Topical skin therapeutics Flashcards

1
Q

What kind of solution is a gel?

A

Thickened aqueous solution

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2
Q

What do gels contain?

A

High molecular weight polymers

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3
Q

Where are gels commonly used?

A

Scalp, hair baring areas

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4
Q

What kind of solution is a cream?

A

Semisolid emulsion of oil in water

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5
Q

What do creams often contain?

A

Emulsifier and preservative

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6
Q

What are the advantages of cream?

A

High water content- cooling
Easy to apply
Non-greasy
Cosmetically acceptable

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7
Q

What kind of solution is an ointment?

A

Semi-solid grease/oil

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8
Q

Why are ointments less cosmetically attractive?

A

Greasier and heavier

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9
Q

What do ointments restrict?

A

Trans-dermal water loss

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10
Q

What is the problem with ointments?

A

Highly flammable

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11
Q

What kind of preparation is a paste?

A

Semi-solid

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12
Q

What are pastes used for?

A

Cooling, drying, soothing bandages- often around an ulcer

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13
Q

What do pastes contain?

A

Finely powdered material ZNO

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14
Q

What kind of solution are lotions?

A

Suspension of a solution of medication in water, alcohol or other liquid

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15
Q

What can make lotions hard to use?

A

If it contains alcohol it may sting

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16
Q

Where are lotions used?

A

Scalp

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17
Q

What kind of solution are foams?

A

Usually hydrophilic liquid in continuous phase with foaming agent dispersed in gaseous phase

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18
Q

What are the advantages of foams?

A

Increased penetration of active agents

Spread easily over large areas, no greasy/oily film

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19
Q

What do emollients do?

A

Enhance rehydration of epidermis

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20
Q

When are emollients needed?

A

All dry/scaly conditions

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21
Q

How much emollient should be prescribed weekly?

22
Q

What kind of effects to topical steroids have?

A

Vasoconstrictive
Anti-inflammatory
Antiproliferative

23
Q

What are topical steroids used?

A

Mainly eczema, sometimes psoriasis

24
Q

List topical steroids in order of increasing anti-inflammatory and immunosuppressant effect?

A
  1. Hydrocortisone
  2. Modrasone Clobetasone
    Butryrate
  3. Mometasoine
    Betamethasone
    Valerate
  4. Clobetasol Proprionate
25
What is a risk factor of steroid use?
Rebound psoriasis
26
How much does one fingertip unit cover?
2 hand areas
27
What are side effects of long term topical steroid use?
``` Skin thinning Purpura Stretch marks Steroid rosacea Periolar dermatitis Fixed telangiectasia Adrenal suppression Cushings Tachyphylaxis Glycoma Cataracts ```
28
What are calcineurin inhibitors?
Non steroid anti-inflammatories
29
What are tacrolimus and pimecromilus the same strength as?
Tacromilus: potent steroid Pimecromilus: mild steroid
30
How do calcinuerin inhibitors work?
Suppress lymphocyte activation
31
When are calcinuerin inhibitors used?
Atopic eczema
32
What is the negative feedback received after use of calcinuerin inhibitors?
Cause burning sensation on application
33
What is a risk factor of calcinuerin inhibitors?
Risk of skin cancer | Risk of cutaneous infection
34
Name some antiseptic preparations
- povidone iodine (betadine) skin cleanser - chlorhexidine (hibitane, savlon) - triclosan (aquasept, sterzac) - hydrogen peroxide (crystacide)
35
When should antiseptics be used?
Try to use over antibiotics Recurrent infections Antibiotic resistance Wound irrigation Acute blistering weeping eczema
36
What is given for herpes simplex virus?
Topical antiviral
37
What is given for eczema herpeticum?
Oral antiviral
38
What is given for herpes zoster? (shingles)
Oral antiviral
39
What is given for candida infection?
Antiyeast, clotrimazole
40
What is given for dermatophyte (ringworm) infection?
Antifungal eg - clorimazole - Terbinafine cream
41
What is given for pityriasis versicolor?
Ketoconazole
42
How can pityriasis versicolor be identified?
Areas of hyper/hypo-pigmentation | Pink inflammatory areas on the trunk
43
What are some common antipruritics?
Menthol Capsaicin Camphor/phenol Crotamiton
44
How does menthol work?
added to calamine & other lotions and creams to impart cooling sensation
45
How does capsaicin work?
Depletes substance P at nerve endings and reduced neurotransmission, effect gradually builds
46
What is camphor/phenol used for?
Pruritus ani
47
What is crotamiton used for?
After treatment of scabies to relieve residual itch
48
What are wet wraps used in?
Very dry skin in children with severe eczema
49
How can you treat warts?
Keratolytics Formaldehyde: soaks for whole foot surface Glutaraldehyde: soaks for whole foot surface Silver nitrate: solitary wart cryotherapy (ususally liquid nitrogen), solitary wart podophullin (genital warts), cryotherapy can be used if localised warts
50
What are the topical psoriasis treatments?
``` Emollients Coal Tar Vitamin D analogue Keratolytics Topical steroid Dithranol ```
51
What are the disadvantages of dithranol?
Difficult to use Stains normal skin Irritant