Clinical: Therapeutics Flashcards Preview

Derm Exam 1 > Clinical: Therapeutics > Flashcards

Flashcards in Clinical: Therapeutics Deck (42):
1

2 most common "vehicles" used for topical skin therapy.

Ointments
Creams

2

Advantage of ointments over creams

Moisturizing
Less likely to cause allergic reaction

3

Advantage of creams over ointments

Better for cosmetic use, better patient compliance

4

Which 2 conditions are best treated with ointments?

Atopic Dermatitis
Psoriasis

5

Which conditions are best treated with creams?

Common skin conditions like acne, tinea, seborrheic dermatitis of the face

6

Best time to use lotions for treatment.

When a large area needs treated

7

Best time to use solutions for treatment.

For scalp conditions

8

Best time to use gels for treatment.

For hairy areas

9

Best time to use powders for treatment.

Mainly fungal infections: they absorb moisture which is mainly prophylactic against fungal infection

10

Best time to use pastes for treatment.

Diaper dermatitis

11

Best time to use foams for treatment.

Scalp condition

12

3 effects topical corticosteroids have on the skin

1. Anti-inflammatory
2. Immunosuppressive
3. Anti-proliferative

13

4 conditions highly responsive to topical corticosteroids.

1. Psoriasis
2. Atopic Dermatitis
3. Seborrheic Dermatitis
4. Intertrigo

14

Which steroid class is best used for sensitive areas like the face, groin, and axilla?

Class 4-7

(class 1 is most potent, class 7 is least potent)

15

major side effects of topical corticosteroid use

1. Skin atrophy and Striae (both occur because steroids have anti-proliferative effects)
2. Telangeictasia/Purpura
3. Hypopigmentation
4. Periorbital Dermatitis
5. Infections

16

Main reason to use Topical Immunomodulator Drugs.

Used in patients that develop a topical steroid dependency.

17

Name the two topical immunomodulator drugs and the MOA.

Pimecrolimus and Tacrolimus
MOA: Inhibition of calcineurin
-protein phosphatase enzyme that activates T cell receptor production and cytokine production
-overall effect is reduced immune response

18

3 topical antibiotics used for Gram (+) superficial skin infections.

Mupirocin
Retapamulin
Bacitracin

19

2 topical antibiotics used for Gram (-) superficial skin infections.

Neomycin/Gentamycin
Silvadene

20

Topical antifungal used for dermatophyte infections.

Allylamines/Benzylamines

21

Topical antifungal used for superficial yeast infections.

Imidazoles

22

Topical antifungal used for onychomycosis.

Cyclopirox
-good penetration of the stratum corneum

23

Which antifungals should you not use for dermatophytes or malassezia?

Polyenes

24

Main use for retinoids

Acne
(bexarotene used for cutaneous T cell lymphoma)
(alitretinoin used for Kaposi Sarcoma)

25

2 indications for 5-Fluorouracil

Actinic Keratoses
Squamous Cell Carcinoma

26

Indication for Podophyllin

Genital Warts

27

What is the minimal erythema dose (MED)?

Minimal dose of UVB radiation required to turn the skin red. Sunscreens use an MED of 10 minutes when advertising SPF values.

28

What is the SPF of sunscreen?

MED of skin with sunscreen/MED of skin without it

MED with sunscreen is 300minutes/MED without is 10minutes. So ratio is 300/10 and the SPF is 30

29

Main two components of inorganic sunscreens.

Zinc Oxide
Titanium Dioxide
(has broad spectrum coverage)

30

Most common UVB blocker in organic sunscreens.

Octinoxate

31

Most common UVA blocker in organic sunscreens.

Oxybenzone

32

Why don't most systemic corticosteroids work in liver disease?

They need to be converted to an active form by 3beta-OH steroid dehydrogenase (liver enzyme)

33

Main immune suppressing effect of corticosteroids.

Inhibits production of IL-2 receptors on T cells preventing T cell proliferation.

34

Most important side effect of corticosteroid use.

Osteoporosis
-prevents Vitamin D3 induction of osteoblast activity

35

3 derm indications of methotrexate.

1. Psoriasis
2. Chronic T cell leukemia
3. Atopic Dermatitis

36

Side effects of methotrexate

Nausea
Cytopenias
Hepatotoxicity

37

MOA of hydroxychloroquine (Plaquenil)

Anti-malarial
-mainly inhibits antigen presentation to B cells and T cells
(used for cutaneous lupus, dermatomyositis, sarcoid, porphyria, cutanea tarda

38

Major risk factor in using antimalarial meds.

Retinal Toxicity

39

MOA and indications of Dapsone

MOA: inhibits neutrophil chemotaxis mainly by inhibiting binding of IgA to neutrophils
Indications: Linear IgA disease, IgA pemphigus

40

MOA and indication for Azathioprine

MOA: purine analog, inhibits purine synthesis in T cells and B cells
Indication: Immunobullous Diseases

41

MOA of Mycophenolate Mofetil

Inhibits inosine monophosphate dehydrogenase preventing purine synthesis selectively in B and T cells

42

MOA of cyclophosphamide

DNA alkylating agent preventing DNA synthesis mainly in B cells
(mainly used for immunobullous disease)