Topical therapies in small animal medicine

Question 1

What are the advantages of topical medicine?

Answer 1

Reduction in systemic drug absorption and adverse rxns, adjunctive and synergistic effects of meds, less $$$

Question 2

What are the disadvantages of topical medicine?

Answer 2

More time and labor, messy, unpleasant odors, residues, localized adverse rxns

Question 3

What are the different factors affecting absorption and distribution of topical therapies?

Answer 3

The vehicle, interactions with receptors, concentration, solubility, ability to disrupt the epidermal barrier, acid or base status, lonized or not, skin temp/hydration, body region affected, bf to the area, health and condition of the patient, pH of the patient’s skin

Question 4

How long is the adequate contact time for shampoos?***

Answer 4

10-15 mins of coat contact time

Question 5

What animal has a very thin stratum corneum that improves absorption with gels?

Answer 5

Cats (ex methimazole)

Question 6

What are the four types of active ingredients in topicals?

Answer 6

Antimicrobials, anti-inflammatories, immunomodulating, miscellaneous agents

Question 7

Antiseborrhic shampoos have what two active ingredients? What is their MOA?

Answer 7

Keratolytic agents (induces sloughing of cornified epithelium - strip skin)

Keratoplastic agents (promote keratinization and thickening of the keratin layers - thicken)

Question 8

What are key benefits of liquid aqueous and organic spot on formulations?

Answer 8

Lipophilic with large molecular weight, slow dermal absorption and last usually a month, large volume of distribution, long plasma and tissue half lives

Question 9

What are 4 topical antimicrobial agents?

Answer 9

Chlorhexidine, miconazole, iodine, Mupirocin

Question 10

____ is a pheno related biguanide antiseptic and disinfectant

Answer 10

chlorhexidine

Question 11

____ is an imidazole antifungal with some antibacterial properties against some bacteria

Answer 11

Miconazole

Question 12

___ is bacterialcidal, fungicidial, virucidal and spoicidal

Answer 12

Iodine

Question 13

____ is an antibiotic derived from fermentation of Pseudomonas fluorscens that causes interrupted bacterial protein synthesis and inhibited bacterial RNA synthesis

Answer 13

Mupirocin

Question 14

______ ingestion can lead to nephrotoxicity. It is used for tx of multi-drug resistant Staphylococcus spp. including MRSA

Answer 14

Mupirocin

And Miconazole is used for non staphylococcus resistant strains

Question 15

___ is a topical immunomodulating agent via inhibiting antigen presenting T cells and cytokine production, calcineurin inhibition

Answer 15

Tacrolimus

Question 16

How can sulfur be keratolytic and keratoplastic?

Answer 16

Keratolytic in high concentrations and keratoplastic in low concentration

Question 17

____ has hygroscopic and keratolytic actions and promotes desquamation by dissolving “____ ____”

Hygroscopic– (of a substance) tending to absorb moisture from the air.

Answer 17

Urea; “intracellular substances”

Question 18

What is a simple hygroscopic organic solvent that facilitates absorption of other substances and is veryyyy penetrative!

Answer 18

DMSO

Question 19

What topical antimicrobial gets rid of Staph aerus?

Answer 19

Miconazole

Question 20

_____ is synergistic with chlorhex

Answer 20

Miconazole

Question 21

___ inhibits M. canis growth and is a degreasing agent that can be keratolytic or keratoplastic

Answer 21

sulfur