topical derm

Question 1

emollient vs moisturizer

Answer 1

Emollients: soften skin
Moisturizers: add moisture

Question 2

humectant vs occlusive

Answer 2

Humectant: helps retain/absorb ambient water
Occlusive: reduce water loss, best on damp skin

Question 3

glycerol or glycerin are examples of _____ and is often used in moisturizers and creams

Answer 3

humectant

Question 4

petroleum jelly, lanolin, topical mineral oil are examples of _____

Answer 4

occlusives

Question 5

Burrows solution is a ____

Answer 5

topical cleansing agent/astringent

Question 6

name of the class of drying agents that draw out protein causing skin to contract & vessels to constrict soothing inflammation

Answer 6

Astringents

Question 7

5 general uses of burrows soln and one specific use that we learned

Answer 7

bites, rhus, edema, allergies, bruises
dyshydrosis bullae (1/40)

Question 8

components of burrows solution

Answer 8

aluminum acetate 1/20 or 1/40; 1 packet in 1 pint

Question 9

provides temporary relief of itching/pain from minor skin irritations d/t bites, poison ivy; dries oozing weeping rhus

Answer 9

diphenhydramine creams

Question 10

max daily application diphenhydramine creams

Answer 10

QID

Question 11

can cause skin sensitization & subsequent contact dermatitis

Answer 11

diphenhydramine creams

Question 12

inhibits phospholipase A2 which reduces skin levels of pro-inflam kinines; vasoconstriction & antimitotic

Answer 12

topical steroids

Question 13

most potent steroid vehicle with occlusive effect and poor compliance

Answer 13

ointments

Question 14

more potent than steroid lotions but less than ointments & washes off with water

Answer 14

steroid creams

Question 15

drying vehicle for scalp/hair application

Answer 15

steroid solutions

Question 16

for moist dermatoses or pruritic; hairy or larger areas

Answer 16

steroid lotion

Question 17

alcohol base with sting effect; colorless and liquifies on skin

Answer 17

steroid gels

Question 18

more expensive but great for inflamed skin on scalp

Answer 18

steroid foams

Question 19

2 factors that increase potency

Answer 19

occlusive dressings promote hydration with increased absorption & potency
ointments

Question 20

you can use super high potency for severe dermatoses. list 3 of them (2 conditions, 1 location)

Answer 20

psoriasis
severe atopic derm
palms & soles

Question 21

Betamethasone dipropionate(cream), Halobetasol propionate are of what potency

Answer 21

super high

Question 22

max amount of time to use super high potency

Answer 22

4 wks

Question 23

can be used for mid to moderate non-facial and non-intertriginous areas

Answer 23

medium to high potency steroids

Question 24

Fluticasone propionate (ointment), Triamcinolone acetonide (cream, ointment) are examples of what potency

Answer 24

medium to high (intermediate) potency

Question 25

you should not use mid to high potency steroids for more than _______

Answer 25

8 wks

Question 26

potency considered for larger areas being treated (systemic absorption)

Answer 26

low to medium potency

Question 27

potency used for eyelid and genital dermatoses & pediatrics

Answer 27

low potency

Question 28

of FTUs used to cover face/neck, trunk and leg

Answer 28

face/neck-- 2.5 trunk-- 7 leg---6

Question 29

of FTUs used to cover arm, hand and foot

Answer 29

arm-- 3 hand-- 0.5 foot---2

Question 30

if tx facial, intertriginous or genital dermatoses with low to mid potency; how long is tx course

Answer 30

1-2 wks

Question 31

potency for pregnancy

Answer 31

low to mid potency

Question 32

which potency has atrophy, telangiectasia, striae as ADR

Answer 32

super potent

Question 33

2 cutaneous ADRs of topical steroids

Answer 33

acneiform eruptions w/ prolonged use perioral dermatitis with chronic facial use

Question 34

which potencies can cause HPA suppression

Answer 34

super high, high, routine mid potency

Question 35

2 other systemic ADR of topical steroids

Answer 35

hyperglycemia and unmasking of diabetes glaucoma & cataracts w/ topical high potency used around the eye

Question 36

antifungal class that interferes w/ lipid biosynthesis to disturb membrane integrity

Answer 36

imidazoles

Question 37

Cures most tinea pedis, tinea cruris, tinea versicolor, ringworm, and oral & vaginal candidiasis

Answer 37

miconazole (monistat)

Question 38

Wide systemic spectrum (dermatophytes and yeast) that Requires gastric acidity for absorption & is available PO and shampoo

Answer 38

ketoconazole (nizoral)

Question 39

most serious ADR of hepatitis; jaundice, anorexia, malaise and N&V

Answer 39

ketoconazole

Question 40

Drug of choice for Crytococcus neoformans & Coccidioidomycosis; also for vaginal candidiasis

Answer 40

fluconazole (Po & topical)

Question 41

imidazole with No endocrine side effects and great CSF penetration; Less systemic SE than Ketoconazole

Answer 41

fluconazole

Question 42

Drug of choice for Blastomycosis, Histoplasmosis, Sporotrichosis

Answer 42

Itraconazole

Question 43

imidazole with No endocrine side effects, poor CSF penetration

Answer 43

itraconazole

Question 44

2 meds you must be over 2 yo to use

Answer 44

ketoconazole and terbinafine

Question 45

oral med that must be over 30lbs to use

Answer 45

griseofulvin

Question 46

med that you must be over 2 wks old to use

Answer 46

fluconazole

Question 47

an opportunistic infection caused by pigeon droppings and treated with fluconzaole

Answer 47

Crytococcus neoformans

Question 48

Highly infectious soil is found near areas inhabited by bats and bird; Missionary Workers, pulmonary form

Answer 48

Histoplasmosis

Question 49

educate patient on showering with topical imidazole

Answer 49

shower right after applying topical, not hours later bc it takes hours for it to start coming out your pores

Question 50

dont use -azole with ____ bc of risk of cardiac effects

Answer 50

cisapride

Question 51

azoles and _____ potentiate oral anticoagulants and antihypoglycemics so you should check for interactions

Answer 51

griseofulvin

Question 52

inhibits fungal squalene epoxidase, resulting in fungal cell death and available PO and topical

Answer 52

terbinafine

Question 53

Drug of choice for dermatophyte infections (onychomycosis), also works for candida albicans; Better tolerated and shorter course than Griseofulvin & Itraconazole

Answer 53

Terbinafine

Question 54

Deposited in skin, hair and nails for up to 6 weeks after therapy.

Answer 54

terbinafine

Question 55

#1 ADR is GI disturbances (N/V/D), also HA and rash. Rare hepatotoxicity

Answer 55

Terbinafine

Question 56

inhibiting cell wall synthesis by targeting certain cellular organelles; only for dermatophyte; best on actively growing dermatophyte

Answer 56

Griseofulvin

Question 57

taken with meals for absorption once or twice a day

Answer 57

griseofulvin

Question 58

ADR: HA, GI symptoms. Rarely hepatotoxicity, leukopenia, photosensitivity

Answer 58

griseofulvin