Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm > Derma Abx > Flashcards

Derma Abx Flashcards

(48 cards)

Start Studying
1
Q

what variables determine topical drug penetration

A 
lichenification
thickness (palms/soles)
solubility 
location (thick skin is harder )
duration of exposure
frequency of application
allergies/sensitives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the general uses of topical steroids?

A 
non specific antiinflammatory
reduces itching
mainstay of tx : acute or chronic derm
low/medium dose--> eczema, irritant term, atopic derm
high dose--> psoriasis, allergic derm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MOA of topical steroids

A

decrease migration of PMS and fibroblasts
reverse capillary permeability
control rate of protein synthesis
- gene regulation of inflammatory response
lysosomal stabilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Low strength corticosteroids

A

Alclometasone dipropionate

Desonide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

intermediate strength

A

fluticasone propionate
mometasone furoate
hydrocortisone valerate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

high strength

A

amcinonide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Very high strength

A

clobetasol propionate

halobetasol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Commons Adverse drug effects of topical/corticosteroids

A

cutaneous atrophy
- telangiectasia, purpura
other/serious
- striae, acne, refractory rosacea, hypo pigmentation,
adrenal suppression and iatrogenic cushings:
- Increase dose/duration
- Increase with children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are safety considerations

A 
drug interactions
   - minimal if topical
contraindications
     - systemic or fungal infection
     - hypersensitivity 
caution in pregnant women
caution in children < 12 (avoid or use low dose)
caution if symptoms worsen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment considerations for Corticosteroids

A

chronic use effects (ADE, tolerance, tachyphylaxis)
use low doses on areas with increase absorption
occlusive dressings
- caution with low to mid potency
- do not recommend with high very high potency corticosteroids
- do not use in diaper area

ointments have highest effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is remember 3?

A

ultra high potency steroids
- should not be use for > 3 weeks (usually 2-4 weeks)

Low –> high potency steroids
should not be used for > 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are prescribing consideration of topicals?

A

hydration improves absorption
- consider applying after a shower
most are once or twice daily
finertip method

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the fingertip method?

A

1/2 fingertip covers area of hand
fingertip 0.5g covers 2 hands surface area
1g–> cover 4 hands surface area (4%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are topical meds for treating psoriasis?

A

coticosteroids

vitamind d analogues (calcipotriene, calcitriol)

retinoids (tazarotene) (NO PREGNANT)

calcineruin inhibitors (Tacrolimus, pimecrolimus)
consider for facial
  • cortico steroids are generally a first line
  • calcipotrience and corticosteroids are more effective than mono therapy (no longer term effects)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are oral nonbiologics for treating psoriasis?

A

methotrexate (NOT WITH PREGNANT, hepatotoxic)

cyclosporine (NOT with grapefruit juice, renal pt, hypertension, many drug interactions).

oral retinoid –> acitretin (soriatane) (AVOID PREGNANCY 3 years)

apremilast –> suppress immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are clinical acknowledges for nonbiologics?

A

frequent lab monitoring–> baseline and follow up, CBC, BUN, pregnancy tests

concern for drug interactions–> methotrexate and cyclosporine

potential for ADE

Consider referring to specialist once oral therapy is indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are biologic agents for treating psoriasis?

A

ends in “-MAB” –> its a biologic

injectable
Most are subcutaneous
EXPENSIVE!!!

BBW!! –> concern for serious infection
PPD
Increased risk for infection
Suppress immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

considerations for phototherapy for psoriasis?

A

benefit from UVB exposure
Clinic and home treatments

Can use natural sunlight, 30 min at noon, avoid over exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are drugs for treating urticaria?

A

Urticaria is a histamine response

  • PO or Topical

treat with antihistamine

1st generation

  • diphenhydramine, doxylamine
    • drowsiness! BPH, dry mouth

2nd generation –>

  • cetirizine, levocetirizine
    - almost no drowsiness
  • not getting into skin/tissue or CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What drugs should you NEVER use for derm?

Study These Flashcards
A

loratadine, fexofenadine

21
Q

What are drugs for attic dermatitis?

Study These Flashcards
A

Maintenance –> moistuizers

can prevent an itch that rashes with moisturizer

1 Topical steroids –> cheaper

2 Topical calcineurin inhibitors
- Tacrolimus (Protopic)
- Pimecrolimus 
-BBW stinging and burning
- good for face, body folds
no tachyphalaxsis

3 Topical phosphodiesterase-4 inhibitor
- crisaborole (eucrisa) –> specifically for term

4 Dupiexent/ Dupilumab
(BBW warning need ppd)

22
Q

What are Topical Keratolytics for Acne? What is MOA?

Study These Flashcards
A
  1. bezoyl peroxide
    -oxidize bacteria
    1-3 times a day,
    can bleach
    no resistance
    can be irritating
    topical antimicrobial

–> Salicyclic Acid
twice daily

Available OTC-mild acne

MOA:rapid shedding of epidermis
-prevent clogging and formation of comedones

23
Q

Considerations of acne keratolytics

Study These Flashcards
A

formulation

  • gels penetrate better than cream
  • look for oil free versus oil base
  • alcohol base will increase ADRS

strength
- benzyl peroxide [ ] + efficacious

ADRS
BPO and SA–> skin irritation, contact dermatitis, dry, erythema, peeling, stinging, photosensitivity
BPO bleaches fabric

24
Q

What are topical retinoids used to treat acne? what is their MOA? Dosage?

Study These Flashcards
A
  1. Adapalene
    - least irritating
  2. Tazarotene
    - AVOID PREGNANCY BBW
    - not use with sensitive skin
  3. Aklief/ Trifarotene
    - selective targets
    - $$$$
  4. Tretinoin –> irritating

BID application

MOA: prevents formation of comedones and inflammatory lesions
does not contribute to abs resistance
no concern with long term use
negligible systemic absorption

25
Considerations for Topical retinoids for treating acne?
Formulation - gel, cream, solution (irritating), lotion Strength - consider pt skin type, preference and previous use Use daily with moisturizer apply to entire affected area
26
Describe Azelaic Acid? (azalea, finacea)
Available in cream, gel, foam also approved for rosacea well tolerated local effects help with skin pigmentation MOA - Anti-inflammatory - anti-bacterial effects
27
What antimicrobials are used to treat acne?
``` minocycline (topical and PO) erythromycin (Topical) clindamycin (Topical and PO) dapsone (Topical) doxycycline (PO) Sarecycline ( PO weight based) ```
28
Characteristics of antimicrobials
decrease bacteria load decrease inflammation oral reserved for severe cases to reduce abs resistance *With acne you want to use dual therapy from different categories Clindamycin and benzoyl peroxide or retinoids
29
Safety considerations of antimicrobials used for acne?
ideal length Po is 3 months should not use an abs alone due to resistance when considering combo use drugs with different MOA (NOT 2 abx) Tetracyclines p.acnes has resistance to use monocycle, or doxy do not use in children or pregnant women Drug drug food interaction (Al, MG, Fe, Ca) Clindamycin--> cdiff Minocyline has CNS ADR --> discolor skin Erythromycin resistance may be increasing
30
Name other agents that can be used to treat acne
``` Sulfur sulfacetamide resorcinol spironolactone oral conceptreptives intralesional steroids ```
31
Oral Isotretinoin
``` PO 2times/day vitamin 1 derivative reduces 4 pathogenic factors of acne 1. sebum production 2. comedone formation, decrease keratinization 3. p. acnes colonization 4. inflammation ```
32
safety considerations of isotretinoin
NO PREGNANCY ADRS monitor LFT, lipid, and CBC iPledge
33
Drugs for ectoparasitic infections
if drug doesn't kill egg have to repeat ( 9 days) permethrin (NIX) - OTC - not kill egg - kills ticks - approves age 2 months and older-apply to damp hair for 10 min pyrethrins - OTC - repeat 7-10 days - apply to hair for 10 min - AVOID in its with chrysanthemum allergy THESE 2 AGENTS ARE CHEMICALLY SIMILAR SO IF 1 RESISTANT BOTH ARE
34
treatment failure for ectoparasitic
reinfestation inappropriate application resistance if lice are moving slow after 8-12 hours do not retreat
35
drugs for pediculocides
benzyl alcohol - reapplication - appropriate in age > 6months - alt applied to hair depends on length - 4 oz for 0-2" - 48 oz for >22" malathion lotion/ Ovide - its > 2 years - reapplication not necessary Spinosad suspension - approved for >4 years - high ovoidal activity - reapplication not necessary ivermectin topical lotion - age >6 months when suspected resistance
36
scabies
permethrin 5% | 2 oz tube per person is ok for adult dose
37
Fungal infections
treat with Topical or PO depends on location
38
types that fungals that topicals work well for
``` topical treatments sufficient for Tinea corporis Tinea pedis Tineas cruris Tinea Versicolor ``` Usually candidiasis but may require oral if severe
39
Oral treatment is necessary for?
``` tinea capitis tines unguium (onchomycosis) ```
40
Types of Drugs for antifungals: imidazole and triazole
Topical: Clotrimazole ketoconazole miconazole PO: fluconazole MOA inhibit conversion of lanosterol to ergosterol via CYP
41
Types of drugs for antifungals: Allylamines
butenafine (OTC) terbinafine (OTC and RX) *** OTC is short duration MOA: inhibit squalene epoxidase-ergosterol synthesis
42
Types of drugs for antifungals: OTHER
griseofulvin MOA binds to fungal microtubuals and inhibit mitosis Ciclopirox MOA : block cell membrane transport
43
Safety for antifungals
topical --> mainly local Ade Systemic azoles CYP drug interactions itraconazole BBW: Chronic heart failure QT prolongation Terbinafine: hepatic concerns
44
Drugs for superficial bacterial infections: impetigo
causative organism Staph aureus, Strep pyro, HIGHLY CONTAGIOUS--> honey crusted lesions Topical tx is sufficient for small area: Mupirocin or Retapamulin apply BID 1 week If MRSA TMP-SMX, doxy, clindamycin
45
Purulent infections
mild--> Incision and drainage, abx not required moderate--> incision and drainage PO abx cover for MRsa (doxy and TMP sulfa) Severe --> incision and drainage IV abx to cover for MRSA (Vance, dap, linezolid, telavancin, cefaroline)
46
Severe non purulent cellulitis: No necrotizing
Vanco PLUS pip-taco imipenem/cilastin or meropenum
47
Purulent infections
mild--> Incision and drainage, abx not required moderate--> incision and drainage PO abx cover for MRsa (doxy and TMP sulfa) Severe --> incision and drainage IV abx to cover for MRSA (Vance, dap, linezolid, telavancin, cefaroline)
48
Sever nonpurulent cellulitis: necrotizing
Vanco or linezolid plus pip-taco or imipenem/cilastatin or merpenem or ertapenem or ceftriazone and metronidazole

Pharm (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions