used for inffected eczema?

A

Combined corticosteroid/antibiotic (short-term)

29
Q

How is herpes simplex (cold sore) treated?

A

Topical antiviral

30
Q

How are eczema herpeticum and herpes zoster treated (shingles) treated?

A

Oral antiviral

31
Q

How is candida (thrush) treated?

A

Anti-yeast, e.g: clotrimazole

32
Q

How is dermatophytes (ringworm) treated?

A

Antidungal, e.g: clotrimazole

33
Q

How is pityriasis versicolor treater?

A

Ketoconazole

34
Q

Examples of anti-pruritics?

A

Menthol
Capsaicin
Camphor/phenol
Crotamiton

35
Q

Function of keratolytics?

A 
Used to soften keratin, e.g: in:
Viral warts
Hyperkeratotic eczema and psoriasis
Corns and calluses
To remove keratin plaques on the scalp
36
Q

Example of a keratolytic?

A

Salicylic acid

37
Q

How to treat warts?

A 
MECHANICAL PAIRING plus:
Keratolytics, e.g: Salicylic acid
Formaldehyde
Glutaraldehyde
Silver nitrate
Cryotherapy (usually                            liquid nitrogen)
Podophyllin (genital warts)
38
Q

Treatment of topical psoriasis?

A

EMOLLIENTS and a choice of:

Coal tar - messy and smelly

Vitamin D analogue - clean with no smell and easy to apply, but can be an irritant

Keratolytic

Topical steroid

Dithranol - effective but difficult to use; it is an irritant and stains normal skin

39
Q

Scalp psoriasis treatment?

A

Greasy ointments to soften scale

Tar shampoo

Steroids in alcohol base or shampoo

Vitamin D analogues

40
Q

What is Imiquimod used for?

A

Licensed for genital warts and superficial BCC; also, in solar keratoses, lentigo maligna, Bowen’s disease and verrucae

41
Q

Function of Imiquimod?

A

Imidazoquinoline amine; it is an immune response modulator that enhances innate and cell-mediated immunity

It has anti-viral and anti-tumour effects

42
Q

What are Calicneurin inhibitors?

A

Suppress lymphocyte activation and are used in the topical treatment of atopic eczema, esp. on the face and in children

There is no cutaneous atrophy but they may cause a burning sensation on application; there may be a risk of cutaneous infections and of skin cancer

43
Q

Other topicals?

A

Sunscreens

Cosmetic camouflage

44
Q

Side effects of topical therapies?

A

Burning/irritation
Contact allergic dermatitis
Local toxicity
Systemic toxicity

Year 2 Clinical (119 decks)

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