Dermatology Flashcards Preview

Pharmacology > Dermatology > Flashcards

Flashcards in Dermatology Deck (60):
1

When is drug absorption increased?

broken, damaged skin, dry or wet skin, inflammation, large surface area, thinner skin

2

when is drug absorption decreased?

hairiness, small surface area, thicker skin

3

What are the risk factors of xerosis?

cold weather, dehydration, elderly, endocrine disorders, frequent hand washing

4

Xerosis treatment

reduce risk factors, emollients, humectants, urea, allantoin

5

When should xerosis treatment be administered?

everyday, every other for prevention

6

Topical acne treatments

retinoic acid, adapalene, adapalene/benzoyl peroxide, dapsone

7

What are the antibiotics of choice for antibiotics?

clindamycin, doxycycline, erythromycin, minocycline, sulfamethoxazole/trimethoprim

8

What is the dosage of isotretinoin

1-2 mg/kg divided in two doses daily for 4-5 months

9

What is considered to be the most efficacious for acne?

isotretinoin (Accutane)

10

What is the cause of seborrheic dermatitis

unknown but due to fungal infections

11

What is the treatment of seborrheic dermatitis?

selenium sulfide, cortisone, diphenydramine, cetrizine, fexofenadine, loratadine, ketoconazole, urea, coal tar

12

Examples of psoriasis meds

hydrocortisone, salicylic acid, urea, eucerin, aquaphor, calamine, coal tar, lactic acid

13

What are the RX steroids for psoriasis

triamcinolone, betamethasone

14

Adverse effects of steroids in psoriasis

dermatitis, atrophy, systemic side effects

15

What is the class 1 steroid?

clobetasol

16

Calcipotriene, calcitriol for plaque psoriasis

synnthetic vit D3, up to 8 weeks of therapy, ADRs- burning, itching, irritation

17

Tazarotene treatment of psoriasis

retinoid prodrug, anti-inflammatory,, antiproliferative, once daily

18

Systemic treatment of psoriasis

acitretin (Soriatane), methotrexate

19

Acitretin pearls

retinoid metabolite, effective in pustular psoriasis, 25-50 mg daily, ADR- liver failure, high cholesterol, teratogenic

20

Methotrexate pearls

immunosuppressant, antifolate, must give folic acid, dosed weekly to limit toxicity, ADR- abdominal, nausea, immunosuppression, liver failure, renal failure

21

What are contraindications of methotrexate?

pregnancy, hepatitis, renal impairment, thrombocytopenia, leukemia

22

Biologic treatment for psoriasis

hymire, enbrel, infliximab

23

Adalimumab (Humira) dosage

80 mg SQ, then 40 mg every other week

24

Etanercept (Enbrel)

50 mg SQ twice weekly x3 months, then 50 mg weekly

25

Infliximab (remicade)

5 mg/kg/IV infusion, repeated at week 2 and 6 then every 8 weeks

26

ADRs of biologic

serious infections, increased risk of lymphoma, require negative TB test prior to initiation

27

OTC dermatitis treatment

cortisone, Benadryl, zyrtec, allegra, Claritin, eucerin, aquaphor, tecnu

28

Dermatitis prescription treatment

phototherapy, tacrolimus, pimecrolimus

29

Tacrolimus (Prograf)

suppresses inflammation, apply twice daily until skin is clear, available as .03% and .1%, ADR of burning and local irritation

30

Pimecrolimus (Elidel)

suppresses inflammation, apply twice daily until skin is clear, is available in 1% cream, ADR- burning and local irritation

31

OTC wart treatment

freeze away, compound-W, caustic pencil (silver nitrate)

32

Salicylic acid in wart treatment

solubilize cell surface protein that keep the stratum corneum intact, keratolytic at concentrations 3-6%, ADR- urticaria, local irriation, inflammation, salicylism

33

Urea in wart treatment

breaks hydrogen bonds that keep the stratum corneum intact, 20% concentration is keratolytic

34

Genital wart treatment options

surgical removal, cryosurgery, laser treatment, imiquimod (Aldara), Sinecatechins (Veregen), podophyllum resin, podofilox

35

Imiquimod (Aldara)

anti-proliferative, apply 3 times per week leave on 6-10 hours, ADR- pruritis, erythema, superficial erosion

36

Sinecatechins (Veregen)

water extract from green tea leaves, apply TID, long duration of therapy, no more than 16 weeks,, ADR- local irritation

37

Podophyllum resin, podofilox

cytotoxic agents, resin- apply 25% conc to wart then remove after 2-3 hours, if no improvement after 3-5 therapies consider alternative options, podofilox- apply .5% conc BID x3 days then at least 4 days of no treatment

38

ADRs of resin and podofilox

highly irritating, toxic if systemically absorbed, NV, muscle weakness, neuropathy

39

Treatment options of lice

lice comb, petroleum jelly, mayo, PB, benzyl EtOH, malathion

40

Rid treatment of lice

synergized pyrethrins, head+ pubic lice, apply for 10 mins then shampoo and comb, does not kill eggs so repeat in 7 days

41

Nix treatment of lice

permethrin, head lice only, apply washed hair, leave on for 10 mins and comb through, may repeat in 7-9 days if active lice seen

42

Ovide treatment of lice

malathion, head+ pubic lice, apply to dry hair, leave on 8-12 hrs, then shampoo and comb, may repeat 7-9 days, most efficacious, but$$

43

OTC scabies treatment

Calcmine lotion, camphor, benadryl, zyrtec, allegra, claritin

44

Prescription treatment of scabies

permethrin, 5%, Croamiton (eurax), lindane

45

Crotamiton (Eurax)

MOA unknown, 10% conc of cream or lotion, apply twice, separated by 24 hrs, ADR- dermatitis, local irritation

46

Lindane

single application left on for 8-12 hrs, repeat if active mites and >1 week after initial treatment, ADR- local irriation, systemic absorption leading to neurotoxicity and hematotoxicity, may be carcinogenic

47

Topical treatment for bacterial infections

Bacitracin/polymixin B/neomycin (Neosporin), bacitracin, gramicidin, mupirocin, retapmulin, neomycin, gentamycin

48

Bacitracin and gramicidin

peptide abx, ADR- allergic contact dermatitis, urticaria

49

Mupirocin (bactroban)

inhibits synthesis, eradication of nasal colonization of MRSA, adr- pruritis, localized burning

50

Retapamulin (Altabax)

inhibits protein synthesis, ADR- eczema, pruritus, irritation

51

Neomycin (neo-fradin)

aminoglycoside abx, activity against gram -, partial activity against gram +, ADR- allergic contact dermatitis

52

Gentamycin (Garamycin)

aminoglycoside abx, activity against gram -, partial activity against gram +, if applied to large SA, detectable serum conc possible, ADR- nephrotoxicity, neurotoxicity (systemic only)

53

OTC fungal infection products, topical

terbinafine (Lamisil), clotrimazole (Lotrimin), Ketoconazole (Nizoral), miconazole (Desenex), Tolnaftate (Tinactin), Naftifine (Naftine)

54

OTC fungal infection products, internal

niconazole (Monistat), tioconazole (vagistat)

55

Imidazole

reduce ergosterol synthesis by inhibiting fungal cytochrome P450, applied once/twice dialy for 2-3 weeks, combo w/ steroid for more rapid symptomatic improvement

56

Allylamines

active against dermatophytes, less against yeast, selectively inhibit squalene epixidase, a key enzyme in the synthesis of ergosterol, applied BID

57

Nystatin

active against yeast not dermatophytes, binds to ergosterol and forms pires, leading to potassium loss, adicofication and cell death, apply 2-4 times/ day, minimal SE, loca irritation, amphotericin B- yellow skin

58

Dosage of azole derivatives

Fluconazole- 100 mg, itraconazole- 200 mg, ketoconazole- 200 mg

59

ADR of azole deriviatives

nausea, elevations of hepatitic enzymes, hepatitis

60

Terbinafine (terbinex)

alters fungal cell membrane, causing cell death, 250 mg daily for 6 weeks, or 12 weeks for toe infections, ADR- hepatitc infection