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Dermatology > Topical Steroids > Flashcards

Topical Steroids Flashcards

1
Q

Which vehicle is the most lipophilic, moisturizing, and occlusive?

A

Ointments

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2
Q

Vehicle of choice for occlusve skin folds: ointment, cream, gel, or foam?

A

Creams

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3
Q

creams wet or dry things?

A

dry

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4
Q

Do gels wet or dry things?

A

dry

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5
Q

Best vehicle of choice for a full head of hair?

A

foams

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6
Q

Cautions for foams?

A

Do not use if age < 12 yrs
Do not use longer than 2 weeks
The steroid affect -> HPA axis suppression

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7
Q

Topical steroid + Anti-fungal Combo Therapy

What is Mycolog-II?

A

Nystatin + Triamcinolone (Kenalog)
Use: Candida in skin folds

Nystatin = Antifungal
Kenalog = Class 3 steroid

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8
Q

What is tinea pedis, cruris, capitis?

A

Tinea is a fungal infection caused by dermatophyes

Tinea pedis = fungal infx of feet
Tinea cruris = fungal infx of crotch “jock itch”
Tinea capitis = fungal infx of scalp

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9
Q

Topical steroid + Antifungal Combo therapy

What is Lotrisone?

A

Lotrimin (Clotrimazole) / Betamethasone dipropionate topical
Use: tinea pedis/cruris/corporis
popular 1st choice for topical anti-inflammatory trmnt

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10
Q

Why does Mycolog-II not treat tinea pedis/cruris/capitis?

A

Mycolog-II = Nystatin/Triamcinolone
Nystatin is an antifungal that works well for Candida, NOT dermatophytes

unsure why exactly, data just says it doesnt work well

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11
Q

Should hydrocortisone cream on a diaper rash be used cautiously?

A

yes, it can still create HPA axis suppression

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12
Q

do central or distal areas absorb better?

A

central

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13
Q

Which steroid class is most and least potent?

A

Class I - most potent
Class VII - least potent

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14
Q

SE of steroids?

A

Striae
Hypopigmentation
Atrophy
Purpura (easy skin bruising)

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15
Q

Which SE of steroids is this?

pt put Class II Desoximetasone on her eyelids and it resulted in bleeding eyelids and incr in intraocular pressure.

A

Atrophy

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16
Q

Which SE of steroids is this?

Pt put steroid on his dick and now its bleeding

A

Atrophy
the foreskin acts like an occlusive dressing and incr absorption of the steroid

17
Q

Pts groin was red and angry, so they put steroids on it. symp go away and come back after stopping steroid use. What else could this be?

A

underlying fungal infection (tinea cruris)

Fungal infections of this type typically have a sharp, scaly border and show little tendency to spread

18
Q

Possible skin signs of allergic rxn to topical steroids?

A

MC: eczema look
Exanthema
Purpura
Utricaria

19
Q

Pt uses a Class V topical steroid for more than 6mo. Now she has numerous red papules on her cheeks. What is this?

A

Steroid Rosacea

20
Q

Pt uses Class V topical steroid on her entire face and then gets diffuse pustular eruptions. The inflammation goes away each time she puts more steroid on and then flares up again when she stops. What is this?

A

Steroid acne

21
Q

Systemic effects of topical steroids?

A
22
Q

Use the ____ method when giving IM injections

A
23
Q

5 common mistakes of topical steroid use

A
  1. steriod too weak for process and area
  2. underdosing
  3. failure to FU
  4. too strong on kids
  5. too strong on face
24
Q

the entire skin surface of an average adult = _______ g of cream

A

20-30

25
Q

1 Fingertip Unit (FTU) = _____ g cream

A

1 FTU = 0.5g Cream

Note: this only works if the tube nozzle aperature is 5mm diameter

26
Q

Rule of Hand Area

2 HA = ____ FTU or _____ g cream

A
27
Q

Tachyphylaxis

A

Decrease in responsiveness to a drug as a result of enzyme induction with successive use

overtime, you buld up a tolerance to how well the steroid can vasoconsrict you

28
Q

Vasoconstriction _______ progressively when a potent topical steroid is applied TID for >4days

A

decreases

vasoconstriction response returns after 4 days off the steroid

29
Q

use no more than _____ g of a Class I steroid per week

A

Dermatology (4 decks)

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