Thrp: Derm + Nutrition

Question 1

Cetaphil

Answer 1

OTC brand - Mild Soap, cream

Question 2

Tazarotene

Answer 2

Topical Retinoid: Most potent/Greatest SE
crm/gel - 0.5 or 0.1%
Pregnancy= Class X

(Tazorac * No Generic)

Question 3

Tretinoin

Answer 3

Topical Retinoid: Mid potency
crm/gel - 0.025-0.1%
Rx breaks down benzoyl peroxide* Must seperate two Rx’s

(Retin-A * Generic Available)

Question 4

Adapalene

Answer 4

Topical Retinoid: Least potent, best tolerated
crm/lotion/gel - 0.1 or 0.3%
3rd gen Rx; has some antimicrobial effect

(Differin * Generic available)

Question 5

Azelaic Acid

Answer 5

Mild-Mod Acne Alternative Rx; For pts don’t tolerate Benzoyl Peroxide
crm - 20%
Qday dosing just as effective as BID ($)

(Azelex * No generic $$200/30g)

Question 6

Salicyclic Acid

Answer 6

Alt. Mild Acne; Good for pts cant tolerate Top-Retinoids
gel, foam, pads, patch et.c - OTC (0.5 - 2%) Rx (up to 5%)
Apply several (3-4X)/Day

Question 7

Clindamycin Top

Answer 7

Topical Antimicrobial

Generic - gel, lotion, solution foam - ALL 1%

Question 8

Cleocin

Answer 8

Clindamycin Topical Antimicrobial
gel, lotion, sln - 1%

Apply BID

Question 9

ClindaMAx

Answer 9

Clindamycin Topical Antimicrobial
gel, lotion - 1%

Apply BID

Question 10

Clindagel

Answer 10

Clindamycin Topical Antimicrobial
gel - 1%

Apply QD

Question 11

Evoclin

Answer 11

Clindamycin Topical Antimicrobial
Foam* - 1%

Disp onto cool surface, NOT HAND, apply small amy using fingertips and gently massage until disappears

Question 12

Erythromycin

Answer 12

Topical Antimicrobial
gel, ung, sln, pad - 2%

Apply BID

Generic available

Question 13

Minocycline

Answer 13

Tetracycline Oral Abx: Acne-Strongest

50-100mg QD-BID w or w/o food

AE: pigmentation, lupus-like syndrome, hepatitis, has least photosensitivity, tooth discoloration
*Pregnancy class D

Delayed Rel available but $$$

Question 14

Doxycycline

Answer 14

Tetracycline Oral Abx: Acne-Middle strength

50-200mg QD-BID w or w/o food

No Specific AE: tooth discoloration
*Pregnancy class D

Question 15

Tetracycline

Answer 15

Tetracycline Oral Abx: Acne-weekest (AVOID THIS RX)

500mg BID w food NOT on empty stomach -> lots of GI upset
BUT
AE: Absorbiton limited by dairy, antacids, iron lots of foods;
severe GI SE

*Pregnancy class D

Question 16

Erythromycin

Answer 16

Macrolide Oral Abx: Acne

1g QDay

AE higher rates of Resistance, More GI upset

Question 17

Azithromycin

Answer 17

Macrolide Oral Abx: Acne

500mg QDay (or several times per week- long t1/2)

AE higher rates of Resistance, More GI upset

Question 18

Clindamycin

Answer 18

Macrolide Oral Abx: Acne

Possible induction of pseudomembranous colitis!

Question 19

Benzoyl peroxide

Answer 19

Anti-moderate - severe Acne: Used in combo

Lotion, gels, crms, washes 2.5%, 5%, 10% MAX

Question 20

Benzaclin

Answer 20

Benzoyl peroxide with clindamycin

Question 21

Duac

Answer 21

Benzoyl peroxide w/ clindamycin

Generic

Question 22

Epiduo

Answer 22

Benzoyl peroxide w/adapalene (an anti-acne ~retinoid)

NO Generic

Question 23

Norgestimate

Answer 23

3rd gen Oral Contraceptive (Acne)

Less Androgenic

Question 24

Desogestrel

Answer 24

3rd gen Oral Contraceptive (Acne)

Less Androgenic

Question 25

Drospirenone

Answer 25

4th gen Oral Contraceptive (Acne)

Anti-Androgenic

Question 26

Yasmine

Answer 26

4th gen Oral Contraceptive (Acne)

Anti-Androgenic

Question 27

Yaz

Answer 27

4th gen Oral Contraceptive (Acne)

Anti-Androgenic

Question 28

ethinyl estradiol

Answer 28

20-35mcg Low-Dose Oral Contraceptive

Rx is estrogen dominant which = antiandrogenic

Question 29

Spironolactone

Answer 29

K+ sparing diruretic with anti-androgenic properties
Tx: Acne

50-100mg QD-BID

AE: Hyperkalemia, Hypotension, Breast Tenderness

Question 30

Isotretinoin

Answer 30

(Retanoid) Acne
Dose: Wt based: Start 0.5mg/kg/day X 1mo. Th inc to 1mg/kg/day (QD or BID)
Goal= Cummulative 120-150mg/kg
MAX Duration = 20wk or ≥70% acne resolution
Stop if LFT 3X ULN or TG>800

Question 31

Terbinafine

Answer 31

Antifungal: Fungicidal 1st line
Topical: Tx: Mild Tinea Pedis/manuum/corporis 4wks QD/BID Tx: Tinea cruris 1-2 wks
Oral: (Tinea Pedis/manuum/cruris) 250mg BID X 2w
Tinea corporis 250mg QD X 1-2 wk
Tinea unguium 250mg QD X 6wk fingernail or 12wks toenail

AE: GI upset, rash/pruritus, HA, taste disturbances, fatigue, LFT abnormalities/Hepatotoxicity, DDI w CYP2D6

Question 32

Itraconazole

Answer 32

Antifungal 1st line (needs acidic environment to absorb)
Oral: (Tinea Pedis/manuum/cruris) 200mg BID X 1wk
Tinea corporis 200mg QD X 1-2 wk
Tinea unguium 2o0mg QD X 6wk fingernail or 12wks toenail

AE: GI upset, rash/pruritus, HA,, fatigue, decreased libido, LFT ab/Hepatotoxicity, risk of CHF, DDI with CYP3A4*

Question 33

Fluconazole

Answer 33

Antifungal
Oral: (Tinea Pedis/manuum/cruris) 150mg QD X 2-6wks
Tinea corporis 150mg QD X2-4 wks

Question 34

Clotrimazole

Answer 34

Antifungal: Fungistatic
Topical: Tx: Mild Tinea Pedis/manuum/corporis 4wks QD/BID Tx: Tinea cruris 1-2 wks

Question 35

Miconazole

Answer 35

Antifungal: Fungistatic
Topical: Tx: Mild Tinea Pedis/manuum/corporis 4wks QD/BID Tx: Tinea cruris 1-2 wks

Question 36

Griseofluvin

Answer 36

Anti fungal: Tx: Tinea capitis in children
Old Rx but Hx of safer use in children with lots of safety data in children

Should be taken with fatty meal to help absorption

AE: hypersensitivity, photosensitivity, GI distress, HA, paresthesias, altered sensorium

Question 37

Selenium Sulfide

Answer 37

Topical Antifungal shampoo
2.5%
Tx: adj therapy OR for A-Sx carriers

Question 38

Ketoconazole

Answer 38

Topical Antifungal shampoo

Tx: adj therapy OR for A-Sx carriers

Question 39

Ciclopirox

Answer 39

Nail Lacquer
8% sln Tx: X 1yr

(Penlac)