Dermatopharmacology Flashcards
(151 cards)
1
Q
___ are 1/2 water and 1/2 oil with an emulsifier
A
Cream
2
Q
Indication for a cream
A
oozing “wet” skin conditions
3
Q
Characteristics of Creams (3x)
A
1) Spread easily (good for large areas)
2) Well absorbed
3) Wash off with water
4
Q
___- are 20% water in 80% oil
A
Ointments
5
Q
Components of Ointments (2x)
A
1) Mineral Oil
2) Petroleum Jelly
* ** Hydrocarbons
6
Q
Characteristics of Ointments (3x)
A
1) Greasy and Occlusive
2) Stay on skin surface
3) Not well absorbed
7
Q
Indications of Ointments (2x)
A
1) Dry skin since they trap moisture
2) Increase absorption of active ingredient
8
Q
Ointments or Creams are less likely to cause an allergic rxn
A
Ointments
9
Q
When to clean hands
A
1) Before touching a patient
2) Before clean/aseptic procedures
3) After body fluid exposure
4) after touching pt
5) After touching pts surroundings
10
Q
Alcohol-base disinfectant isn’t effective against ___
A
C. Diff
11
Q
List the components of moisturizers
A
1) Emollients
2) Humectants
3) Horny Substances Softeners
12
Q
Examples of Emollients (components of moisturizers) (4x)
A
1) Petrolatum
2) Lanolin
3) Mineral Oil
4) Dimethoate
13
Q
Examples of Humectants (3x)
A
1) Glycerin (glycerol)
2) Lecithin (glycerophospholipids)
3) Propylene glycol
14
Q
Examples of Horny Substances (3x)
A
1) alpha hydroexyacids (lactic, citric, glycolic)
2) Salicylic Acid
3) Urea
15
Q
List the different bases for Sunscreen (3x)
A
1) PABA and its Esters
2) Benzophenones
3) Dibenzoylmethanes
16
Q
PABA is active in the ___ range but isn’t used as much anymore due to ___ rxn
A
1) UVB
2) Hypersensitivity
17
Q
___ are active in the UVA and UVB range and contain salicylate stabilizers
A
Benzophenones
18
Q
List two examples of Benzophenones
A
1) Oxybezone
2) Octocrylene
19
Q
List two examples of Salicylate Stabilizer
A
1) Homosalate
2) Octosalate
20
Q
____ are active in the UVA range only and are useful for __ induced photosensitivity and cutaneous lupus
A
1) Dibenzoylmethanes
2) Drug
21
Q
Active component in Sunshades-
A
Titanium Dioxide
22
Q
___- is the ratio of minimal erythema dose with sunscreen divided by the minimal erythema dose w/o sunscreen
A
SPF
23
Q
What is the common disinfectant that is used in hospitals
A
Chlorhexidine
24
Q
Name the growth factor that promotes wound healing
A
Becaplermin (Platelet-Derived Growth Factor)
25
____ is a platelet-derived growth factor that promotes proliferation and angiogenesis
Becaplermin
26
____ is the only FDA approved drug that is used for chronic diabetic foot ulcers
Becaplermin
27
wound Dressings: When a wound is in the debridement stage use a ____
Hydrogel
28
Wound Dressings: When the wound is in the granulation stage use ___ dressing
Foam and low adherence
29
When the wound is in the epithelization stage use ____ dressing
Hydrocolloid and Low Adherence
30
List the 3 active agents in Neosporin
1) Bacitracin
2) Neomycin
3) PolymyxinB
31
Mechanism of Action of Bacitracin
Inhibits cell wall synthesis
32
Indication for Bacitracin (4x)
1) Gram + Organisms
2) Anaerobic Cocci
3) Neisseria
4) Tetanus Bacillus
33
Neomycin is an ___glycoside
aminoglycoside
34
MOA of Neomycin
Binds 30s Subunit to decrease protein synthesis
35
Indication for Neomycin
Gram Negative Organisms
36
MOA of PolymyxinB
Binds to phospholipids to alter membrane permeability and damage cytoplasm
37
Indications of Polymyxin B (5x)
1) Gram Negative Organisms
2) P. Aeruginosa
3) E Coli
4) Enterobacter
5) Klebsiella
38
Imidazoles are an anti-____ agent
Fungal
39
MOA of Imidazoles
Block ergosterol synthesis
40
Indications for Imidazoles
Dermatophytes and Yeast
41
List the different types of Imidazoles
1) Miconazole
2) Clotrimazole
3) Efinaconazole
4) Ketoconazole
42
What two agents are used for Vulvovaginal Candidias
1) Miconazole
| 2) Clotrimazole
43
What agent is used for onychomycosis
Efinaconazole
44
Antifungal is used for dermatophytosis, Candidiasis, and Seborrheic Dermatitis
Ketoconazole
45
MOA of ciclopirox
Disrupts macromolecular synthesis
46
Ciclopirox is a ____ spectrum antifungal
Broad
47
Indications for Ciclopirox
1) Dermatophytes
2) Candida
3) Malassezia
48
Terbinafine is an anti-____
Fungal
49
List all of the Antifungals (6x)
1) Imidazole
2) Ciclopirox
3) Terbinafine
4) Tolnaftate
5) Nystatin
6) Amphotericin B
50
MOA of Terbinafine
Inhibits squalene epoxidase
51
Purpose of Squalene Epozidase
1) Key enzyme of Ergosterol
52
indication for Terbinafine
1) Dermatophytes BUT NOT YEAST
| 2) Mucous Membranes
53
Indication for Tolnaftate
Dermatophyte and Malessezia
| ***NOT Candida
54
Which two anti-fungals can treat Malassezia
Ciclopirox
| Tolnaftate
55
Nystatin MOA
Alters membrane permeability
56
Indications for Nystatin
1) Mucosal Candida
- Hold in mouth before swallowing
2) Cutaneous Candida
57
MOA of Amphotericin B
Alters membrane permeability
58
Indication of Amphotericin B
Candida (Cutaneous)
59
Which antifungals cannot treat Candida?
1) Tolnaftate (Lamisil)
| 2) Terbinafine (Tinactin)
60
MOA of Acyclovir
Synthetic Guanine Analog
61
Indication of Acyclovir
Orolabial Herpes Simplex virus infection
62
Where should you use low potency steroid use?
1) Face
2) Genitals
3) Skin Folds
63
Salicylic Acid is a ___ softener
Skin
64
MOA of Salicylic Acid
Cox inhibitor
65
Indications for Salicylic Acid
1) Calluses and Warts
| 2) Lichen Simplex Chronicum
66
Which two agents treat Rosacea
1) Brimonidine
| 2) Oxymetazoline
67
MOA of Brimonidine
1) Alpha2 adrenergic agonist
| - stimulate post synaptic vascular a2 receptors
68
MOA of Oxymetazoline
a1/a2 adrenergic agonist
69
Which 4 agents treat eye vasodilation
1) Naphazoline
2) Tetrahydrozoline
3) Phenylephrine
4) Oxymetazoline (can also treat Rosacea)
70
All agents that treat the eye are ___ receptor agonist
adrenergic
71
List the four agents that kill ectoparasites
1) Malathion
2) Permethrin
3) Ivermectin
4) Lindane
72
Malathion MOA - Ectoparasite
Organophosphate cholinesterase inhibitor
73
Permethrin MOA - Ectoparasite
Insect Na+ channel, blocks repolarization
74
Ivermectin MOA - Ectoparasite
Binds glutamate-gated Cl- channels --> hyperpolarizes nerve and muscle cell
75
Lindane MOA - Ectoparasite
Disrupts GABAergic transmission in insects
76
Which ectoparasite agent should only be used if the others fail?
Lindane
77
List all the possible ways that you can Generally treat Acne Vulgaris (6x)
1) Topical Retinoids
2) Topical Antimicrobials
3) Azelaic Acid
4) Oral Antibiotics
5) Hormonal Agents
6) Oral Retinoid
78
List a Topical retinoid that is used for Acne Vulgaris
Tretinoin
79
What are the Adverse Effects of Tretinoin
1) Local Skin Irritation, Dryness, Flaky and sun sensitivity
80
Before administering Tretinoin which is a __, you want to make sure that pts dont have a sensitivity or allergy to ___
1) Topical Retinoid
| 2) Fish
81
List the Topical Antimicrobials
1) Benzoyl Peroxide
2) Clindamycin
3) Erythromycin
82
What are the adverse effects of benzoyl peroxide
Local skin irritation, may bleach hair or clothing
83
Clindamycin is a ____. List the adverse effects of Clindamycin.
1) Topical Antibiotic
| 2) Pseudomembranous Colitis
84
Azelaic Acid MOA
1) Kill acne bacteria and decrease production of keratin
85
Adverse effect for Azelaic Acid
Local skin irritation
86
List all of the oral antibiotics that can treat Acne Vulgaris
1) Tetracycline
2) Doxycycline
3) Minocycline
4) Erythromycin
5) Azithromycin
6) Trimethoprim-sulfamethoxazole
87
List the hormonal agents that can treat Acne Vulgaris
1) Oral Contraceptives (Estrogen/Progestin)
| 2) Spironolactone
88
Spironolactone is indicated in ____
Adult women w/ menstrual acne
89
Tetracycline and Doxycycline Adverse Effects
1) Photosensitivity
| 2) GI Distress
90
Minocycline Adverse Effects
Dizziness and Drug-induced lupus and Skin coloration
91
Erythromycin and Azithromycin Adverse Effects
Gastrointestinal Distress
92
Trimethoprim-Sulfamethoxazole Adverse Effects
1) Steven Johnsons Syndrome
| 2) Toxic Epidermal Necrolysis
93
List the contraindications of Tetracycline, Doxycycline, and Minocycline
Pregnant Women and Children
94
List the contraindication of Spironolactone
Pregnancy
95
List the Oral Retinoid that is use for Acne Vulgaris
Isotretinoin
96
MOA of Isotretinoin
1) Decreases cohesiveness of keratinocytes
| 2) Decreases Follicular occlusion and microcomedone formation
97
When is Isotretinoin an absolute contraindication
Pregnancy - Teratogenicity
98
Adverse effects of Isotretinoin (3x)
1) Teratogenicity
2) Mucocutaneous effects
3) Hypertriglyceridemia
99
Adverse Effects of Spironolactone
1) Menstrual Irregularity
2) Breast Tenderness
3) Orthostatic Hypotension
4) Hyperkalemia
100
Adverse Effects of Oral Contraceptives
1) Nausea
2) Breast Tenderness
3) Weight Gain
4) Thromboembolic Events
101
List the general treatments of Psoriasis
1) Topical Therapies
2) UV Light Therapies
3) Systemic Therapies
102
List the Topical Therapies
1) Emollients and Corticosteroids
2) Topical Vit D analog
3) Tar
4) Anthralin
103
What is the initial choice for mild to moderate psoriasis
Emollients and Corticosteroids
104
MOA of Topical Vit D analog in treating Psorasis
Decreased Keratinocyte proliferation
105
MOA of Tar in treating Psoriasis
Decreased Proliferation
106
Anthralin MOA in treating Psoriasis
Anti-inflammatory
107
What are the two UV Light therapies that can treat Psoriasis
1) UVB
| 2) PUVA (Photochemotherapy UVA Radiation)
108
MOA of UVB therapy for Psoriasis
Immunomodulation
109
How would you administer UVB therapy with a pt who has psoriasis
Radiation to the point of erythema + Topical Tar
110
PUVA treatment has increased ___ risk
Melanoma
111
Pts who undergo PUVA treatment have to be protected from the ___
Sun
112
MOA of PUVA therapy
Penetrates deep into skin w/o sunburn
113
Pts must ingest photosensitizer ___ 2hr before treatment
Psoralen
114
List the systemic therapies for Psoriasis
1) Apremilast
2) Ustekinumab
3) Secukinumab and Ixekuzumab
115
MOA of Apremilast in treatment for Psoriasis
Inhibits Phosphodiesterase 4 (PDE4)
116
Apremilast, treatment for Psoriasis, inhibits Phosphodiesterase 4 (PDE4). This results in ..... (2x)
1) Increased cAMP levels
| 2) Increased IL10 and Decreased inflammatory mediators
117
Adverse Effects of Apremilast
D/N/V; Headache; Depression
118
ustekinumab is an agent that treats ____. what is the MOA
1) Psoriasis
| 2) Targets IL12 and 23
119
Since Ustekinumab targets ___ and ___ when treating Psoriasis systemically, what are the effects? (3x)
1) Decreased NK Cells
2) Decreased CD4+ T-cell
3) Decreased inflammatory molecule expression
120
Adverse side effect of Ustekinumab
Increased risk of infections
121
Secukinumab and Ixekuzumab are treatments for ___. The MOA is is targeting ____. The effects are____. The Adverse Effects are___.
1) Psorasis
2) IL-17A
3) Can't produce any other inflammatory drug
4) Increased risk of infection
122
When wanting to treat a mild comedonal acne what is your 1st choice
Topical Retinoid
123
When wanting to treat Mild mixed papular/pustular acne what is your 1st choice
1) Topical Retinoid + Topical Antimicrobial
124
When wanting to treat moderate mixed papular and pustular ance what is the 1st choice
1) Topical Retinoid + Oral Antibiotic
| 2) +/- BPO
125
When wanting to treat moderate nodular acne what is your 1st choice
1) Oral Antibiotic
2) Topical retinoid
3) BPO
126
When Treating Severe Nodular/Conglobate acne what is your 1st choice
Oral Isotretinoin
127
What is the first choice of topical antimicrobials
Benzoyl Peroxide
128
What is the first choice in terms of oral antibiotics
Tetracyclin and its family
129
How would you treat Hypertropic Actinic Keratosis?
Topical 5-flurouracil
130
List the 4 other agents other than Topical 5-flurouracil that can treat Hypertropic Actinic Keratosis
1) Imiquimod
2) Ingenol mebutate
3) Topical Diclofenac
4) Retinoids
131
Topical diclofenac is a __
NSAID
132
Melanoma Treat consists of ____ (3x)
1) Surgical
2) Chemo
3) MAP Kinase Pathway Inhibitor
133
Dacarbazine is a chemo agent that treats ____
Melanoma
134
What chemo agent treats melanoma
Dacarbazine
135
What is the MAP Kinase Pathway inhibitor that inhibits the mutated BRAF gene in melanoma
Vemurafenib
136
Vemurafenib is a ___ kinase pathway inhibitor that inhibits mutated ____ gene in Melanoma
1) MAP
| 2) BRAF
137
For advance BCC physicians use __ or ___ for treatment
1) Vismodegib
| 2) Sonidegib
138
MOA of Vismodegib and Sonidegib is
1) Oral hedgehog signaling pathway inhibitors
139
What are the topical meds that treat BCC and SCC
1) Imiquinimod
| 2) 5-Fluorouical
140
What is the MOA for Imiquimod
Immune response modifier (triggers toll like receptors) --> Inflammatory cell infiltration
141
Male Pattern Baldness 1st line of defense is
Minoxidil
142
MOA of Minoxidil
1) Vasodilates due to K+ channel opening
- Increases duration of anagen (growth phase)
- Shortening Telogen (rest phase
- Leads to enlargement of follicle
143
Alterantive treatment for Male pattern baldness is _______
Finasteride
144
MOA of Finasteride
Inhibits dihydrotestosterone (DHT) production --> increase hair count
145
Which treatment of male pattern baldness can cause sexual dysfunction
Finasteride
146
List the two agents that can treat Male pattern baldness
Minoxidil
| Finasteride
147
What is the first line for female hair loss
Minoxidil
148
What is the second line of defense for female hair loss if Minoxidil fails
Anti-Androgens
149
List the Anti-Androgens that can treat female baldness
1) Spironolactone ( androgen partial agonist)
2) Finasteride (block dihydrotesttosterone syn)
3) Flutamide (androgen antagonist)
150
____ is chronic relapsing immune-medatiated inflammatory disorder affecting hair follicle
Alopecia Areata
151
List the treatments for Alopecia Areata
1) Corticosteroids
| 2) Topical Immunotherapy (Diphenylcyclopropenone) (DPCP)
