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Pharmacology > Dermatology > Flashcards

Flashcards in Dermatology Deck (60)
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1
Q

When is drug absorption increased?

A

broken, damaged skin, dry or wet skin, inflammation, large surface area, thinner skin

2
Q

when is drug absorption decreased?

A

hairiness, small surface area, thicker skin

3
Q

What are the risk factors of xerosis?

A

cold weather, dehydration, elderly, endocrine disorders, frequent hand washing

4
Q

Xerosis treatment

A

reduce risk factors, emollients, humectants, urea, allantoin

5
Q

When should xerosis treatment be administered?

A

everyday, every other for prevention

6
Q

Topical acne treatments

A

retinoic acid, adapalene, adapalene/benzoyl peroxide, dapsone

7
Q

What are the antibiotics of choice for antibiotics?

A

clindamycin, doxycycline, erythromycin, minocycline, sulfamethoxazole/trimethoprim

8
Q

What is the dosage of isotretinoin

A

1-2 mg/kg divided in two doses daily for 4-5 months

9
Q

What is considered to be the most efficacious for acne?

A

isotretinoin (Accutane)

10
Q

What is the cause of seborrheic dermatitis

A

unknown but due to fungal infections

11
Q

What is the treatment of seborrheic dermatitis?

A

selenium sulfide, cortisone, diphenydramine, cetrizine, fexofenadine, loratadine, ketoconazole, urea, coal tar

12
Q

Examples of psoriasis meds

A

hydrocortisone, salicylic acid, urea, eucerin, aquaphor, calamine, coal tar, lactic acid

13
Q

What are the RX steroids for psoriasis

A

triamcinolone, betamethasone

14
Q

Adverse effects of steroids in psoriasis

A

dermatitis, atrophy, systemic side effects

15
Q

What is the class 1 steroid?

A

clobetasol

16
Q

Calcipotriene, calcitriol for plaque psoriasis

A

synnthetic vit D3, up to 8 weeks of therapy, ADRs- burning, itching, irritation

17
Q

Tazarotene treatment of psoriasis

A

retinoid prodrug, anti-inflammatory,, antiproliferative, once daily

18
Q

Systemic treatment of psoriasis

A

acitretin (Soriatane), methotrexate

19
Q

Acitretin pearls

A

retinoid metabolite, effective in pustular psoriasis, 25-50 mg daily, ADR- liver failure, high cholesterol, teratogenic

20
Q

Methotrexate pearls

A

immunosuppressant, antifolate, must give folic acid, dosed weekly to limit toxicity, ADR- abdominal, nausea, immunosuppression, liver failure, renal failure

21
Q

What are contraindications of methotrexate?

A

pregnancy, hepatitis, renal impairment, thrombocytopenia, leukemia

22
Q

Biologic treatment for psoriasis

A

hymire, enbrel, infliximab

23
Q

Adalimumab (Humira) dosage

A

80 mg SQ, then 40 mg every other week

24
Q

Etanercept (Enbrel)

A

50 mg SQ twice weekly x3 months, then 50 mg weekly

25
Q

Infliximab (remicade)

A

5 mg/kg/IV infusion, repeated at week 2 and 6 then every 8 weeks

26
Q

ADRs of biologic

A

serious infections, increased risk of lymphoma, require negative TB test prior to initiation

27
Q

OTC dermatitis treatment

A

cortisone, Benadryl, zyrtec, allegra, Claritin, eucerin, aquaphor, tecnu

28
Q

Dermatitis prescription treatment

A

phototherapy, tacrolimus, pimecrolimus

29
Q

Tacrolimus (Prograf)

A

suppresses inflammation, apply twice daily until skin is clear, available as .03% and .1%, ADR of burning and local irritation

30
Q

Pimecrolimus (Elidel)

A

suppresses inflammation, apply twice daily until skin is clear, is available in 1% cream, ADR- burning and local irritation

31
Q

OTC wart treatment

A

freeze away, compound-W, caustic pencil (silver nitrate)

32
Q

Salicylic acid in wart treatment

A

solubilize cell surface protein that keep the stratum corneum intact, keratolytic at concentrations 3-6%, ADR- urticaria, local irriation, inflammation, salicylism

33
Q

Urea in wart treatment

A

breaks hydrogen bonds that keep the stratum corneum intact, 20% concentration is keratolytic

34
Q

Genital wart treatment options

A

surgical removal, cryosurgery, laser treatment, imiquimod (Aldara), Sinecatechins (Veregen), podophyllum resin, podofilox

35
Q

Imiquimod (Aldara)

A

anti-proliferative, apply 3 times per week leave on 6-10 hours, ADR- pruritis, erythema, superficial erosion

36
Q

Sinecatechins (Veregen)

A

water extract from green tea leaves, apply TID, long duration of therapy, no more than 16 weeks,, ADR- local irritation

37
Q

Podophyllum resin, podofilox

A

cytotoxic agents, resin- apply 25% conc to wart then remove after 2-3 hours, if no improvement after 3-5 therapies consider alternative options, podofilox- apply .5% conc BID x3 days then at least 4 days of no treatment

38
Q

ADRs of resin and podofilox

A

highly irritating, toxic if systemically absorbed, NV, muscle weakness, neuropathy

39
Q

Treatment options of lice

A

lice comb, petroleum jelly, mayo, PB, benzyl EtOH, malathion

40
Q

Rid treatment of lice

A

synergized pyrethrins, head+ pubic lice, apply for 10 mins then shampoo and comb, does not kill eggs so repeat in 7 days

41
Q

Nix treatment of lice

A

permethrin, head lice only, apply washed hair, leave on for 10 mins and comb through, may repeat in 7-9 days if active lice seen

42
Q

Ovide treatment of lice

A

malathion, head+ pubic lice, apply to dry hair, leave on 8-12 hrs, then shampoo and comb, may repeat 7-9 days, most efficacious, but$$

43
Q

OTC scabies treatment

A

Calcmine lotion, camphor, benadryl, zyrtec, allegra, claritin

44
Q

Prescription treatment of scabies

A

permethrin, 5%, Croamiton (eurax), lindane

45
Q

Crotamiton (Eurax)

A

MOA unknown, 10% conc of cream or lotion, apply twice, separated by 24 hrs, ADR- dermatitis, local irritation

46
Q

Lindane

A

single application left on for 8-12 hrs, repeat if active mites and >1 week after initial treatment, ADR- local irriation, systemic absorption leading to neurotoxicity and hematotoxicity, may be carcinogenic

47
Q

Topical treatment for bacterial infections

A

Bacitracin/polymixin B/neomycin (Neosporin), bacitracin, gramicidin, mupirocin, retapmulin, neomycin, gentamycin

48
Q

Bacitracin and gramicidin

A

peptide abx, ADR- allergic contact dermatitis, urticaria

49
Q

Mupirocin (bactroban)

A

inhibits synthesis, eradication of nasal colonization of MRSA, adr- pruritis, localized burning

50
Q

Retapamulin (Altabax)

A

inhibits protein synthesis, ADR- eczema, pruritus, irritation

51
Q

Neomycin (neo-fradin)

A

aminoglycoside abx, activity against gram -, partial activity against gram +, ADR- allergic contact dermatitis

52
Q

Gentamycin (Garamycin)

A

aminoglycoside abx, activity against gram -, partial activity against gram +, if applied to large SA, detectable serum conc possible, ADR- nephrotoxicity, neurotoxicity (systemic only)

53
Q

OTC fungal infection products, topical

A

terbinafine (Lamisil), clotrimazole (Lotrimin), Ketoconazole (Nizoral), miconazole (Desenex), Tolnaftate (Tinactin), Naftifine (Naftine)

54
Q

OTC fungal infection products, internal

A

niconazole (Monistat), tioconazole (vagistat)

55
Q

Imidazole

A

reduce ergosterol synthesis by inhibiting fungal cytochrome P450, applied once/twice dialy for 2-3 weeks, combo w/ steroid for more rapid symptomatic improvement

56
Q

Allylamines

A

active against dermatophytes, less against yeast, selectively inhibit squalene epixidase, a key enzyme in the synthesis of ergosterol, applied BID

57
Q

Nystatin

A

active against yeast not dermatophytes, binds to ergosterol and forms pires, leading to potassium loss, adicofication and cell death, apply 2-4 times/ day, minimal SE, loca irritation, amphotericin B- yellow skin

58
Q

Dosage of azole derivatives

A

Fluconazole- 100 mg, itraconazole- 200 mg, ketoconazole- 200 mg

59
Q

ADR of azole deriviatives

A

nausea, elevations of hepatitic enzymes, hepatitis

60
Q

Terbinafine (terbinex)

A

alters fungal cell membrane, causing cell death, 250 mg daily for 6 weeks, or 12 weeks for toe infections, ADR- hepatitc infection