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Nurs 5229 Clinical Pharmacotherapeutics > Derm Conditions > Flashcards

Flashcards in Derm Conditions Deck (33)
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1
Q

Local Anesthetics - Can be

A

Can be applied topically to relieve pain and itching associated with skin disorders
Benzocaine
Lidocaine
Pramoxine

2
Q

Urticaria - 20%

A

20% prevalence in general population

3
Q

Urticaria - intensly

A

Intensely pruritic, erythematous plaque

4
Q

Urticaria - sometimes with

A

Sometimes with angioedema (swelling deeper in skin)

5
Q

Urticaria - trigger

A

Acute (<6 weeks); chronic (>6 weeks)

6
Q

Urticaria - acute

A

Acute (<6 weeks); chronic (>6 weeks)

7
Q

Urticaria - Prefered

A
H1 anithistimines
Second-generation (preferred*)
First-line
Minimally sedating
Some patients requiring higher than standard doses

First gen can also be used

8
Q

Urticaria - Glucocorticoids

A
Glucocorticoids – do not appear to be necessary in isolated urticaria
Brief course (one week or less) of systemic glucocorticoids could be added to anti-histamine therapy – patients with prominent angioedema or if symptoms persist past a few days
Suppress a variety of inflammatory mechanisms
9
Q

Drug-induced exanthems

A

most common cutaneous reactions to drugs (90% of all drug rashes)a
Exanthems, morbilliform, and macular and popular eruptions

10
Q

Pruritis - Can be due to

A

Can be due to a distinct dermatological condition or an occult underlying systemic disease.

11
Q

Pruritis - Can contribute to

A

Can contribute to a high burden, decreased quality of life

12
Q

Pruritis - Acute - Less than

A

less than 6 weeks

13
Q

Pruritis - Chronic

A

6 weeks or greater

14
Q

Identify underlying

A

dermatologic or systemic cause

15
Q

Non-pharmacological interventions

A

Stop medications that cause pruritis
Cool environment
Avoidance of skin irritants
Stress reduction

16
Q

Puritis managment

A

Topical and intralesional corticosteroids
Treatment inflammatory skin disease with outcome of relief of associated pruritis.
NOT indicated if no evidence of skin inflammation.
Systemic therapy – H1 antagonists (1st and 2nd)
TCA – doxepin (Sinequan) 25mg at night up to 150mg daily (divided doses)
Gabapentin (Neurotonin) 200 to 300mg nightly – dialysis patient, neurogenic pruritis.

17
Q

Irritant contact dermatitis (ICD) (80%

A

occupational) – direct cytotoxic action of an agent on the cells of the epidermis and dermatitis.

18
Q

Allergic contact dermatitis (ACD)

A

type 4 delayed hypersensitivity reaction (exposure to nickel, neomycin, fragrances).

19
Q

Atopic dermatitis (AD) –

A

pruritic inflammatory skin disorder, exacerbations and remissions of dry, itchy, red skin.

Common at 3 to 6 months of age
Associated with other atopic disorders (asthma, AR, urticaria, food allergy)

20
Q

Contact Dermatitis Management -

A
Avoidance of the offending agents
Handwashing to a minimum
Emollients
Medium-high potency corticosteroids (choice based on thickness, surface involved). Ointments often preferred
Topical calcineurin inhibitors
21
Q

ACD involving >20% of the body, involving face, hands, feet or genitalia

A

Prednisone

22
Q

Poison iv dermatitis severe

A

(involving face or genitlia) – 1m/kg/day tapered over 2 to 3 weeks

23
Q

Antihistamines – use in

A

ACD, unsure beneficial in contact dermatitis

24
Q

Atopic Dermatitis Management

A
Patient education
Eliminate exacerbating factors
Moisturization, control of inflammation, prevention of scratching.
Antihistamines
Emollient moisturizer
Bathing practices 
Controlling pruritis
Topical corticosteroid ointment
Calcineurin inhibitors
Prevent secondary skin infections
Systemic corticosteroids – extreme cases
25
Q

Herpes Zoster - unilateral

A

Unilateral within one dermatome (20%, adjacent dermatome)

26
Q

Herpes Zoster - prodrome

A

Prodrome – pain (stabbing, burning, aching, or excruciating), dysesthesia, or pruritis

27
Q

Herpes Zoster erythematous

A

Erythematous and maculopapular, becomes cluster of clear vesicles

28
Q

Herpes Zoster low

A

Low-grade fever, lymphadenopathy

29
Q

Herpes Zoster zoster

A

sine herpete

30
Q

Herpes Zoster - Uncomplicated – symptomatic treatment

A

prevention secondary infection

31
Q

Herpes Zoster Antiviral

A

Antiviral therapy
< 72 hours after onset
Greatest benefit in patients older than 50 years of age
> 72 hours after onset
New lesions are appearing
Choice based on cost, dosing
Acyclovir – 800mg five times daily x 7 days
Valacyclovir – 1000mg three times day x 7 days
Famciclovir – 500mg three times day x 7 days
Analgesics – narcotics
Topical cool moist compresses, Lidoderm patches
Adjunct therapies – gabapentin, TCA, oral steroids

32
Q

Pediculosis Capitis - Common condition

A

Common condition caused by infestation of the hair and scalp by Pediculus humanus capitis (the head louse)

33
Q

Pediculosis Capitis - Treatment

A

Multiple topical pediculicides

Wet combing – very young infants/want to avoid pediculides