Topical Skin Therapeutics Flashcards

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1
Q

Advanatages of topical treatments?

A

Direct application

Reduced systemic efefects

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2
Q

Disadvantages of topical treatments?

A

Time consuming
Correct dosage can be difficult
Messy to use

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3
Q

What are drugs dissolved in when used on the skin?

A
Bases or vehicles
eg 
Gels
creams
Ointments 
Pastes 
Lotions 
Foams
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4
Q

Icythosis?

A

Lizard skin

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5
Q

What do creams contain?

A

Emulsifier

Preservative

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6
Q

Creams are greasy. True or fasle?

A

False

Non-greasy

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7
Q

Ointments are semisolid grease/oil. True or False

A

True

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8
Q

Where do lotions and gel treat?

A

Hair bearing areas

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9
Q

What are pastes often used in?

A

Cooling
Drying
Soothing Bandages

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10
Q

Types of topical therapies?

A
Emollients 
Topical steroids
Antiinfective agents 
Antipruritecs 
Keratolytics 
Psoriasis therapies 
Cytoxic & antineop,astic aents
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11
Q

What do emollients do?

A

Enhance rehydration of epidermis

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12
Q

What are emollients for?

A

Dry/scaly conditions

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13
Q

What emollients need to be?

A

Effective

Cosmetically acceptable

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14
Q

Emollient prescribing tips?

A
  • Apply immediately after bathing
  • Apply in direction of hair growth
  • Make skin and surfaces slippery
  • Use clean spoon or spatula to remove from tub
  • Fire risk if parrafin based
  • Avoid those containing SLS in leave on products
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15
Q

When is wet wrap therapy used?

A

VERY dry (xerotic) skin

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16
Q

Mode of action for topical steroids?

A

Vasoconstrictive
Anti-inflammatory
Antiproliferative

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17
Q

Mild topical steroids?

A

Hydrocortisone 1%

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18
Q

Moderate topical steroid

A

Modrasone
Clobetasone
Butyrate

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19
Q

Potent topical steroids?

A

Mometasone
Betamethasone
Valerate 0.1%

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20
Q

Very potent topical steroids?

A

Clobetasol

Proprionate 0.05%

21
Q

Use of topical corticosteroids?

A
  • Eczema (dermatitis)
  • Psoriasis
  • Other non-infective inflammatory dermatoses eg lichen planus
  • Keloid scars
22
Q

Side effects of topical steroids?

A
Thinning of skin 
Purpura 
Stretch marks 
Steroid rosacea 
Perioral dermatitis 
Fixed telangectasia
23
Q

Other side effects of topical steroids?

A

-May worsen or mask infections
-Systemic absorption (can cause adrenal suppression, cushings syndrome)
Tachyphylaxis: decrease in response to anti-inflammatory effects
Glaucoma and cataract

24
Q

Calicneurin inhibitors?

A
  • Suppress lymphocyte activation
  • Topical treatmnet of atopic eczema
  • May cause burning sensation on application
  • Risk of cutaneous infections/skin cancer
25
Q

Alternative to steroid?

A

Calicnuerin inhibitors

26
Q

Examples of a calicneurin inhibitors?

A

Tacrolimus

Pimecrolimus

27
Q

Anti-infectives?

A
  • Antivirals
  • Antiseptics
  • Antibiotics
  • Antifungals
28
Q

What type of effects do antiseptics have?

A

Bacteriostatic or bacteriocidal effects

29
Q

Examples of antiseptics?

A

Povidone iodine (betadine) skin cleanser

  • Chlorhexidine (hibitane, savlon)
  • Triclosan (aquasept, sterzac)
  • Hydrogen peroxide (crystacide)
30
Q

Clinical use of antiseptics?

A
Recurrent infections (broad spectrum)
Skin cleansing 
Wound interrogation
31
Q

Clinical use of Antibiotics?

A

Treatmnet of acne/rosacea
Skin infections
Infected eczematous process

32
Q

Antiviral agents treat?

A

Herpes simplex- cold sore- topical antiviral
Eczema herpeticum- oral antiviral
Herpes zoster (shingles)- oral antiviral

33
Q

What do you treat with topical antifungals?

A
  • Candida (thrush)
  • Dermatophytes (ringworm)
  • Pityriasis versicolor
34
Q

What you treat candida with?

A

Anti-yeast

Nystatin, clotrimazole

35
Q

What you treat ringworm with?

A

Antifungal
-Clotrimazole
Terbinafine cream

36
Q

What you treat pityriasis versicolor?

A

Ketoconazole cream or shampoo

37
Q

Examples of antipruritics?

A

Menthol - cooling sensation
Capsaicin - from red chilli peppers
Camphor/phenol- for pruritis ani
Crotamiton - eurax cream

38
Q

What are keratolytics used for?

A

To soften keratin
Viral warts
Hyperkeratotic eczema/psoriasis
Corns and calluses

39
Q

Examples of keratolytics?

A

Salicylic acid ointment

40
Q

Treatment of warts?

A
Keratolytics 
Formaldehyde 
Glutaraldehyde 
Silver nitrate 
Cryotherapy 
Podophyllin (for genital warts)
41
Q

Topical psoriasis treatments?

A

Emollients +

  • Coal tar
  • Vit D analogue
  • Keratolytic
  • Topical steroid
  • Dithranol
42
Q

Pros and cons of vitamin D analogues for psoriasis?

A

Clean, no smell
Easy to apply
Can be irritant
Use limited to 100g a week

43
Q

Pros and cons of dithranol for psoriasis

A

Effective but difficult to use

Irritant and stains normal skin

44
Q

Treatment of scalp psoriasis?

A

Greasy ointmnet soften scale
Tar shampoo
Steroids in alcohol base or shampoo
Vit D analogues

45
Q

Cytoxic and antineoplastic therapies?

A

5- Fluorouracil for solar damage, bowens disease and superficial basal cell carcinoma

46
Q

What is imiquimod used to treat?

A

Solar damage and superficial basal cell carcinoma

47
Q

Side effects of topical therapies?

A

Burning or irritation
Contact allergic dermatitis
Local toxicity
Systemic toxicity

48
Q

Example of systemic effects

A

Salicylism- from twice daily (40% salicyclic acid ointment)
Hypercalceamia & hypercalcuria with vit D analogues
Suppression of pituitary: adrenal axis & cushingoid features with XS topical steroid