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Endocrine Pharm > Topical Agents > Flashcards

Topical Agents Flashcards

1
Q

What are the 4 layers of the epidermis?

A

Stratum Corneum
Stratum Granulosum
Stratum Spinosum
Stratum Basale

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2
Q

Which layer of the epidermis has actively dividing cells?

A

Stratum basale

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3
Q

What is another name for exfoliation?

A

Desquamatization

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4
Q

What are the absorption pathways of intact skin?

A 
Through appendages (shunt)
Transcellular(through corneocytes of S corneum) Hydrophilic drugs
Through intercellular lipid domains (most common for small uncharged molecules) Hydrophobic
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5
Q

What are the different vehicles or carriers for topical drugs?

A

Ointments:water in oil
Creams: oil in water
Gel/Foams: water soluable emulsion
Lotions/solns: powder in water
Aerosols: fine solid or liquid particles in gas
Pastes: Semisolid with finely powdered materials
Tinctures: alcoholic solns

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6
Q

How to select a vehicle based on area of the body?

A 
Scalp/hairy areas
Lotion, 
gels, 
soln, 
foam 
aerosol
Intertriginous Areas:
Creams, 
Lotions
solutions
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7
Q

How to select a vehicle based on condition of skin:

A 
Ointment (Wetting for Dry and Scaly Skin
Cream
Gel
Lotion/soln
Aerosols
Pastes
Powders
Tinctures (Drying for Wet and Oozing skin)
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8
Q

What is the late limiting step for per cutaneous absorption?

A

Passage through the stratum corneum

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9
Q

What variables determine the rate of percutaneous absorption?

A

Concentration of drug in vehicle
Partitioning of drug into SC
Intrinsic ability of drug to diffuse across skin layers (MW and Lipophilicity)
Thickness of SC.

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10
Q

What does fick’s Law tell us?

A

Takes into account all the variables that effect absorption rate

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11
Q

What is the best molecular weight and properties for a topical agent?

A
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12
Q

What is different about applying topical agents to mucous membranes or inflamed skin?

A

Will get systemic absorption

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13
Q

What variables can increase PCA?

A

Inflamed or ulcerated skin
Additional Skin hydration
Occlusion of medication (plastic wrap)
Age of patient (younger will have more systemic effect)

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14
Q

What are the regional differences in absorption?

A 
Mucous membranes(most)
Scrotum
Eyelids
Face
Chest and back
Arms/Legs
Dorda of hands/feet
palmar/plantar skin
Nails(least)
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15
Q

What are the Tx of Acne?

A

Abtx, Retinoids, salicylic acid, oral contraceptives, anti-androgens

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16
Q

What are the Topical Antibiotics given for acne?

A

Erythromycin and clindamycin
Metronidozole
Sodium Sulfacetamide
Azelaic Acid

17
Q

What is the MOA of Azelaic Acid?

A 
Red. growth of Staph epidermidis
Red. inflammation (free rad scavenging)
Red. Keratinization
Keriolytic effect
Drying and lightening of the skin
18
Q

What is the MOA of Benzoyle Peroxide?

A 
Kills anaerbic bacteria
Derived from coaltar
keratolytic
Comeodolytic(gets rid of plugs)
antiinflammatory
Use in combo with erythromycin, clindamycin, or adapalene
19
Q

What is the MOA of Salicylic Acid?

A

Increases solubilization of stratum corneum. Low conc for acne on face. High conc for warts.

20
Q

What is an AA of retinoids?

A

Photosensitivity

21
Q

What is the MOA of Tretinoin?

A

Dec cohesiveness of cells that produce comeodones
Increase mitotic activity in follicular cells
Reduces keratinization

22
Q

What are the drug and envt interactions of Retinoids?

A

Get degraded in the sun

Benzoyl Peroxide inactivates Retinoic acid

23
Q

What are the AA and Contraindications of Retinoids?

A

Pruritis, erythema, dry skin, and increased sun sensitivity

Teratogen(birth defects)

24
Q

What is a benefit of the Retinoid Adapalene?

A

More stable. not broken down by benzoyl peroxide

More lipophiclic.

25
Q

What is the use, AA and MOA of Isotretinoin?

A

SEVERE acne.
Decreases Sebum production
Significicant teratogen

26
Q

What is the MOA of Tazarotene?

A

Topical prodrug that is hydrolyzed into tazarotenic acid
Decreases fine wrinkles by inc. granular cell layers

Decreases inflammation and epidermal hyperproliferation.

27
Q

What are the AA of Tazarotene?

A

Teratogen
USE CONTRACEPTIVES!
Photosensitivity

28
Q

What is used for severe psoriasis that is refractory?

A

Isoretinoin

29
Q

What are the AA of Isoretinoin?

A

Teratogen (wait 3 years before becoming pregnant!)

Half life made even longer if they drink alcohol

30
Q

What is the MOA of Calciprotriene?

A

Vitamin D Receptor agonist
Decreases inflammation by inhibiting production of IL2 and IL6
Inhibits lymphocye proliferation

31
Q

What are the AA of Calcipotriene?

A

Hypercalcemia and Hypercalciuria

32
Q

What are the Weak, intermediate, and Super high potency corticosteroids?

A

Hydrocortisone
Momentasone furoate
Clobetasol propionate

33
Q

Waht are the AA of Topical corticosteroids?

A 
Topical: Atrophy
Acne
Enhanced Fungal infection
Retards wound healing
contact dermatitis
Glaucoma, cataracts 
Systemic: HPA suupression
Sushing Synd
Growth Retardation
34
Q

What drugs are in the Psoralen group?

A

Methoxsalen

Trioxsalen

35
Q

What are the uses of Photochemical therapy?

A

Alopecia
Cutaneous T-Cell lymphoma
Eczema
Psoriais

36
Q

What are the short and long term effects of ST and LT use of phototherapy?

A

ST: Nausea, blistering, painful erythema
LT: Photoaging, actinic keratosis, non-melanoma skin cancer

Endocrine Pharm (11 decks)

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