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MSK Exam 1 Spring 2015 > Dermatologic Pharmacology > Flashcards

Dermatologic Pharmacology Flashcards

(77 cards)

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1
Q

rate limiting step drug absorption

A

stratum corneum

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2
Q

vehicle reservoir

A

to extend the release of dermatologic agent

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3
Q

routes of drug absorption

A

through stratum corneum
sweat ducts
sebaceous follicles

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4
Q

percutaneous absorption

A

concentration gradient estabilished

partition coefficient - drug ability to leave vehicle

diffusion coefficient

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5
Q

wet lesion

A

wet dressings

pulls moisture out as evaporates

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6
Q

ointments

A

most able to stop evaporation

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7
Q

dry skin

A

use cream or ointment

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8
Q

wet skin

A

use gel or lotion

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9
Q

transdermal patch

A

constant drug delivery

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10
Q

10yo M mountain bike wreck, abraded areas

A

tx approach - clean with soap and water

use of topical antibiotic debated - promote resistance

clean wound and remove debris**

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11
Q

MOA of neosporin

A

bacitracin - inhibit cell wall synthesis
polymyxin B - increases permeability of cell wall
neomycin - bind and inhibit 30S ribosomal subunit

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12
Q

bacitracin

A

gram positive

anaerobic cocci

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13
Q

polymyxin B and neomycin

A

gram negative coverage

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14
Q

5yo F, red sores around mouth, suspect impetigo

what antibiotic cover group A beta-hemolytic strep and staph aureus (including MRSA)

A

mupirocin

retapamulin

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15
Q

group A beta-hemolytic strep

A

strep pyogenes

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16
Q

tx of impetigo

A

non-bullous - topical therapy - mupirocin or retapamulin for 5 days

bullous - oral antimicrobial for 7 days

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17
Q

benefits of topical tx

A

fewer side effect

low risk of bacterial resistance

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18
Q

adverse of bacitracin and neomycin

A

contact dermatitis

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19
Q

acne

A

topical antibiotics
-less effective than benzylperoxide

clindamycin, erythromycin, metrondiazole, sodium sulfacetamide

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20
Q

MOA clindamycin

A

macrolide - inhibits 50S

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21
Q

MOA erythromycin

A

macrolide - inhibit 50S

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22
Q

MOA metrondiazole

A

damages DNA

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23
Q

MOA sodium sulfacetamide

A

sulfonamide - inhibit folic acid synthesis

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24
Q

organism in acne

A

proprionibacterium acnes

gram positive rod**

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25
35yo M construction worker, itching of both feet, dermatophyte infection -athletes foot tx?
azole allylamine butenafide toinaftate
26
MOA azole
inhibit synthesis of ergosterol -inhibits lanosterol 14-a-demethylase for ring worm, athletes foot, etc. also cutaneous candidiasis - vaginal yeast infection
27
MOA ciclopirox alamine
inhibit uptake of precursors of macromolecule synthesis topical detmatomycosis, candidiasis, tinea versicolor
28
MOA allylamines
inhibit squalene epoxidase
29
terbinafine and naftifine
allylamines
30
MOA toinaftate
unknown
31
use of nystatin
cutaneous and mucous candida infection - thrush swish and spit
32
amphotericin B
for systemic infection - broad antifungal coverage
33
fever, chills, hypotension, kidney dysfunction, liver, anemia
side effects of amphotericin B also - long half life - lots of organ toxicity
34
esophageal candida
use azoles
35
MOA griseofulvin
inhibit fungal cell mitosis at metaphase in dermatophyte infection induces CYP enzymes
36
azoles
lots of drug rxns
37
terbinafine
high first pass metabolism | -accumulate in skin, nails, fat
38
tinea
dermatophyte function capitis - scalp - oral pedis - feet - topical cruris - groin - topical corporis - body - topical
39
candida infections
thrush - oropharyngeal - oral esophageal - systemic vulvovaginitis - topical - fluconazole invasive - systemic antifungal
40
40yo M frequent cold sores | -organism is what?
herpes simplex type 1
41
tx for herpes simplex type 1
acyclovir, penciclovir, docosanil - modest benefit docosanil is OTC
42
chronic suppression of HSV1
acyclovir valacyclovir
43
MOA cyclovirs
converted to pharmacologically active triphosphate metabolites - inhibit DNA synthesis and viral replication
44
MOA docosanol
inhibit fusion between plasma membrane and HSV envelope | -prevent viral entry and replication
45
immunomodulators
imiquimod - external genital warts tacrolimus - atopic dermatitis - inhibit T lymphocyte activation - in transplant patients
46
oral for transplant rejection
tacrolimus
47
14yo F acne treatment -benzoyl peroxide dries out skin other options
topical retinoids - tretinoin - adapalene - tazarotene MOA - decrease cohesion epidermal cells - increased epidermal turnover
48
MOA benzoyl peroxide
releases free radical oxygen species - oxidize bacterial proteins - activity against P. acnes no resistance occurs**
49
CI of retinoids
pregnant women
50
isotretinoin
oral retinoid reduces sebaceous gland size
51
CI for isotretinoin
pregnancy** need 2 forms of birth control and monthly preg test and cannot donate blood iPLEDGE program
52
few lesions, little or no inflammation
mild acne
53
many lesions, significant inflammation
moderate acne
54
numerous lesions, extreme inflammation, significant scarring
severe acne
55
acne tx approach
1 - topical retinoid 2 - topical retinoid and antimicrobial 3 - topical retinoid, antibiotic, benzyl peroxide 4 - oral isotretinoin
56
<5% psoriasis on body
use topical
57
topical glucocorticoids
for psoriasis - don't use for long term
58
coal tar
for psoriasis | -historical agent - older
59
calcipotriene
vit D3 analog | -up and coming mild to moderate psoriasis - <5% body - slow onset - no long term effects
60
tazarotene
topical retinoid | -for psoriasis
61
systemic psoriasis tx
if >5% body covered methotrexate acitretin cyclosporine
62
not in pregnancy or alcohol
acitretin
63
not in kidney or liver dysfunction
methotrexate
64
not in kidney dysfunction or HTN
cyclosporine
65
methotrexate and phototherapy
systemic tx psoriasis
66
MOA methotrexate
inhibit dihydrofolate reductase - folic acid analog with phototherapy for tx of psoriasis
67
TNF inhibitors
new psoriasis drugs etanercept infliximab adalimuab rule out TB**
68
cannot use with TB
TNF inhibitors
69
topical steroids
immunosuppressive and anti-inflammatory grouped based on potency
70
low potency corticosteroids
hydrocortisone
71
high potency corticosteroid
betamethasone | clobetasol
72
keratolytic agent
salicylic acid causes softening and dissolution of peeling of stratum corneum
73
pruritis and itching
antihistamines - can cause allergic dermatitis also topical anesthetics
74
H1 antagonists
effective and treatment for itching diphenhydramine and promethiaizine**
75
agents for hair growth
trichogenic agent minoxidil - unknown MOA finasteride
76
finasteride MOA
competitive selective inhibitor of 5-a reductase -blocks T > DHT conversion adverse - decreased libido, erectile dysfunction
77
pregnant women
should not handle finasteride

MSK Exam 1 Spring 2015 (21 decks)

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