Exam 3 dermatological therapeutics Flashcards Preview

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Flashcards in Exam 3 dermatological therapeutics Deck (71):
1

What is drug delivery dependent on?

Skin type, skin condition, lipid vs. water-based vehicle, charge, concentration gradient

2

What is the rate limiting step of topical therapy absorption?

The stratum corneum

3

What increases absorption of topical treatments through the skin?

Hydration of the skin

4

What are the actions of corticosteroids?

Anti-inflammatory, immunosuppressive, anti-proliferative, vasoconstrictive

5

What can corticosteroids be used for?

eczema, contact dermatitis, psoriasis, itch, lichen planus

6

What are adverse side effects of corticosteroids

Skin atrophy (thinning), striae, acne, suppression of the HPA (hypothalamus, pituitary, adrenal) axis

7

Explain the levels of corticosteroid strength

1 is for very thick skin, 7 is for very thin skin and babies

8

What are retinoids in terms of their background?

vitamin A analoges

9

How do retinoids work?

working through nuclear receptors on DNA causing alteration of gene transcription

10

What is the action of retinoids?

regulate cell growth, inhibit carcinogenesis, alter enzymes involved with cellular differentiation

11

What can retinoids be used for?

acne, psoriasis, cosmetic skin improvement (reduction of fine wrinkles and pigmentation)

12

What are the side effects of retinoids?

dryness, irritation, sun sensitivity

13

What is calcipotriene

Vitamin D analog that acts through DNA receptors to alter skin differentiation

14

What are the uses for calcipotriene

psoriasis (localized), eczema

15

What are side effects of calcipotriene?

irritation, increased serum calcium

16

What are topical antimicrobials used for?

wounds, acne, fungal infections, rosacea

17

What do non-steroidal anti-inflammatories (topical calcinuerin inhibitors) work through?

calcineurin to alter T-cell activation

18

What are the uses for non-steroidal anti-inflammatories (topical calcinuerin inhibitors)

Eczema around the eyes, dermatitis

19

What sun rays are the best to block for sunscreen?

UVA and UVB

20

What new sunscreens help to block UVA rays?

avobenzone/helioplex or mexoryl

21

What is so special about titanium and zinc oxide for blocking sun rays?

they stay on the skin and do not get absorbed so they block longer

22

How does Imiquimod/aldara cream work?

increase local immune activity through toll receptors

23

What is imiquimod used for?

condyloma, actinic keratosis, BCC, common warts, molluscum, in situ cancer

24

what can topical 5-fluorouracil be used for?

actinic damaged skin cells; actinic keratosis,

25

How does 5-flourouracil work?

inhibits thymidylate synthase resulting is reduced DNA synthesis

26

How do systemic retinoids work?

by repairing disordered keratinization

27

What can systemic retinoids be used for?

acne, psoriasis, ichthyosis, Darier's disease, chemoprophylaxis of skin cancer

28

What are two systemic retinoids?

isotretinoin, acitretin

29

What are side effects of systemic retinoids?

teratogenicity (don't use during pregnancy), depression, arthralgia, hair loss

30

What labs should be ordered with retinoids?

Lipids, LFT, HCG

31

What kind category is dapsone in?

Sulfones

32

What can dapsone be used for

Leprosy therapy, dermatitis herpetiformis, linear IgA disease, bullous lupus, Sweet's syndrome, spider bites

33

How does dapsone work?

inhibits myeloperoxidase in PMNs (affects CD11a/CD18)

34

What are the side effects of dapsone?

Hemolysis in people with G6PD deficiency

35

What labs should be done before Rx dapsone?

G6PD, CBC

36

What is the action of methotrexate?

Dihydrofolate reductase inhibitor that disrupts DNA synthesis to block cell division

37

What can methotrexate be used for?

extensive psoriasis, CTCL, lupus

38

Side effects of methotrexate

hepatotoxicity, myelosuppression, pneumonitis

39

Labs to order before Rx methotrexate

CBC, LFT, Liver biopsy

40

What can biological therapies be used for?

psoriasis, psoriatic arthritis and rheumatoid arthritis

41

What proteins do Biological therapies target?

TNF and IL12 and IL23

42

What can oral antibiotics be used for?

acne, folliculitis, cellulitis, rosacea, wound infection

43

What can anti-vitals be used for?

HSV infection, cold sores, zoster

44

What can antifungals be used for

Ring worm, athletes foot, infected foot

45

What are some miscellaneous therapies that can be used for different derm disorders?

UV light (psoriasis, eczema, inflammatory), Minoxidil, finasteride, Liquid nitrogen (some keratoses)

46

what can UV light therapy be used for?

psoriasis, pruritis, eczema, CTCL

47

What is minoxidil used for?

Alopecia

48

What is the action of minoxidil?

vasodilation and direct stimulation of hair shaft growth

49

What is finasteride used for?

androgenic alopecia

50

What is the action of finasteride?

Blocks 5-alpha reductase enzyme in follicles to inhibit the conversion of testosterone to dihydrotestosterone

51

What can liquid nitrogen be used for?

Warts, actinic keratoses, skin cancer

52

What are the three cycles of hair cycle?

Anagen, catagen, telogen

53

What typically causes scarring alopecia?

diseases

54

What causes androgenetic alopecia

Genetically determined miniaturization of follicles triggered by androgens

55

What are treatments of androgenetic alopecia?

minoxidil, finasteride, hair transplants

56

What causes telogen effluvium

Major stressors disrupting growth cycle of hairs causing premature shift to telogen

57

What causes alopecia areata

Autoimmune disease where T-cells attack hair bulb

58

What is treatment of alopecia areata?

minoxidil, anthralin

59

What does alopecia areata look like?

Circular patches on scalp or beard. Totalis= all scalp hair lost. Universalis= all body hair lost. Looks like that basketball player who KG called a cancer patient.

60

What causes secondary alopecia?

Chemotherapy, meds, thyroid disease, iron deficiency, nutritional disorders, renal or hepatic failure

61

What usually causes tinea capitis?

Trichopyton tonsurans

62

What is the treatment for tinea capitis?

Oral Grisofulvin, possibly terbinifine or itraconazole

63

What form of lupus causes hair loss?

Discoid lupus of the scalp can destroy hair units

64

Treatment of discoid lupus?

hydroxychloroquine

65

What is pediculosis?

Head lice and pubic lice

66

What is the treatment for pediculosis?

Permethrin, vaseline for eyelids, cetaphil cleansear, Remove nits, wash bedding and clothes

67

What is paranychia?

inflammation of the nail folds

68

What causes causes acute paranychia?

trauma, bacteria, contact dermatitis, acute eczema flair

69

What causes chronic paranychia?

contact dermatitis, eczema, psoriasis, candida

70

What organisms cause onychomycosis (tinea unguium)

T. rubrum, T. mentagrophytes

71

How do you treat onychomycosis (tinea unguium)

terbinafine, intraconazole, ciclopirox