Topical Therapeutics

Question 1

Give 2 advantages of topical treatments

Answer 1

Direct application

Reduced systemic effects

Question 2

Give 3 disadvantages of topical treatments

Answer 2

Time consuming
Difficult to measure dosage
Messy

Question 3

Name 5 topical bases/vehicles

Answer 3

Gels
Creams
Ointments
Pastes
Lotions

Question 4

Describe the composition of creams

Answer 4

Semisolid emulsion of oil in water
Contain emulsifier & preservative
Cool, moisturiser, non greasy

Question 5

Describe the composition of ointments

Answer 5

Semisolid grease/oil 
No preservative
Occlusive and emollient
Cheapest 
Greasy

Question 6

Describe the composition of lotions

Answer 6

Liquid
Suspension of medication in water or alcohol
May sting
Good for hairy skin

Question 7

Describe the composition of gels

Answer 7

Thickened aqueous lotions
Semi-solids
Treat scalp, hair bearing areas, face

Question 8

Describe the composition of pastes

Answer 8

Semisolids
Contain finely powdered material
Stiff, greasy,difficult to apply
Protective,occlusive,hydrating

Question 9

Name the 6 types of topical therapies

Answer 9

Emollients
Topical steroids
Antinfective agents
Antipruritics
Keratolytics
Psoriasis therapies

Question 10

Name the 4 types of anti-infective agents

Answer 10

Antiseptics
Antibiotics
Antivirals
Antifungals

Question 11

What are the features of emollients

Answer 11

Rehydrate epidermis
In dry/scaly skin conditions e.g. eczema
Need to be cosmetically appealing

Question 12

What is the recommended weekly allowance for emollients?

Answer 12

300-500g weekly

Question 13

Give one example of a soap subtitute

Answer 13

Emulsifying ointment (emollient)

Question 14

What are the indications for Wet Wrap Therapy?

Answer 14

Xerotic skin

Question 15

What are the 3 modes of action of topical corticosteroids?

Answer 15

Vasoconstrictive
Anti-inflammatory
Antiproliferative

Question 16

Give an example of a mild corticosteroid

Answer 16

Hydrocortisone

Question 17

Give an example of a potent corticosteroid

Answer 17

Betamethasone

Question 18

Name 4 conditions where topical corticosteroids may be used

Answer 18

Eczema
Psoriasis
Lichen planus
Keloid scars

Question 19

How much topical corticosteroid is needed to cover an adult body?

Answer 19

20-30g

Question 20

How much is a fingertip unit of topical corticosteroids?

Answer 20

Half a gram

- covers 2 palms

Question 21

Name 6 side effects of topical steroid use

Answer 21

Thinning skin
Purpura
Stretch marks
Steroid rosacea
Fixed telangectasia
Perioral dermatitis

Question 22

Which antiseptic is commonly used with exudative/pompholyx eczema

Answer 22

Potassium permanganate rinse/bath

Question 23

What topical antibiotics are used for acne?

Answer 23

Clindamycin

Erythromycin, tetracycline

Question 24

What topical antibiotics are used for rosacea?

Answer 24

Metronidazole

Question 25

What topical antibiotics are used for Impetigo?

Answer 25

Mupirocin

Question 26

Which condition may warrant use of a topical antiviral?

Answer 26

Herpes simplex

Question 27

Which 2 conditions may warrant use of oral antivirals?

Answer 27

Eczema herpeticum | Herpes Zoster

Question 28

Which 2 conditions may warrant use of topical antifungals?

Answer 28

Candida - nystatin | Dermatophytes (ringworm) - clotrimazole

Question 29

Give 4 examples of antipruritics

Answer 29

Menthol - in calamine Capsaicin - from peppers Camphor - for pruritus ani Crotamiton

Question 30

What are the indications for keratolytics?

Answer 30

Viral warts Hyperkeratotic eczema & psoriasis Corns and calluses Remove keratin plaques in scalp

Question 31

Give an example of a keratolytic

Answer 31

Salicylic acid

Question 32

Name 6 classes of psoriasis treatment

Answer 32

Emollients + - coal tar - vit. D analogue - keratolytic - topical steroid - dithranol

Question 33

What is imiquimod?

Answer 33

Immune response modifier Antiviral + anti-tumour Enhances innate and adaptive immunitiy

Question 34

Name 4 conditions where Imiquimod may be used

Answer 34

Genital warts Superficial BCC Solar keratoses Verrucae

Question 35

What are the 2 types of Calicneurin Inhibitors?

Answer 35

Tacrolimus | Pimecrolimus

Question 36

How do Calicneurin Inhibitors work?

Answer 36

Decrease inflammation of the skin | Suppress lymphocyte activation

Question 37

Which condition is a Calicneurin Inhibitor commonly used?

Answer 37

Atopic eczema

Question 38

Give 5 treatment options for eczema

Answer 38

``` EMOLLIENTS Topical steroids Infection control Phototherapy (UVB) Systemic immunosuppressants ```