Flashcards in Dermatologic Drugs Deck (36):
What are side effects of Polymyxin B when given via IV
ototoxicity and nephrotoxicity
What should you not use polymyxin B topical
if there is perforation of the TM
If MRSA is recurrent, what area should be swabbed
nares. often carries MRSA
What antibiotic is still effective against a topical MRSA infection
what drug class is ketoconazole
where should topical glucocorticoids generally not be used
over bacterial infection, on the face, genitalia, other thin skin areas, over a viral infection
what are the topical delivery forms of derm drugs (least oil to most oil content)?
solution (least oil)
ointment (most oil)
what aspects of a drug allows for increased penetration?
decreased molecular size, increased lipid content, and increased concentration
what aspects of the skin allow for increased penetration of drug?
decreased integrity of skin, thinner skin (face, armpit, genitalia), applying large surface area: body (i.e. children)
what is neosporin indicated for?
Superficial bacterial skin infections, eyes and external ear infection. Used prophylactically against bacterial contamination of abrasions, burns, skin grafts or incisions. Application may prevent infection and permit normal healing.
what is the MOA of Neosporin?
Polymyxin disrupts the structure of the bacterial cell membrane by interacting with phospholipids. Bacitracin interferes with the peptidoglycans of the bacterial cell wall.
what is Mupirocin/bactroban indicated for?
Impetigo and other bacterial infections. Best against staph and strep. Also MRSA. NOT for fungal or viral
what is the MOA of mupirocin?
inhibits bacterial protein syn
what is ketoconazole/nizarol indicated for?
Superficial fungal infection such as tinea pedis, tinea cruris and tinea corporis (ring worm), superficial yeast infections and seborrheic dermatitis.
conditions where topical steroids are used?
atopic/contact/allergic dermatitis, psoriasis, eczema, bullous pemphigus, SLE, and sarcoidosis
how are the classes of topical glucocorticoids grouped in terms of potency?
Class 1 is the most potent class of topical glucocorticoids whereas class 7 is the least potent class of topical steroid.
what is the most potent form of corticosteroid?
Halogenated corticosteroids are generally the most potent forms of topical steroids.
some side effects of topical glucocorticoids
Overgrowth of skin fungus and bacteria
what are some systemic side effects of highly potent glucocorticoids?
suppression of the hypothalamic-pituitary-adrenal axis, increased risk for hyperglycemia, osteoporosis and osteonecrosis.
what is a local side effect of injected intralesional corticosteroids?
may develop atrophy of underlying fat and/ or muscle
what is the MOA of hydrocortisone/cortef?
Anti-inflammatory. Affects gene transcription to either stimulate or repress protein production.
what are some conditions that respond to retinoids?
Cystic and papular acne
Basal cell cancer
Squamous cell cancer
how is acne generally treated?
Topical agent, if that fails then oral antibiotics or oral retinoins (accutane)
what class is Tretinoin/Retin A
Vitamin A derivative
what is tretinoin indicated for?
acne and tx of photodamaged skin
what the MOA of tretinoin?
Reduction of hyperkeratinization that leads to microcomedone formation, the initial lesion in acne. Retin A also increases epidermal thickness and increases dermal collagen synthesis.
Side effects of tretinoin that you need to parq ?
Erythema, peeling, burning and stinging. Photosensivity.
what is Isoretinoin/Accutane indicated for?
Acne, acne rosacea and hidradenitis superativa
what is the MOA of Isoretinoin/Accutane?
Reduction of hyperkeratinization, reduction in sebaceous gland number and sebum production and reduction of Propionibacterium acne, the organism that is believed to contribute to acne associated inflammation.
*Side effects of Accutane?
*Teratogenicity – most noted in the first three weeks of gestation. Pregnancy is an absolute contraindication (2 forms of birth-control are recommended). Pregnancy test at every visit and you only write one month script at a time.
Other potential side effects include headache, myalgias, arthralgias, hyper-lipidemia, fatty liver, hepatitis and pancreatitis.
Additional warnings about Accutane?
use of the drug may cause “depression, psychosis, and on rare occasions suicidal ideation, suicide attempts and suicide.“
treatment options for psoriasis?
Topical vitamin D (ex. Calciprotriene)
Topical vitamin A analogs (ex. Tazarotine)
Systemic therapy including oral steroids: chemo agents
what does phototherapy for psoriasis involve?
UVA or UVB often with psoralen (photochemotherapy agent that reacts with light)
MOA of PUVA?
not fully understood, however, there is evidence that it induces an anti-inflammatory affect through immunosuppression as well as an inhibitory effect on DNA synthesis.
what other conditions can be treated with PUVA?
vitiligo, T-cell lymphomas, alopecia areata and urticaria pigmentosa