TOPICAL MEDS

Question 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

Answer 1

TACHYPHYLAXIS

Question 2

VEHICLES CONSIST OF 3 BASIC COMPONENTS

Answer 2

POWDERS
OILS
LIQUIDS

Question 3

TINCTURE

Answer 3

Alcoholic or hydroalcoholic solutions (may cause pain and irritation on erosions and abrasions)

Question 4

considered the least potent topical therapy

Answer 4

lotion

Question 5

lotions

Answer 5

hairy areas
wet lesions
large areas
has cooling/soothing effect

do NOT use on dry cracked/fissured skin - will burn due to alcohol

Question 6

determines the rate at which the active ingredient is absorbed through the skin

Answer 6

vehicle (base)

Question 7

penetrates the stratum corneum of the skin well

Answer 7

creams

• stronger than lotions but less potent than ointments

Question 8

OINTMENTS

Answer 8

• most lubricating & moisturizing
• most potent vehicle - due to occlusive effect, but patient acceptance may be low because ointments are greasy
• usefor for dry dermatosis in non-seborrheic / non-intertriginous areas
• NOT useful in hairy areas

Question 9

GELS

Answer 9

• considered drying - used in seborrheic areas (face / chest)
• useful for exudative inflammation (poison ivy) and in scalp / hair bearing areas
• useful for treating acne

Question 10

AEROSOLS / SPRAY

Answer 10

• considered to be drying
• wasteful - as much of the active medication does NOT reach the skin
• most frequently used in the scalp

Question 11

most potent
potent
least potent

Answer 11

most potent = ointment / gels
potent = creams
least potent = lotions

Question 12

*** IN GENERAL, OINTMENTS > CREAMS > LOTIONS IN TERMS OF POTENCY
exception:

Answer 12

retin-A in gel form and solutions = more effective and irritating than creams

Question 13

TOPICAL STEROIDS MOA

Answer 13

MOA = corticosteroids pass through the stratum corneum and cause VASOCONSTRICTION, decrease inflammation and inhibit cellular proliferation

• the more potent the topical steroid = the more vasoconstriction, the less inflammation, and the less proliferation of cells
• the vasoconstriction can be quantified - serves as a parameter by which topical steroids are ranked in potency

Question 14

indications for topical steroids

Answer 14

therapy of choice for most inflammatory conditions (dermatitis, psoriasis, sarcoid)

Question 15

BENEFITS OF TOPICAL STEROIDS

Answer 15

broad applicability in treatment of numerous diseases
rapid action with small doses
ease of use - no odor, no pain
lack of sensitization
prolonged stability
compatible with most other topical medications