Topical agents

Question 1

what are the living layers of the epidermis?

Answer 1

basal
spinous
granular

Question 2

in which epidermal layer does most of the cell division occur?

Answer 2

basal

Question 3

which epidermal layer synthesizes the most epidermal proteins?

Answer 3

spinous

Question 4

which epidermal layer is the major barrier to percutaneous absorption? why?

Answer 4

corneum

lipid-enriched extracellular matrix with lipid bilayers produced by corneocytes

Question 5

definition: corneocytes

Answer 5

flattened and lipid-depleted keratinocytes composed of keratin granules

Question 6

what are the absorption pathways of intact skin?

Answer 6

1. appendages (shunt)
2. transcellular (corneocytes)
3. intracellular lipid domains

Question 7

what is the most common absorption route for small uncharged molecules?

Answer 7

intracellular lipid domains

Question 8

which vehicles are convenient for scalp and hairy areas?

Answer 8

lotions 
gels 
solution 
foams 
aerosols

Question 9

which vehicles are convenient for intertrigous areas (rubbing) without causing maceration?

Answer 9

creams
lotions
solutions

Question 10

lotions 
gels 
solution 
foams 
aerosols 

are useful for what areas?

Answer 10

scalp and hairy

Question 11

creams
lotions
solutions

are useful for what areas?

Answer 11

intertrigous areas (rubbing) without causing maceration

Question 12

what vehicle is best for dry and scaly skin?

Answer 12

ointment

Question 13

what vehicle is best for wet and oozing skin?

Answer 13

tinctures

Question 14

ointment is best for what type of skin?

Answer 14

dry and scaly

Question 15

tinctures are best for what type of skin?

Answer 15

wet and oozing

Question 16

what is the rate limiting step for percutaneous absorption?

Answer 16

passage through corneum

Question 17

definition: partition coefficient

Answer 17

partitioning of drug from vehicle into stratum corneum

Question 18

definition: drug diffusion coefficient

Answer 18

molecular aspects of the drug allowing diffusion across skin layers

Question 19

what does Fick’s law describe?

Answer 19

rate of absorption or flux of substance across barrier

Question 20

what are the drug factors affecting PCA?

Answer 20

concentration
lipophilicity
molecular size

Question 21

how does hydration of skin affect PCA?

Answer 21

increase

Question 22

is there first pass metabolism of topical drugs?

Answer 22

no

Question 23

what are the general drug classes used to treat acne?

Answer 23

antibiotics 
retinoids 
salicylic acid 
oral contraceptives 
anti-androgens

Question 24

what is the primary bacterium responsible for acne?

Answer 24

proprionibacterium acnes

Question 25

what is the main way to reduce the effects of acne?

Answer 25

reduce sebum production

Question 26

what are the topical agents used to treat acne?

Answer 26

``` erythromycin clindamycin metronidazole sodium sulfacetamide azelaic acid benzoyl peroxide salicylic acid ```

Question 27

what is the MOA of benzoyl peroxidase?

Answer 27

comedolytic (destroys plugs) | keratolytic (dries and desquamates)

Question 28

what are the MOAs of salicylic acid?

Answer 28

increases solubilization of stratum corneum by altering keratin by breaking hydrogen bonds clears comedones by desquamation

Question 29

retinoid agents are used for what purposes?

Answer 29

acne psoriasis skin aging skin cancer

Question 30

what are the adverse effects of the retinoids?

Answer 30

photosensitivity

Question 31

tretinoin is what class of drug?

Answer 31

retinoid

Question 32

what are the therapeutic uses for tretinoin?

Answer 32

acne | photoaging

Question 33

what is the MOA of tretinoin?

Answer 33

1. decrease cohesiveness of follicular epithelial cells responsible for producing microcomedones 2. comedolytic 3. reduces keratinization

Question 34

tretinoin whould NOT be applied in combination with what other drug? why?

Answer 34

benzoyl peroxide BP inactivates it

Question 35

what is the main adverse effect of tretinoin?

Answer 35

pregnancy (category C - possible to use but caution) | photosensitivity

Question 36

adapalene is what class of drug?

Answer 36

retinoid

Question 37

which retinoid can be combined with benzoyl peroxide?

Answer 37

adapalene

Question 38

what is the MOA of isotretinoin?

Answer 38

suppress sebum production by inducing apoptosis in sebum producing cells of sebaceous glands

Question 39

what is the primary adverse effect of isotretinoin?

Answer 39

teratogenesis

Question 40

what class of drug is tazarotene?

Answer 40

retinoid

Question 41

what class of drug is isotretinoin?

Answer 41

retinoid

Question 42

which drugs inhibit sebaceous gland function?

Answer 42

antiandrogens oral contraceptives isoretinoin

Question 43

what class of drug is acitrecin? what is the therapeutic use?

Answer 43

retinoid psoriasis (severe, recalcitrant)

Question 44

what increases the elimination time of acitrecin?

Answer 44

alcohol

Question 45

what class of drug is calcipotriene? what is the therapeutic use?

Answer 45

vitamin D receptor antagonist psoriasis - moderate to severe

Question 46

what are the strength ratings of hydrocortisone, mometasone furoate, and clobetasol proprionate?

Answer 46

hydrocortisone - low mometasone furoate - intermediate clobetasol proprionate- high

Question 47

what constitutes photochemical therapy? what are the therapeutic uses?

Answer 47

psoralen plus UVA light alopecia cutaneous T cell lymphoma eczema psoriasis

Question 48

what are the psoralen agents?

Answer 48

methoxsalen | trioxsalen