Dermatologic Pharmacology

Question 1

Drugs used in the treatment of the skin can be

Answer 1

delivered systemically
applied topically
injected directly to the dermis
phototherapy

Question 2

pharmacologic responses are determined by:

Answer 2

1. Regional variation in drug penetration
2. Concentration Gradient
3. Dosing schedule
4. Vehicles & Occluion
5. State of Stratum Corneum
6. Presence of Penetration Enhancers

Question 3

which part easily absorbs drug:

face, scrotum, axilla scalp vs soles of foot

Answer 3

face, scrotum, axilla, scalp

Question 4

increase in conc gradient increases the

Answer 4

mass of drug transferred per unit time

Question 5

may be long enough to permit

once daily application with short systemic half-lives

Answer 5

local half life

Question 6

Topical absorption increased in dermatologic

disorders due to

Answer 6

presence of breaks/ lesions in the skin

Question 7

these are added for better drug penetration

Answer 7

penetration enhancers

Question 8

examples of penetration enhancers

Answer 8

Org solvents such as dimethyl sulfoxide urea, and salicylic acid

Question 9

drug absorption i influenced by

Answer 9

1. conc of drug in the vehicle
2. The partition coefficient of drug between the
   stratum corneum and the vehicle
3. Diffusion coefficient of the drug in the stratum
   corneum

Question 10

Rate of diffusion is proportional to

Answer 10

concentration

Question 11

drug’s ability to escape

from the vehicle.

Answer 11

partition coefficient

Question 12

Increased lipid-solubility favors penetration through

the skin in

Answer 12

relatively lipophilic stratum corneum

Question 13

refers to the extent to which the matrix of the barrier

restricts the mobility of the drug

Answer 13

Diffusion coefficient

Question 14

Increase in the molecular size of the drug will

Answer 14

decrease the diffusion coefficient.

Question 15

any of various media acting usually as

solvents, carriers, or binders for active ingredients.

Answer 15

vehicle

Question 16

Acute inflammation with oozing, vesiculation &

crusting are best treated with

Answer 16

drying preparations (e.g. tinctures,
wet dressings, lotions)

Question 17

Chronic Inflammation with xerosis, scaling &

lichenification are best treated with

Answer 17

more lubricating preparations (e.g.

Creams or Ointments)

Question 18

Most effective hydrating agents

Answer 18

ointment

Question 19

Most acceptable, accessible, and common

preparation

Answer 19

cream

Question 20

Amount of ointment when squeezed out of a tube to the
palmar aspect of the index finger from the distal skin
crease to the end of the finger

Answer 20

FTU - fingertip unit

Question 21

Known as steroids in laymen’s term

Answer 21

glucocorticoid

Question 22

therapeutic effectiveness of topical glucocorticoids is based on

Answer 22

based on their anti-inflammatory activity

Question 23

inhibition of accumulation of Neutrophils and monocytes at the site of inflammation would lead to

Answer 23

decreased proliferation and migration of lymphocytes and macrophages

Question 24

Steroid to be used are chosen on the basis of

Answer 24

potency, ite of involvement and severity

Question 25

T or F: application of steroid more than twice a day increases it efficacy

Answer 25

F more frequent application doen't improve response due to half life

Question 26

All absorbable topical corticosteroids possess the | potential to

Answer 26

suppress the pituitary adrenal axis

Question 27

use of steroids in children would result to

Answer 27

early closure of long bones/ growth retardation

Question 28

Intralesional glucocorticoids can cause

Answer 28

cutaneous atrophy and hypopigmentation

Question 29

Reserve for acute treatment of transient illnesses or lifethreatening dermatoses

Answer 29

systemic glucocorticoids

Question 30

why do you need to gradually decrease the dosing schedule of glucocorticoids

Answer 30

for less adverse effect for withdrawal and to prevent adrenal crisis

Question 31

Used mainly for the treatment of psoriasis, dermatitis & | lichen simplex chronicus

Answer 31

tar compounds

Question 32

main cause of the discontinuation of | certain drug practices

Answer 32

sensitization

Question 33

why you should not advocate the use of topical antibacterial agent

Answer 33

exposure of the individual to the possibility of sensitization

Question 34

mode of action of bacitracin and B. Gramicidin

Answer 34

inhibits cell wall synthesis

Question 35

side effects of bacitracin

Answer 35

contact urticaria anaphylaxis systemic toxicity contact dermatitis

Question 36

why is neomycin used in surgery

Answer 36

because it is an aminoglycoside and they are not aborbed in GI tract; they stay to disinfect the area

Question 37

Used to treat Impetigo contagiosa specifically

Answer 37

mupirocin

Question 38

New synthetic drug, newer than mupirocin

Answer 38

retapamulin

Question 39

retapamulin is effective in treatment of

Answer 39

uncomplicated superficial skin infection caused by Grp. A beta-hemolytic strep and S. aureus excluding MRSA for adult and pediatric patients 9 months and older

Question 40

Peptide antibody effective against Gram (-) organism including P. Aeruginosa, E. Coli, Enterobacter & Klebsiella

Answer 40

polymyxin B sulfate

Question 41

why should you not exceed 200mg of Polymyxin B sulfate when applied to denuded skin

Answer 41

Causes neurotoxicity and nephrotoxicity

Question 42

MOA of Neomycin

Answer 42

inhibits CHON synthesis

Question 43

Adverse effects of aminoglycosides in general

Answer 43

neurotoxicity, nephrotoxicity and ototoxicity, | neuromuscular blockage

Question 44

What is cross sensitivity

Answer 44

means that even if an individual has not been exposed to these drugs, he may still develop allergies to other related drugs

Question 45

generally, aminoglycosides are for

Answer 45

Gm (-)

Question 46

clindamycin may cause rare cases of ___ when aborbed systemically

Answer 46

bloody diarrhea & pseudomembranous colitis

Question 47

clindamycin is known commercially as

Answer 47

Dalacin C

Question 48

effect of erythromycin

Answer 48

inhibotry on P. acnes

Question 49

side effect of erythromycin

Answer 49

burning drying irritation

Question 50

drug for amoebiasis

Answer 50

metronidazole

Question 51

Topical Gel effective in acne rosacea

Answer 51

metronidazole

Question 52

MOA of metronidazole

Answer 52

UNKNOWN but may relate to the inhibitory effects | on Demodex brevis (face mite)

Question 53

MOA of sodium sulfacetamide

Answer 53

Inhibition of P. Acnes by competitive inhibition of | PABA utilization

Question 54

sodium sulfacetamide is contraindicated in patients that are

Answer 54

sensitive to sulfonamides

Question 55

action of Retinoic acid in acne

Answer 55

decreased cohesion between epidermal cells and increased epidermal cell turnover which results in expulsion of open comedones

Question 56

For severe cystic acne

Answer 56

isotretinoin

Question 57

MOA of isotretinoin

Answer 57

inhibit sebaceous gland size & function

Question 58

Still a Vitamin A/retinoid; | Treatment of psoriasis especially pustular forms

Answer 58

etretinate

Question 59

MOA of doxepin

Answer 59

H1 & H2 antagonists property percutaneous | absorption

Question 60

why does doxepin cause urinary retention

Answer 60

anticholinergic effects

Question 61

For itchiness, we administer

Answer 61

anesthetics or antihistaminics

Question 62

why older h1 receptor antagonists sedating?

Answer 62

they can cross blood brain barrier

Question 63

difference of newer H1 receptor antagonists from the old ones

Answer 63

they do not cross the BBB and they don't cause drowiness/ sedation

Question 64

why H2 receptor blockers are better used for patients with peptic ulcer

Answer 64

Decreases gastric acid secretion; | Inhibit HCl production