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Flashcards in Dermatologic Deck (58):
1

Which area of the skin will have the most permeation and absorption?

#1 groin
#2 face

2

Bacitracin-Neomycin-Polymyxin B (Neosporin) class

Topical antimicrobial

3

Bacitracin-Neomycin-Polymyxin B (Neosporin) indications

Superficial bacterial skin infx, eyes and external ear infx

can be used prophylactically against bacterial contamination of abrasions, burns, skin grafts or incisions

4

Bacitracin-Neomycin-Polymyxin B (Neosporin) MOA

polymyxin disrupts the structure of the bacterial cell membrane by interacting with phospholipids; bacitracin interferes with the peptidoglycans of the bacterial cell wall

5

Do not use Bacitracin-Neomycin-Polymyxin B (Neosporin) is __________

allergic to systemic aminoglycosides

6

Drugs of choice to tx impetigo

Mupirocin (Bactroban)

7

When to use topical therapy with tx impetigo

only if there is a limited # of lesions

8

Mupirocin (Bactroban) class

topical antibiotic

9

Mupirocin (Bactroban) MOA

inhibits bacterial protein synthesis

10

T/F: Mupirocin (Bactroban) can be used to tx MRSA colonization

TRUE

should be applied to nares to eradicate nasal carriage of infx

11

Mupirocin (Bactroban) local s/e

irritation

12

What is the MC type of Tinea?

Tinea pedis

13

Drug of choice to tx Tinea

Ketoconazole (Nizoral)

14

Ketoconazole (Nizoral) class

topical antifungal

15

Ketoconazole (Nizoral) MOA

inhibits sterol synthesis, a component of fungal cell membranes

16

Ketoconazole (Nizoral) local s/e

skin irritation

17

Commonly encountered conditions in which topical corticosteroids are used?

1) Atopic dermatitis/Eczema
2) Contact/allergic dermatitis - environmental exposure
3) Psoriasis

18

Potency of topical corticosteroids is based on

vasoconstriction effects (not on the anti-inflammatory effects)

19

Very high potency (Class I) corticosteroid considerations

1) do not discontinue abruptly - switch to lower potency agent
2) tx duration should not exceed 2-4 wks

20

High potency (Class II-III) corticosteroid considerations

avoid occlusive dressings with betamethasone dipropionate, use with caution in other high potency agents

21

Low potency (Class VI-VII) corticosteroid considerations

1) consider these agents for children, pregnant women, elderly, and pt. w/ large areas to be treated
2) preferred agents for face, groin, armpits, or skinfolds

22

potency classes of topical corticosteroids

Very high = Class I
High = Class II-III
Medium = Class IV-V
Low = Class VI-VII

23

cutaneous adverse rxn to topical corticosteroids

skin atrophy (thinning), telangiectasia, hypopigmentation, steroid acne, increased hair growth

24

________ topical corticosteroids can be systemically absorbed

Very high (Class I) and High (Class II-III) potency

25

systemic/LT s/e of topical corticosteroids

insomnia, hyperglycemia, osteoporosis, impaired wound healing

26

last line therapy for tx of atopic dermatitis/eczema, used if pt. have failed to respond to topical corticosteroids

Topical Calcineurin Inhibitors

27

Tacrolimus (Protopic) ointment class

Topical Calcineurin Inhibitors

28

Pimecrolimus (Elidel) cream class

Topical Calcineurin Inhibitors

29

Topical Calcineurin Inhibitors local s/e

local stinging, burning

30

Treat pruritis/hives with

systemic antihistamines

31

Loratadine (Claritin) class

systemic antihistamines

32

Cetirizine (Zyrtec) class

systemic antihistamines

33

T/F: topical antihistamines can be used to treat pruritus/hives

FALSE

they are ineffective & topical doxepin carries risk of local contact dermatitis

34

What are pharmacologic options for tx acne?

1) salicylic acid
2) benzoyl peroxide
3) topical retinoids
4) antibacterial agents
5) antisebum agents

35

Which antibacterial agents are used to tx acne?

1) Erythromycin, clindamycin
2) azelaic acid
3) dapsone

36

Which antisebum agents are used to tx acne?

1) oral contraceptives
2) spironolactone
3) isotretinoin

37

Isotretinoin (Accutane) class

Vitamin A derivative

38

Isotretinoin (Accutane) indications

acne, acne rosacea, and hidradenitis supperativa

39

Isotretinoin (Accutane) MOA

1) reduction of hyperkeratinization
2) reduction in # of sebaceous glands and sebum production
3) reduction of Propionbacterium acne, the organism believed to contribute to acne-associated inflammation

40

Isotretinoin (Accutane) ADRs

1)**Teratogenicity (1' in first 3 wks)
2) Depression
3) Psychosis
4) Myalgias
5) Hyperlipidemia

41

What is the iPLEDGE program?

that Isotretinoin (Accutane) Rx requires registration from: physician, patient, pharmacy, and wholesaler

goals: no female pt. starts Isotretinoin (Accutane) if pregnant and no female pt. on Isotretinoin (Accutane) becomes pregnant

42

T/F: LT use of topical corticosteroids can cause systemic s/e such as insomnia, hyperglycemia, osteoporosis, and impaired wound healing

False

(although depends on potency of steroid)

43

Treatment options for psoriasis

1) topical corticosteroids
2) topical vitamin D analog
3) topical vitamin A analog/retinoid (i.e. tazarotene)
4) phototherapy
5) systemic therapy

44

Which systemic therapies are used to tx psoriasis?

1) oral steroids,
2) chemotherapy agents (methotrexate)
3) TNF-a inhibitors (Infliximab/Remicade and Etanercept/Enbrel)

45

Cacipotriene (Dovonex) class

Vitamin D analog

46

Cacipotriene (Dovonex) MOA

inhibits epidermal proliferation and stimulation of differentiation

47

Cacipotriene (Dovonex) indications

plaque psoriasis, scalp psoriasis

48

T/F: the vitamin D analog, Cacipotriene (Dovonex, is as effective as topical corticosteroids but has more frequent adverse effects

TRUE

49

Cacipotriene (Dovonex) s/e

- photosensitivity
- hypercalcemia
- may worsen psoriasis
- skin irritation

50

Cacipotriene (Dovonex) is potentially more effective in tx psoriasis when used with _________

Betamethasone

51

Tazarotene (Tazorac) class

topical retinoid

52

Tazarotene (Tazorac) indications

plaque psoriasis, acne

53

Tazarotene (Tazorac) s/e

skin burning, irritation, stringing

54

Tazarotene (Tazorac) is recommended to use with _______ for improved efficacy and tolerability when tx psoriasis

topical corticosteroids

55

What is phototherapy?

use of UVA & UVB as therapeutic agents

56

What is photochemotherapy?

adding an agent such as a psoralen drug (e.g. methoxsalen) to phototherapy tx

57

PUVA

psoralen (P) + UVA

58

phototherapy s/e

-nausea
-painful erythema and blistering
-chronic use associated w/ incr. risk of skin cancer