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OTC > Skin 1 > Flashcards

Skin 1 Flashcards

1
Q

Applications

A

Are usually viscous solutions, emulsions for application.

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2
Q

Collodions

A

Are painted on the skin and allowed to dry to leave a flexible film

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3
Q

Creams

A

Are emulsions of oil and water and are generally well absorbed into the skin. Creams are less great and easier to apply compared to ointments

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4
Q

Gels

A

Consist of API in a suitable hydrophilic or hydrophobic bases; they generally have a higher water content. Particularly suitable for face and scalp

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5
Q

Lotions

A

Have a cooling effect and maybe preferred for hairy areas.

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6
Q

Ointment

A

Are greasy preparations which are normally anhydrous and insoluble in water, and are more inclusive than water

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7
Q

Pastes

A

Are stiff preparation containing high proportion of finely powered solids such as zinc oxide and starch suspended in an ointment

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8
Q

Dusting powder

A

are used only rarely. They reduce friction between opposing skin surfaces. Dusting powders should not be applied to moist areas because they can cake and abrade the skin. Talc is a lubricant but it does not absorb moisture; it can cause respiratory irritation. Starch is less lubricant but absorbs water.

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9
Q

Quantities for specific areas of body

Face

A

Cream: 15-30g
Lotion: 100ml

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10
Q

Quantities for specific areas of body

Both hands

A

Cream: 25-50g
Lotion: 200ml

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11
Q

Quantities for specific areas of body

Scalp

A

Cream: 50-100g
Lotion: 200ml

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12
Q

Quantities for specific areas of body

Both arms or both legs

A

Cream: 100-200g
Lotion: 200ml

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13
Q

Quantities for specific areas of body

Trunk

A

Cream: 400g
Lotion: 500ml

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14
Q

Quantities for specific areas of body

Groin and genitals

A

Cream: 15-25g
Lotion: 100ml

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15
Q

What dose ACBS stand for?

A

Advisory committee on borderline substances

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16
Q

MHRA alert: fire risk with paraffin containing emollients

A

There is a danger that smoking or using a naked flame may cause a fire while emollients are in contact with their medical dressing or clothing.

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17
Q

Barrier preparations

A

contain a water repelamt

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18
Q

Nappy rash

A

change nappies frequently
expose to air
mild corticosteroid - no longer than a week.

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19
Q

Skin infections

cellulitis

A

systemic antibacterial
Staph aureus
e.g. flucloxacillin

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20
Q

Skin infections

impetigo

A

topical fusidic acid
mupirocin - MRSA
extensive or long standing - fluclox/clari

21
Q 
Skin infections
Ring worm
Tinea capitis
Tinea Corporis
Tinea cruris
Tinea manuum
Tinea pedis
Tinea uguium
A

scalp, body, groin, hand, foot, nail

Imidazole antifungal - clotrimazole, ketoconazole, miconazole,

22
Q

Skin infections

Pityriasis versicolor

A

Ketoconazole shampoo
is a common fungal infection that causes small patches of skin to become scaly and discoloured.
is caused by a type of yeast called Malassezi

23
Q

Skin infections

Candidiasis

A

Imidazole antifungal - clotrimazole, ketoconazole, miconazole,
Nystatin
thrush

24
Q

Angular cheilitis

A

miconazole

is inflammation of one or both corners of the mouth. Often the corners are red with skin breakdown and crusting.

25
Q

Herpes simplex

A

Aciclovir

26
Q

Suitable quantities of parasiticidal preparations

Scalp (head lice)

A

lotion/ cream rinse - 50-100ml

27
Q

Suitable quantities of parasiticidal preparations

body (scapies + crap lice)

A

cream - 30-60g lotion - 100ml

28
Q

scabies

A

Permethrin
Malathion
all members of household should be treated

29
Q

head lice

A

Dimeticone - suffocates
Malathion - insectaside
MHRA: head lice eradication products: seroius risk of burns if treated hair exposed to open flame

30
Q

Eczema

Skin dryness

A

Skin dryness and the consequent irritant eczema requires emollients applied regularly (at least twice daily) and liberally to the affected area;

31
Q

Eczema

Mild corticosteroids

A

Mild corticosteroids are generally used on the face and on flexures; potent corticosteroids are generally required for use on adults with discoid or lichenified eczema or with eczema on the scalp, limbs, and trunk. Treatment should be reviewed regularly, especially if a potent corticosteroid is required. In patients with frequent flares (2–3 per month), a topical corticosteroid can be applied on 2 consecutive days each week to prevent further flares.

32
Q

Eczema

Bacterial infections

A

(commonly with Staphylococcus aureus and occasionally with Streptococcus pyogenes) can exacerbate eczema and requires treatment with topical or systemic antibacterial drugs. Antibacterial drugs should be used in short courses (typically 1 week) to reduce the risk of drug resistance or skin sensitisation.

33
Q

Lichenification

A

which results from repeated scratching is treated initially with a potent corticosteroid. Bandages containing ichthammol paste (to reduce pruritus) and other substances such as zinc oxide can be applied over the corticosteroid or emollient. Coal tar and ichthammol can be useful in some cases of chronic eczema.

A non-sedating antihistamine may be of some value in relieving severe itching or urticaria associated with eczema. A sedating antihistamine can be used if itching causes sleep disturbance.

34
Q

psoriasis is provoked or exacerbated by drugs

A

lithium, chloroquine and hydroxychloroquine, beta-blockers, non-steroidal anti-inflammatory drugs, and ACE inhibitors. Psoriasis may not be seen until the drug has been taken for weeks or months.

35
Q

treatment for chronic stable plaque psoriasis

A

vitamin D analogues, coal tar, dithranol, and the retinoid tazarotene.

36
Q

Systemic treatments for psorasis

A

Pimecrolimus, tacrolimus - mild to moderate eczema
Corticosteroids for flare ups
Ciclosporin severe psoriasis and eczema
Methotrexate severe psoriasis
Etanercept adalimumab infliximab - tumour necrosis factor - severe plaque psoriasis
Secukinumab, ixekizumab interleukin-17A

37
Q

Corticosteroid

A

suppress the inflammatory reaction during use; they are not curative and on discontinuation a rebound exacerbation may occur

38
Q 
Quanities of corticosteroids for specific areas
face and neck
both hands
Scalp
Both arms
Both legs
trunk
Genitalia
A 
15-30g
15-30g
15-30g
30-60g
100g
100g
15-30g
39
Q

Corticosteroids in children

A

are particularly susceptible to side effects

40
Q

Corticosteroids MHRA

A

rare risk of central chorioretinopathy with local as well as systemic administration

41
Q

Hyperhidrosis

A 
Excessive sweating
Aluminium chloride potent antipersperant
oxybutynin - limited evidence
glycopyrronium - plantar and palmar areas
Botox - botulinum toxin type A
42
Q

Pruritis - cause

A

jaundice, endocrine disease, CKD, iron deficiency, malignant disease, skin condiditons - eczema, poriasis, scabies

43
Q

Acne - mild to moderate

A 
generally treated with topical preparations. 
Benzoyl peroxide 
Azelaic acid 
tretinoin
erythromycin and clindamycin. 
nicotinamide
44
Q

Acne - moderate to severe

A

Systemic treatment with oral antibacterials is generally used for moderate to severe acne or where topical preparations are not tolerated or are ineffective or where application to the site is difficult. Another oral preparation used for acne is the hormone treatment co-cyprindiol ( cyproterone acetate with ethinylestradiol); it is for women only.

45
Q

Acne - severe

A

Severe acne, acne unresponsive to prolonged courses of oral antibacterials, scarring, or acne associated with psychological problems calls for early referral to a consultant dermatologist who may prescribe isotretinoin for administration by mouth.

46
Q

Isotretinoin - counselling points

A

Isotretinoin is a toxic drug that should be prescribed only by, or under the supervision of, a consultant dermatologist. It is given for at least 16 weeks; repeat courses are not normally required.

Side-effects of isotretinoin include severe dryness of the skin and mucous membranes, nose bleeds, and joint pains. The drug is teratogenic and must not be given to women of child-bearing age unless they practise effective contraception (oral progestogen-only contraceptives not considered effective) and then only after detailed assessment and explanation by the physician. Women must also be registered with a pregnancy prevention programme.

Although a causal link between isotretinoin use and psychiatric changes (including suicidal ideation) has not been established, the possibility should be considered before initiating treatment; if psychiatric changes occur during treatment, isotretinoin should be stopped, the prescriber informed, and specialist psychiatric advice should be sought.

47
Q

Rosacea

A

Rosacea is not comedonal (but may exist with acne which may be comedonal). Brimonidine tartrate is licensed for the treatment of facial erythema in rosacea. The pustules and papules of rosacea respond to topical azelaic acid, topical ivermectin or to topical metronidazole. Alternatively oral administration of oxytetracycline or tetracycline, or erythromycin, can be used; courses usually last 6–12 weeks and are repeated intermittently. Isotretinoin is occasionally given in refractory cases [unlicensed indication]. Camouflagers may be required for the redness.

48
Q

Hirsutism drug SE

A

minoxidil, corticosteroids, anabolic steroids, androgens, danazol, and progestogens.

49
Q

Warts and calluses

A

HPV

Wart - self limiting, salicylic acid, formaldehyde or silver nitrate, cryotherapy

OTC (4 decks)

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