Topical Medications

Question 1

Tachyphylaxis

Answer 1

A progressive decrease in clinical response due to repetitive application of a drug (i.e. glucocorticoids)
Occurs when the body becomes tolerant to the pharmacotherapeutic effects of a particular medication

Question 2

least potent topical therapy

Answer 2

Lotions

Question 3

most potent topical therapy

Answer 3

ointments (most lubricating and moisturizing)

Question 4

The strength of a topical medication is dependent on the vehicle

Answer 4

Ointment forms of topical corticosteroids are more potent than creams of equal concentration
Creams are usually more potent than lotions
Exception:
Retin-A in gel form and solutions are more effective and more irritating than cream form
0.01% Retin-A gel is more irritating and more effective than 0.01% Retin-A cream)

Question 5

Topical Corticosteroids Regional differences in percutaneous absorption

Answer 5

Sole of foot - 0.14%
Palm – 0.83%
Forearm – 1%
Scalp – 3.5%
Forehead - 6.0%
Cheek - 13.0%
Genitalia - 42.0%

Question 6

Bactroban (Mupirocin):

Answer 6

Antibacterial Ointment and cream
A few gram-negative organisms are susceptible (E. coli, H influenza, N. Gonorrhea)
Only topical antibacterial that may be used to treat impetigo* due to Staph aureus and or Strep pyogens
No contact desensitization

Question 7

Silvadene: silver sulfadiazine

Answer 7

Bacteriocidal against gram-positives (including Staph aureus), gram-negatives (including Pseudomonas) and Candida albicans
Do NOT use in patients with sulfa allergies!
Use : 2nd / 3rd degree burns and chronic ulcers

Question 8

Nystatin

Answer 8

Antifungal

Used in the treatment of Candida infections of the skin and mucous membranes, but not used in tinea infections

Question 9

Azelaic acid Side Effects

Answer 9

include skin dryness and lightening of the skin where applied

Question 10

Topical Calcineurin Inhibitors

Answer 10

They are second-line treatment for mild to moderate atopic dermatitis involving the face, including the eyelids, neck and skin folds
Because of the decreased activity ot T cells there is evidence that they may increase the risk of developing lymphomas and skin cancer therefore***:
They should NOT be used on children younger than 2YO
They should NOT be used for extended periods of time and over a minimum area
They should NOT be used in patients with a compromised immune system