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Flashcards in Topical Therapeutics in Dermatology Deck (19):
1

Which layer of the skin is described as having a "brick-and-mortar" appearance? What are the "bricks" and "mortars"?

The stratum corneum of the epidermis; corneocytes are the bricks and intercellular lipids are the mortar

2

The three ways drugs can pass through the skin are _______.

passive diffusion through tissue, seeping through pores in the brick-and-mortar network, and through apendageal structures

3

List the drug factors that affect absorption.

Lipophilicity, vehicle composition, size, and concentration

4

Ointments are _____.

water in oil emulsions

5

Creams are ______.

oil in water emulsions

6

Sites most amenable to gels are ______.

the oral mucosa and the scalp

7

The benefits of ointments are __________. The downsides are _____.

high potency, low sensitization risk, hydrating; greasy, not useful for intertriginous sites or face

8

A common unit of measurement for topicals is the ______.

fingertip unit (FTU), roughly 0.5 g; it is the amount the covers the distal phalange of the second digit with a 5 mm dispensing tube

9

Foams are aerosolized gel matrices. What are their benefits and downsides?

They dry fast and don't leave a residue, so they work well on hair-bearing areas.

10

While most areas of the body are amenable to creams, clinicians should avoid creams on _______.

macerated areas (sites that have been damaged due to excessive moisture)

11

One gram of cream covers _______.

roughly 10 cm^2 (ointment covers 10% more)

12

There are seven classes of topical corticosteroids. Name a class one (most potent), class seven (least potent), and one in between.

1 = clobetasol propionate, 7 = hydrocortisone, and 4 = triamcinolone acetonide

13

List the patient factors that affect drug absorption.

(1) anatomic location, (2) skin hydration, (3) presence of a barrier, and (4) occlusion

14

Gels are _________.

semisolid emulsifications in alcohol; great for the mucosal surfaces or the scalp (because gels dry quickly); not great for fissures or macerated areas

15

Foams have _______ potency.

strong (because the inactive volatile ingredients evaporate, leaving behind only the active ingredients)

16

List some FTUs for various body parts.

Trunk (front or back) 7 FTU; arm 3 FTU; leg 6 FTU; foot 2 FTU

17

How many grams of cream are needed to cover the entire body of an adult man?

20 g

18

Describe the mechanism of glucocorticoid action.

Glucocorticoids bind to cytosolic receptors, which then dimerize and act as a transcription factor for several anti-inflammatory genes. This ultimately leads to the down-regulation of GM-CSF, nF-KB, and several interleukins.

19

In patients with allergic contact dermatitis, what types of topical medications should be used cautiously?

Those that are water-based: water-based medications must have preservatives, which can be a source of ACD.

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