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Pharmacology > Chapter 16: Skin disorders > Flashcards

Chapter 16: Skin disorders Flashcards

(78 cards)

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1
Q

purpose of topical corticosteroids

A

decrease inflammation, reduce itching, acute and chronic dermatitis

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2
Q

delivery types of topical corticosteroids

A

ointments, gels, aerosols, cream and lotions

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3
Q

low potency topical corticosteroids used for

A

eczema, iritant dermatitis, seborrhea, atopic dermatitis

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4
Q

high potency topical corticosteroids are used for

A

psoriasis, lichen planus, allergic contact dermatitis

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5
Q

are cream or ointments generally preferred

A

creams because they are nonocclusive and less greasy

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6
Q

when are aerosols preferred

A

weeping lesions or lesions on scalp

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7
Q

what is the drawback of lotions

A

often contain alcohol and sting

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8
Q

what is the advantage of gels

A

spread easily and can be used on scalp and hairy areas

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9
Q

most common adverse effect

of topical corticosteroids

A

cutaneous atrophy

(thinning of skin accompanied by telangiectasia)

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10
Q

other adverse effects of topical corticosteroids

A

striae, acne, hypopigmentation, alopecia, glaucoma,

adrenal suppression (may be life threatening)

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11
Q

conscientiou prescribing of topical steroids

A

drug absoprtion enhanced by increased skin temp, skin hydration, application to denuded areas

cannot be used extended periods in women who are or may become pregnant

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12
Q

what is the most commonly used topical corticosteroid

A

1% hydrocortisone

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13
Q

topical corticosteroid patient teaching

A

effects are short term, agents cannot be used frequently

symptoms may reappear after effects wear off

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14
Q

mechanism of action for topical corticosteroids

A

controls protein synthesis rate

depresses migration of polymorphonucleic leukocytes

reverses capillary permeability

reverses lysosomal stablization

prevents or controls inflammation

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15
Q

topical corticosteroid pharmacokinetics

A

absorption: no systemic absorption
distribution: 2/3 protein bound if systemically absorbed
metabolism: hepatic if absorbed
excretion: urine

half-life: 6.5 hours

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16
Q

clinical uses for topical corticosteroids

A
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17
Q

contraindication to topical corticosteroids

A

hypersensitivity

systemic fungal infection

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18
Q

dosage and application of topical corticosteroids

A

Page 295

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19
Q

topical corticosteroid patient education

A

avoid occlusive dressings

avoid with diapers (occlusive)

caution with pregnancy

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20
Q

etiologic agent of acne

A

propionibacterium acnes

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21
Q

mild acne

A

few to several papules and pustules but no nodules

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22
Q

moderate acne

A

several papules and pustules with a few nodule

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23
Q

severe acne

A

several papules, pustules, and nodules

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24
Q

drugs used to treat acne

A

keratolytics, antibiotics, vitamin A derivatives

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25
names of mild keratolytics
benzoyl peroxide salicylic acid
26
mild keratolytics mechanism of action
causes epidermis cells to shed faster to prevent pore clogging
27
how does benoyl peroxide decrease anaerobic bacteris in follicles
convert benzoic acid in skin and releases free-radical oxygen that oxidizes bacteria proteins
28
what can happen with high concentration formulations of benzoyl peroxide
hyperpigmentation and increased risk of skin irritation
29
antiobitc mechanism of action
decreases bacterial load and inflammation and infection that results from bacteria presence
30
Administration of antibiotics for acne
may be topical or oral
31
why are ABT and benzoyl peroxide often prescribed together for acne treatment
provides better results than either agent alone
32
side effects of ABT
light sensitivity, gastric upset, diarrhea
33
tetracyclines after expiration date
become more potent don't use
34
caution with ABT prescribing
children under 10 pregnant women to avoid blue-gray discoloration of teeth
35
what infection may clindamycin lead to
c-diff
36
mechanism of action: vitamin A
retinoids prevent the formation of comedones by normalizing the desquamation of follicular epithelium
37
major side effects of retinoids
excessive drying, burning, skin inflammation
38
examples of retinoids
tretinoin (retin A), adapalene, tazoarotene
39
pregnancy category of retinoids
tretinoin - class C tazarotene and isotrentinion - class X Never use in pregnant women
40
treatment of urticaria
antihistamines
41
antihistamine mechanism of action
act on histamine receptor to decrease release of histamine from mast cells
42
first generation antihistamines
diphenhydramine lead to drowsiness
43
second generation antihistamines
loratidine, fexofenadine, cetirizine cause very little drowsiness if used at commonly prescribed doses
44
treatment of superficial bacterial infection
usually topical agents are sufficient if not, oral agents are used
45
impetigo characterisitics
lesions with a honey colored crust highly contagious
46
mupirocin
topical antibiotic that is effective against gram+ bacteria including MRSA
47
examples of oral agents utilized when topicals are insufficient
dicloxacillin, erythromycin, and amoxicillin with clavulanate
48
imidazole and triazole
antifungals that inhibit p450 system to stop conversion of lanosterol to ergosterol (which is necessary for cell wall synthesis)
49
allylamines
antifungals inhibits epoxidase (which is required for ergosterol)
50
griseofulvin
antifungal that binds to microtubules, stopping fungal mitosis
51
patient education on drugs treating superficial bacterial infections
wash with soap and water before applying
52
drugs used to treat superficial fungal infections
imidazole, triazoe, allylamines, griseofluvin
53
treatment of tinea cruris
topical treatment with any antifungal agentunless it has spread to lower thighs and buttocks, then use itraconazole or terbinafine
54
treatment of tinea capitis
oral griseofulvin usually used cause topical agents do not clear infection very well
55
treatment of tinea corporis
topically id 1-2 lesions present, otherwise orally. fluconazole once weekly x 4 weeks
56
treatment of tinea pedis
topical agent in most cases but highly kerototic lesion may require oral therapy
57
treatment of onchyomycosis and candiasis
Page 299
58
Topical conditions that are viral
shingles chicken pox herpes simplex herpes zoster
59
antiviral agents mechanism of action
inhibits DNA synthesis to decrease viral replication
60
antiviral pharmacokinetics
metabolism: liver excretion: urine half-life: 8-10 hours
61
antiviral agents drug interactions
probenecid will increase drug levels risk of toxicity when adinistered with theophylline
62
agents used for cleansing and disinfecting skin
NS, isopropyl alcohol, phenol derivatives, chlorhexidine, cationic surfactants, povidone-iodine, hydrogen peroxide
63
purpose of topical cleansing/disinfecting agents
decrease risk of infection by decreasing bacterial load usually for intact skin
64
first degree burn
exhibit pain and erythema only
65
second degree burn
exhibits blisters and pain
66
third degree burns
full thickness that are insensate and usually require more than outpatient treatment
67
treatment of 2nd degree burns
silver sulfadiazine and covered with guaze. CHange twice daily
68
pressure ulcers
page 302
69
topical drugs used for reatment of psoriasis
corticosteroids vitamin D analogues emollients keratolytics tazarotene calcineurin inhibitors page 303
70
oral drugs for treatment of psoriasis
cyclosporin A methotrexate acitretin fumaric acid esters page 303-304
71
IV/injectable meds for psoriasis
page 304-305
72
drugs to treat seborrhea
mild strength corticosteroids shampoos containing selenium mineral oil pretreatment for debridement
73
example of drugs used to treat seborrhea
page 305-306
74
mechanism of action for topical anethestics
blocks sodium channels, slowing conduction along nerves and disrupting the action potential
75
examples of topical anesthetics
lidocaine benzocaine prilocaine
76
application of topical anesthetics
only to intact skin
77
pregnancy, pediatric, geriatric implications
page 308
78

Pharmacology (28 decks)

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