topical therapy MS

Question 1

Wich products have keratolytic and keratoplastic properties?

Answer 1

1. Tar
2. Selenium sulphide
3. Salicylic acid
4. Sulphur

Question 2

Action of sulphur?

Answer 2

1. keratoplastic
2. keratolytic
3. antibacterial
4. antifungal
5. antiparasitic
6. antipruritic

Question 3

MOA of sulphur?

Answer 3

1. keratoplastic: production of cystine;
2. keratolytic: H2S breaks down keratin;
3. antibacterial-antifungal-antiparasitic: due to conversion to pentathionic acid and H2S by cutaneous bacteria and by KCs

Question 4

Action of salicylic acid

Answer 4

1. keratoplastic (0.1-2%)
2. keratolytic (3-6%)
3. antibacterial (static)
4. antipruritic (mild)

Question 5

MOA of salicylic acid

Answer 5

1. keratolytic: by decreasing pH increases keratin hydration and solubilises intercellular cement

Question 6

Actions of tar

Answer 6

1. keratolytic
2. keratoplastic
3. degreasing (mild)
4. antipruritic (anesthetize peripheral nerves)
5. anti-inflammatory (vasoconstriction)

Question 7

MOA of tar

Answer 7

keratoplastic: reduced DNA synthesis in basal cells

Question 8

Actions of benzoyl peroxide

Answer 8

1. keratolytic
2. degreasing
3. follicular flushing
4. antibacterial (residual effect x 48h)
5. antipruritic

Question 9

MOA of benzoyl peroxide

Answer 9

keratolytic: metabolized to benzoic acid that lyses intercellular substance of horny layer

Question 10

Actions of selenium sulphide

Answer 10

1. keratolytic
2. keratoplastic
3. degreasing
4. anti-fungal (Malassezia)

Question 11

MOA seleenium sulphide

Answer 11

keratolytic: interference with hydrogen bond formation

Question 12

Actions of Zn gluconate

Answer 12

1. antiseborrheic,
2. antibacterial

Question 13

Actions of ammonium lactate

Answer 13

1. keratolytic,
2. keratoplastic

Question 14

What do emollients do

Answer 14

decrease TEWL

Question 15

Name occlusive emollients

Answer 15

1. Vegetable oils: olive, cottonseed, corn, peanut, safflower, sesame
2. Animal oils: lard, whale oil, anhydrous lanolin, lanolin with water
3. Hydrocarbons: paraffin, petrolatum (=mineral oil)
4. Waxes: white wax, yellow wax, spermaceti
5. Silicones

Question 16

What are humectants or moisturizers

Answer 16

hydroscopic agents incorporated into SC

Question 17

Name humectants (moisturisers)

Answer 17

1. Propylene glycol, glycerine (demulcents)
2. Colloidal oatmeal
3. Urea (2-20%)
4. Sodium lactate
5. Carboxylic acid, lactic acid

Question 18

MOA of urea (2-20%)

Answer 18

-at higher concentration is keratolytic (solubilisation of prekeratin and keratin, breakage of hydrogen bonds, dissolving intercellular substance)

Question 19

Name topical retinoids

Answer 19

1. Tretinoin
2. Adapalene (less irritating than tretinoin)
3. Tazarotene (min systemic absorption)

Question 20

Topical retinoids-Tretinoin (vitamin A acid, retinoic acid)
name indications

Answer 20

1. acne (D, C)
2. localized keratinisation disorders

Question 21

Topical retinoids-Tretinoin (vitamin A acid, retinoic acid)
MOA

Answer 21

1. increases epidermal turnover time,
2. reduces cohesiveness of KCs
3. normalized maturation of follicular epithelium
4. comedolytic

Question 22

Topical retinoids-Tretinoin (vitamin A acid, retinoic acid)
side effects

Answer 22

irritations (cats )

Question 23

Adapalene- additional activity

Answer 23

1. inhibition of neutrophil activation,
2. inhibition of lipoxygenases