Topical Agents

Question 1

MOA: Clindamycin

Answer 1

antibacterial. Reduce numbers of P acnes. Inhibit protein synthesis

Question 2

MOA: Erythromycin

Answer 2

antibacterial. Reduce numbers of P acnes. Inhibit protein synthesis

Question 3

MOA: metronidazole

Answer 3

antibacterial. Disrupting DNA - kills P acnes

Question 4

MOA: Na sulfacetamilde

*****

Answer 4

antibacterial. Kills P acnes by inhibiting Folic acid biosynthesis

Question 5

MOA: azelaic acid

Answer 5

antibacterial. Reduces growth of P acnes/Staph Epidermidis. Free radical scavenging - reduced inflammation. Reduced keratinization
Keratolytic effects. Causes lightening of skin.

Question 6

MOA: Benzoyl Peroxide

Answer 6

antibacterial. Good in both inflammatory and non inflammatory acnes. Release Oxygen.
No resistance even if used chronically
maybe inhibiting action of neutrophils
Keratolytic, Comedolytic

Question 7

MOA: betamethasone

Answer 7

corticosteroids. SUper high potency. Reduce inflammation and inhibit immune function disorders

Question 8

MOA: clobetasol

Answer 8

corticosteroids. Super high potency. Reduce inflammation and inhibit immune function disorders

Question 9

MOA: diflorasone

Answer 9

corticosteroids. High potency. Reduce inflammation and inhibit immune function disorders

Question 10

MOA: hydrocortisone

Answer 10

corticosteroid. Low potency. Reduce inflammation and inhibit immune function disorders

Question 11

MOA:triamcinolone

Answer 11

corticosteroid. Medium Potency. Reduce inflammation and inhibit immune function disorders

Question 12

MOA: Calcipotriene

Answer 12

Vitamin D analog. Topical

Use: moderate Plaque psoriasis, inhib prolif keratinocytes, reduce inflammation

Question 13

MOA: tretinoin

Answer 13

Retinoid. Use, acne and photoaging

MOA: dec inflammation, inc mitotic activity leads to extrusion of comedones

Question 14

MOA: adapalene

Answer 14

Retinoid. More chemically stable than tretinoin
Use: acne
MOA: red cell proliferation/inflam, COMEDOLYTIC, reduced keratinization

Question 15

MOA: Isotretinoin

Answer 15

Retinoid. Accutane. oral
Use: severe acne
MOA: suppress sebum prod by killing sebum producing cells
Reduced keratinizatino, inflammation

Question 16

MOA: tazarotene

Answer 16

Retinoid. Topical, hydrolyzed to activate
Use: psoriasis, mild acne, fine wrinkles
MOA: dec inflammation, proliferation, red keratinization

Question 17

MOA: acetretin

Answer 17

Retinoid. Oral
Use: severe recalcitrant psoriasis
MOA: unknown

Question 18

MOA: Salicylic acid

Answer 18

Keratolytic agent.

Question 19

Describe structure of epidermis and how it affects the percutaneous absorption

Answer 19

Stratum Corneum, Stratum Lucidum, Stratum Granulosum, Stratum Spinosum, Stratum Basale
Corneum - dead keratinocytes
Granulosum, Spinosum, Basale - living
Corneum full of corneocytes - flat lipid depleted keratinocytes, membrane is envelope of insoluble proteins, surrounded by lipid slurry

Absorption takes place:
1-through appendages ‘shunt route’ (hair follicles, sweat gland)
2-Transcellular route - through corneocytes
3-Through intracellular lipid domains (small uncharged particles)

Question 20

describe variables affecting absorption

Answer 20

passage through stratum corneum is rate limiting
variables are
1. concentration of drug in vehicle
2. Partitioning of drug from vehicle into strat corneum
3. Molecular aspects of the drug allowing diffusion across skin layers
4. Thickness of stratum corneum
Fick’s Law

Question 21

variables of choice of vehicles

Answer 21

Scalp and Hairy areas - Lotions, gels, solution, foam, aerosols LESS GREASY

Intertrigenous areas - creams, lotions, solutions
AVOID RUBBING PROBLEM

If its wet dry it, if its dry wet it

Ointments creams gels most wet
Tinctures, Powders, Pastes most dry

Question 22

adverse reactions and drug interactions of drugs

Answer 22

Drug Interactions:
Tretinoin: benzoyl peroxide inactivates
Acitretin: alcohol inc elimination time

Adverse Effects:
Tretinoin: pruritis, erythema, xerosis, sun, preg C
Adapalene: Preg C, Pruritis, erythema, xerosis
Isotretinoin: teratogenic
Tazarotene: teratogenic, Preg X, photosensitivity
Acitretin: teratogenic. avoid preg 3 yrs
Corticosteroids: atrophy, acne, infection, bad healing, contact dermatitis, glaucoma, HPA axis suppress, cushings, growth retardation

Question 23

considerations when using topical corticosteroids

Answer 23

initiate lowest potency to control disease
large surfaces with low potency
low potency on face/intertrigous areas. Potent on palms and feet soles
avoid high potency drugs n infants/kids
tachyphylaxis can occur if high potency
if happens do alternate days to reduce.

Question 24

Area of body where drug should be used: Hydrocortisone

Answer 24

Large areas of body, eyelid, scrotum, intertrigous areas, mucous membranes, face, chest/back

Question 25

Area of body where drug should be used: triamcinolone

Answer 25

Large areas, face, intertrigous areas, chest/back, arms/legs

Question 26

Area of body where drug should be used: diflorasone

Answer 26

Palms and soles. Dorsa of hands/feet

Question 27

Area of body where drug should be used: clobetasol

Answer 27

Palms and soles, Nails

Question 28

Area of body where drug should be used: betamethasone

Answer 28

Palms and soles, Nails