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Derm Flashcards

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1
Q

what are 5 clinical uses of topical corticosteroids?

A

atopic dermatitis
seborrheic dermatitis
allergic and nonallergic dermatitis
eczema
psoriasis

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2
Q

what are the MOA of topical steroids?

A

inhibition of phospholipase A2
decreases leukocytes and cytokines
antimitotic- reduces cell turnover
vasoconstrictive properties

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3
Q

low potency topical steroids are indicated for what areas and what populations?

A

face and intertriginous areas in any pop.
infants, children, and elderly

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4
Q

what strength are these topical steroids?
hydrocortisone
hydrocortisone acetate
triamcinolone acetonide (0.025%)

A

low potency

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5
Q

medium potency topical steroids are indicated for use in what population/ areas?

A

adults for the majority of areas

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6
Q

what strength are these topical steroids?
hydrocortisone valerate
mometasone furoate
betamethasone valerate
triamcinolone acetonide (0.1%)

A

medium potency

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7
Q

when are topical high potency steroids indicated?

A

palms and soles
adults with thick plaques not resopnding to low potency

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8
Q

what type of strength are these topical steroids?
fluocinonide
betamethasone dipropionate (0.05%) cream
triamcinolone acetonide (0.5%)

A

high potency

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9
Q

what type of strength of topical steroid are these?
betamethasone dipropionate (0.05%) ointment
clobetasol propionate (0.05%)

A

very high potency

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10
Q

does normal or inflamed skin have more absorption?

A

inflamed skin

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11
Q

are ointments or creams better for topical steroid penetration?

A

typically ointments

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12
Q

what are some ADRs of topical steroids?

A

tachyphylaxis (tolerance)
skin atrophy
rosacea, dermatitis, acne
secondary skin infection

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13
Q

what are systemic ADRs of topical steroid use?

A

iatrogenic cushing’s disease (buffalo hump, moon face)
PUD
myopathy, cataracts, glaucoma

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14
Q

this type of vehicle for topical steroids should be used for thick, lichenified lesions

A

ointment

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15
Q

this type of vehicle for topical steroids should be used for acute and subacute dermatoses and can be used on moist skin and intertriginous areas

A

creams

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16
Q

these vehicles for topical steroids should be used where a non-oil vehicle is needed

A

solutions
gels
sprays

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17
Q

these medications are indicated for mild non-inflammatory acne vulgaris

A

topical retinoid or salicylic acid QHS
if no improvement in 2-3mo, add topical abx

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18
Q

this tx is indicated for mild inflammatory acne vulgaris

A

benzoyl peroxide in AM, may use with abx
if no improvement in 2-3mo, add oral abx

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19
Q

this tx is indicated for moderate non-inflammatory acne vulgaris

A

topical retinoid QHS
if no improvement in 2-3mo, add topical abx

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20
Q

this tx is indicated for moderate inflammatory acne vulgaris

A

topical retinoid QHS
topical abx w/ benzoyl peroxide AM
oral abx

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21
Q

this tx is indicated in hormone related acne vulgaris in non-pregnant females

A

oral contraceptive
topical retinoid QHS
inflammatory- oral abx w/ benzoyl peroxide

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22
Q

this tx is indicated for severe cystic or nodulocystic acne vulgaris

A

derm referral
oral abx + topical retinoid

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23
Q

what is the clinical use of topical salicylic acid?

A

mild noninflammatory acne

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24
Q

what is the MOA of salicylic acid?

A

keratolytic agent
softens tissue
may dissolve protein that keep stratum corneum together
>6% destructive and used for corn/ wart removal

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25
ADRs of salicylic acid
skin irritation photosensitivity allergic rxn (cross sensitivity with aspirin)
26
is salicylic acid more or less effective than topical retinoids?
less effective
27
what is the clinical use of topical retinoids?
mild to severe non-inflammatory and inflammatory acne
28
what are 3 examples of topical retinoids?
tretinoin- Retin-A adapalene- Differin tazarotene- Tazorac
29
what is the MOA of retinoids?
keratolytic agents derivative of vitamin A opens up closed comedones
30
ADRs of topical retinoids
skin irritation photosensitivity teratogenicity (causes fetal abnormalities)
31
clinical use of benzoyl peroxide includes what?
mild to moderate inflammatory acne adjunct with topical or oral abx rosacea
32
MOA of topical benzoyl peroxide
lipophilic oxidizing agent- releases free radicals (oxidizes bacterial proteins) peeling and comedolytic effects
33
ADRs of benzoyl peroxide
bleaching agent skin irritation (2% just as effective as 10%) allergic contact dermatitis inactivation of topical retinoids
34
clinical uses of topical azelaic acid
post-inflammatory hyperpigmentation rosacea alternative to topical abx or benzoyl peroxide
35
MOA of topical azelaic acid
antimicrobial activity against P. acnes mild anti-inflammatory properties inhibits effect of conversion of testosterone to dihydrotestosterone
36
ADRs of topical azelaic acid
skin irritation hypopigmentation hypertrichosis
37
topical abx may be used in combo with corticosteroids for what 3 instances?
secondarily infected dermatosis diaper dermatitis otitis externa
38
this antimicrobial agent can be used in nares to decrease staph, is poorly absorbed, and can be used as ointment alone or in combo with polymyxin B
bacitracin
39
what type of bacterial does bacitracin target
G+: strep, pneumo, staph most anaerobes: neisseriae, tetanus, diptheria bacilli
40
what type of bacteria does polymyxin B sulfate target?
G- : pseud, e coli, enterobacter, kleb resistant: most proteus and serratia
41
this antimicrobial agent should be avoided in pts with sulfa allergies and can be used alone or in combo
polymyxin B sulfate
42
what type of bacteria does neomycin target?
G- : e coli, proteus, kleb, entero
43
this antimicrobial agent is an aminoglycoside and should be avoided if possible (25% have allergic rxn) and is usually used in combo
neomycin
44
this antimicrobial agent targets G+ bacteria including MRSA
mupirocin
45
this abx is a tx for impetigo and usually is in a polyethylene glycol vehicle
mupirocin
46
what type of bacteria does clindamycin target?
p. acnes
47
this abx is used for mild to moderate inflammatory acne, lotion and gel is better than the foam, and can be used solo or in combo
clindamycin
48
this abx is used for mild to moderate inflammatory acne and the water-based gel is less irritating
erythromycin
49
this medication is used to tx rosacea and some rat studies show some carcinogenic effects so it should be avoided in pregnant women
metronidazole
50
this topical antifungal can be used as vaginal cream or suppositories for vulvovaginal candidiasis
miconazole (monistat)
51
this topical antifungal can be used as vaginal cream or tablets
clotrimazole (lotrimin)
52
this topical antifungal can be used: cream- dermatophytosis and candidiasis shampoo- foam for seborrheic dermatitis
ketoconazole (nizoral)
53
this topical antifungal targets c. albicans and is used for thrush, diaper rash, and vaginitis
nystatin
54
what are 3 clinical uses of imiquimod (aldara) which is a topical immunomodulator?
genital and perianal warts actinic keratoses on face and scalp basal cell carcinoma on trunk, neck, and extremities
55
how to apply imiquimod for warts
apply 3x a week and wait 6-10 hrs before washing off
56
how to apply imiquimod for actinic keratoses
apply 2x a week and wash off 8 hrs later
57
what are 2 common ectoparasiticides?
permethrin ivermectin
58
tx for pityriasis/ tinea versicolor
selenium sulfide (selsun blue)
59
tx for nipple irritation due to breastfeeding
lanolin
60
tx for nipple fissures
mupirocin betamethason clotrimazole

Pharmacology (13 decks)

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