Dermatologic Therapies Flashcards
How do you determine efficacy of any topical medication?
Active ingredient (strength)
Anatomic location
Vehicle (mode in which it is transported)
Concentration of medication
Ointments
Vaseline
Use: Smooth non-hairy skin; dry, thick, hyperkeratotic lesions
Avoid: Hairy and intertriginous (skin in contact with skin) areas e.g. armpits, groin, pannus
Creams
Vanish when rubbed in.
Less greasy, drying effects, not occlusive, can sting, more likely to cause irritation (preservatives/fragrances).
Use for acute exudative inflammation, intertriginous areas.
Lotion
Pourable liquid.
Less greasy, less occlusive, may contain alcohol (drying effect on oozing lesion); penetrate easily, little residue.
Use for hairy areas
Oils
Less stinging than lotions or solutions.
Use for scalp, esp for people with coarse or curly hair.
Gel
Jelly-like. May contain alcohol, greaseless, least occlusive, dry quickly.
Use for acne, exudative inflammation (acute contact dermatitis); on scalp/hairy areas without matting.
Foams
Cosmetically elegant; spread readily, easier to apply, more expensive.
Use for hairy areas; inflammation.
Sprays
Aerosols (rarely used), pump sprays
Medication costs
OTC are cheaper than prescriptions.
Not all topical meds are covered by insurance.
Generics are less expensive than brand name prescriptions.
Desonide cream 0.05% apply to affected area (face) BID PRN for scaling #15 grams RF3
Generic name: Desonide
Vehicle: Cream
Concentration: 0.05%
Sig (directions): Apply to affected area BID PRN for scaling
Amount: #15 grams
Refills: RF3
Topical corticosteroids
Produce anti-inflammatory response.
Effective for conditions characterized by hyperproliferation, inflammation, immunologic involvement.
Provide relief for burning/pruritic lesions.
Steroids in any class have the _______ potency.
The same potency
Strength of steroids depends on the _______ not the ________.
Depends on the molecule not the concentration.
Super high potency steroid
Class I
Clobetasol propionate 0.05%
High potency steroid class
Class II
Fluocinonide 0.05%
Medium potency steroid class
III-V
Triamcinolone acetonide ointment 0.1%
Triamcinolone acetonide cream 0.1%
Triamcinolone acetonide lotion 0.1%
Low potency steroid class
Fluocinolone acetonide 0.01%
Desonide 0.05%
Hydrocortisone 1%
What do you use super high potency steroids for?
Severe dermatoses over nonfacial and nonintertriginous areas: Scalp. palms, soles, thick plaques on extensor surfaces.
Medium to high potency steroids (classes II-V) used for?
Mild ot moderate nonfacial and nonintertriginous areas
**OK to use on flexural surfaces for limited periods
Low potency steroids (classes VI, VII) used for?
Large areas and on thinner skin: Face, eyelid, genital, and intertriginous areas.
Side effects of topical steroids?
Skin atrophy, telangiectasias, striae, acne, steroid rosacea, hypopigmentation.
Higher the potency, the more likely ________.
Side effects will occur.
Systemic effects of topical steroids?
Glaucoma (when steroid applied to eyelid). Hpyopthalamic pituitary axis suppression Cushing's syndrome Hypertension Hyperglycemia
Super high potency: How long should treatment time be?
<3 weeks