Skin theraputics

Question 1

What is a cream?

Answer 1

A semisolid emulsion of water and oil

Question 2

What do all creams contain?

Answer 2

Preservative and emulsifier

Have a high water content

Question 3

What is an ointment?

Answer 3

Semisolid grease/oil (soft paraffin)

Question 4

Do ointments contain a preservative?

Answer 4

No

Question 5

What are the uses and advantages of ointments?

Answer 5

Occlusive and emollient

Restrict transepidermalwater loss

Question 6

What is a lotion?

Answer 6

Suspension or solution of medication in water, alcohol or other liquids

Question 7

Which areas are lotions used to treat?

Answer 7

Scalp and hair-bearing areas

Question 8

What are gels and what do they consist of?

Answer 8

Thickened aqueous lotions

Semi-solids, containing high molecular weight polymers e.g. methylcellulose

Question 9

What are pastes and what do they consist of?

Answer 9

Semisolids

Contain finely powdered material e.g. ZNO

Question 10

What are the disadvantages of pastes?

Answer 10

Stiff
Greasy
Difficult to apply

Question 11

What are the advantages of pastes?

Answer 11

Protective
Occlusive
Hydrating

Question 12

Which kind of preparation is often used in bandages?

Answer 12

Pastes

Question 13

What do emollients do?

Answer 13

Enhance rehydration of epidermis

Question 14

How much emollient should be prescribed weekly?

Answer 14

250-500g

Question 15

What are wet wraps used to treat?

Answer 15

Extremely dry skin

Question 16

What is the disadvantage of wet wraps?

Answer 16

Time consuming to apply

Question 17

What are the four main modes of action of topical steroids?

Answer 17

Vasoconstrictive
Anti-inflammatory
Anti-proliferative
Cause immune suppression

Question 18

What is the most mild topical corticosteroid?

Answer 18

Hydrocortisone 1%

Question 19

Which are moderate topical steroids?

Answer 19

Modrasone

Clobetasone butyrate 0.05%

Question 20

Which are potent topical steroids?

Answer 20

Elocon

Betamethasone valerate 0.1%

Question 21

Which is the most potent topical corticosteroid?

Answer 21

Clobetasol proprionate0.05%

Question 22

Which conditions are topical steroids used in?

Answer 22

Eczema
Psoriasis
Other non-infective inflammatory dermatoses e.g. lichen planus
Keloid scars

Question 23

What are the side effects of topical steroids on the skin?

Answer 23

Thinning skin
Stretch marks
Purpura
Fixed telangectasia
Perioral dermatitis
Steroid rosacea

Question 24

What are some examples of topical antiseptics?

Answer 24

Povidone iodine
Chlorhexidine
Triclosan
Hydrogen peroxide

Question 25

Which situations are topical antiseptics used in?

Answer 25

Recurrent infections Antibiotic resisistance Wound irrigation

Question 26

Which topical antibiotics are used for acne?

Answer 26

Clindamycin Erythromycin Tetracycline

Question 27

Which topical antibiotics are used for impetigo?

Answer 27

Mupirocin | Fusidic acid

Question 28

Which topical antibiotics are used for rosacea?

Answer 28

Metronidazole

Question 29

What is the treatment for infected eczema?

Answer 29

Combination of steroid & antibiotics

Question 30

Which condition is treated with a topical antiviral?

Answer 30

Herpes simplex

Question 31

Which conditions are treated with oral antivirals?

Answer 31

Eczema herpeticum | Herpes zoster

Question 32

What are some examples of antiprutitics?

Answer 32

Camphor Crotamiton Menthol Capsaicin

Question 33

What are some topical treatments for psoriasis?

Answer 33

``` Emollients Coal tar Vitamin D analogue Keratolytic Topical steroid Dithranol ```

Question 34

What is imiquimod?

Answer 34

An immune response modulator | Enhances innate & cell-mediated immunity

Question 35

What are the uses of imiquimod?

Answer 35

``` Genital warts Superficial BCC Solar keratoses Lentigo maligna Bowen’s disease Verrucae ```

Question 36

Which layer of the skin is the most important barrier to drug penetration?

Answer 36

Stratum corneum/keratin layer

Question 37

What does the 'brick and mortar' structure of the stratum corneum describe?

Answer 37

‘Bricks’ (Corneocytes, containing keratin filaments in a cornified cell envelope) ‘Mortar’ (lamellar structures of intercellular lipids, i.e. ceramides, cholesterol, free fatty acids)

Question 38

Which two routes can drugs take across the stratum corneum?

Answer 38

Intercellular (around corneocytes) | Transcellular

Question 39

What is the advantage of a high lipid content in a topical drug?

Answer 39

Works better for longer

Question 40

What is the disadvantage of a high lipid content in a topical drug?

Answer 40

Messy and greasy

Question 41

What is the subcutaneous route of drug administration?

Answer 41

Drug delivered by a needle (inserted into the fatty (adipose) tissue just beneath the surface of the skin)

Question 42

Which drugs are best suited to transdermal patch administration?

Answer 42

Those that are potent, lipophilic and of relatively brief half life