Dermatologic Drugs

Question 0

What is a lotion?

Answer 0

Powder in water or oil suspension

Question 1

What is a solution?

Answer 1

Medicine dissolved into solvent. Evaporates more quickly than other topical delivery methods.

Question 2

What is a cream?

Answer 2

Water in oil emulsion

Question 3

What is an ointment?

Answer 3

Oil in water emulsion. Evaporates much more slowly than other types of topical administrations.

Question 4

Polymyxin B + Neomycin (Neosporin)

Answer 4

Topical antibacterial.
Used for superficial skin infx, otitis externa, prophylactically against infx. Disrupts bacterial cell wall and membranes. May be formulated with corticosteroids.
SFx: Irritation. Neomycin is ototoxic; do not use on punctured TM.
Route: Topical cream, lotion, ointment

Question 5

Mupirocin (Bactroban)

Answer 5

Topical antibacterial. Especially active against staph and strep.
Used for impetigo, topical MRSA. Intranasal use for MRSA pts.
SFx: Irritation, burning sensation.

Question 6

Ketoconazole (Nizarol)

Answer 6

Topical antifungal. Inhibits ergosterol in fungal wall synthesis.
Used for superficial fungal infection (most tineas), seborrheic dermatitis, topical yeast infx.
SFx: Skin irritation.
Route: Lotion, ointment or shampoo

Question 7

Glucocortocoids

Answer 7

Anti-inflammatory agents used for: Atopic dermatitis, Contact/ allergic dermatitis, Psoriasis, Eczema, bullous diseases such as pemphigus, collagen vascular diseases such as SLE and granulomatous disease such as sarcoidosis.
SFx: Skin atrophy, Striae, Telangiectasias, Purpura, Acneiform lesions, Perioral dermatitis, Overgrowth of skin fungus and bacteria, Hypopigmentation, Rosacea.

Question 8

Hydrocortisone (Cortef)

Answer 8

Glucocorticoid
Used for a variety of skin conditions
SFx: Skin thinning, hypopigmentation
Route: Topical, but may be used IV or IM as well. 1% or halogenated versions are Rx only.

Question 9

Retinoids

Answer 9

Natural compounds and synthetic derivatives of retinol that exhibit vitamin A activity. Affect skin in a variety of ways:
Cellular proliferation and differentiation, immune function, inflammation and sebum production may all be modified by retinoid treatment.
Used for: Cystic and papular acne, basal cell cancer, squamous cell cancer, actinic keratosis, psoriasis, and cutaneous aging

Question 10

Tretinoin (Retin A)

Answer 10

Retinoid (Vit A deriviative)
Used for: Cystic acne, photo-damaged skin
SFx: Erythema, peeling, burning and stinging. Photosensivity.
Topical, applied once per day. May take months to see clinical results.

Question 11

Isoretinoin (Accutane)

Answer 11

Retinoid.
Used for severe cystic acne, rosacea, hidradenitis supperativa.
Topical.
SFx: Teratogen, depression, psychosis, and on rare occasions suicidal ideation, suicide attempts and suicide, HA, myalgias, arthralgias, hyperlipidemia, fatty liver, hepatitis and pancreatitis.
CAT X - absolute contraindication. Pt must show evidence of using two types of birth control before Rx may be written. NO REFILLS.

Question 12

Psoriasis tx?

Answer 12

Stepwise progression of:
Topical corticosteroids
Topical Vit. D
Phototherapy
Systemic Therapy (oral steroids, chemo agents, TNF inhibitors)

Question 13

PUVA therapy

Answer 13

Stands for:
Psoralen Ultraviolet A therapy. Pt applies a psoralen agent and is exposed to UVA light source. MOA unknown but seems to have anti-inflammatory action and inhibits DNA synthesis.
SFx: Nausea, painful erethema, blistering, premature aging of skin.