Antihistamines And Topical Steroids

Front 1

The non-cellular, fluid component of the blood, which contains ions and non-cellular molecules.

Back 1

Plasma

Front 2

The non-cellular fluid component of blood that exists after the blood has clotted, essentially including the non-cellular fluid component of blood minus the clotting factors.

Back 2

Serum

Front 3

Those cells that comprise a tissue/organ which do the primary work of that tissue/organ.

Back 3

Parenchyma

Front 4

The support components within a tissue/organ

Back 4

Stroma

Front 5

Hives, welts or wheals that are the result of an episodic inflammatory/allergic reaction in a localized area of skin.

Back 5

Urticaria

Front 6

_____________urticaria lasts less than 6 weeks. _____________Urticaria lasts more than 6 weeks.

Back 6

Acute, chronic

Front 7

Urticaria is usually a self limiting condition that resolves in _ to _ days.

Back 7

1 to 7

Front 8

The mainstay of treatment for urticaria is _____________.

Back 8

Antihistamines

Front 9

The most common pathway for urticaria is _____________ activation and _____________.

Back 9

Mast cell, degranulation

Front 10

Mast cells primarily release _____________

Back 10

Histamine

Front 11

Histamine release causes increased vascular _____________, _____________ and _____________. It also constricts bronchial _____________ and leads to _____________.

Back 11

Permeability, vasodilation, itching, smooth muscle, asthma

Front 12

__ receptors are membrane bound histamine receptors found on smooth muscle, CNS and endothelium.

Back 12

H1

Front 13

In urticaria, the H1 receptor stimulates the _____________ vessels and surrounding tissue, causing capillary _____________ with _____________ of fluid, which causes _____________ and pruritis.

Back 13

Dermal, vasodilation, extravasation, wheals

Front 14

Histamine is a _____________ mediator of itch perception.

Back 14

Peripheral

Front 15

Pruritis is mediated through unmyelinated _____________.

Back 15

C fibers

Front 16

Antihistamines are _____________antagonists.

Back 16

H1 receptor

Front 17

Antihistamines have 3 distinct properties:

Back 17

Antihistaminic, anticholinergic, sedative

Front 18

_____________ effect results in a drying effect of nasal, salivary and lacrimal gland secretions (runny nose, tearing, and itching eyes)

Back 18

Anticholinergic

Front 19

_____________ generation antihistamines are older and work both peripherally and centrally. They are _____________, which allows them to penetrate the CNS.

Back 19

First, lipid soluble

Front 20

_____________ generation antihistamines have a sedative effect, while _____________ generations do not.

Back 20

First, second

Front 21

Diphenhydramine, chlorpheniramine, hydroxyzine, meclizine, dimenhydrinate, and promethazine are examples of _____________.

Back 21

First generation antihistamines

Front 22

_____________ can be used orally, topically or parenterally. They are useful for treating poison oak, ivy and sumac.

Back 22

Diphenhydramine

Front 23

Second generation antihistamines were developed to avoid unwanted side effects such as _____________. They are less _____________, and don't readily cross the _____________.

Back 23

Sedation, lipophilic, BBB.

Front 24

Which generation of antihistamines has a longer duration of action?

Back 24

Second

Front 25

Which generation of antihistamine only acts peripherally?

Back 25

Second

Front 26

Fexofenadine, loratadine, desloratadine, cetirizine, levocetrizine, azelastine, and olopatadine are examples of _____________generation antihistamines.

Back 26

Second

Front 27

the most common side effect associated with first generation antihistamines is _____________

Back 27

Sedation/drowsieness

Front 28

A potential benefit of sedation induced by first generation antihistamines is that it may decrease the _____________ perception, which can help patients _____________.

Back 28

Central itch, sleep

Front 29

Steroids act as _____________ agents by suppressing the production of _____________, _____________ and _____________, decreasing the release of _____________ mediators, stabilizing _____________ membranes to prevent enzyme release from neutrophils, and cause _____________ and decrease _____________ permeability.

Back 29

Antiinflammatory, cytokines, leukotrienes, prostaglandins, inflammatory, lysosomal, vasoconstriction, capillary

Front 30

A 43 year old male presents with a buffalo hump, hypertension and hyperglycemia. Further investigation reveals thinning of the skin, easy bruising, increased abdominal fat and a moon face with red cheeks. What drug has this man been using in excess?

Back 30

Steroids

Front 31

Steroids are the mainstay of treatment for _____________ and _____________ dermatitis, _____________ and _____________.

Back 31

Atopic, contact, psoriasis, eczema

Front 32

All topical steroids have the same antiinflammatory properties; they only differ in _____________ and _____________.

Back 32

Strength, preparation

Front 33

The antiinflammatory properties of steroids is due, in part, to the _____________ of small blood vessels in the upper dermis. This property is used to determine the strength or potency of a steroid.

Back 33

Vasoconstriction

Front 34

There are _ steroid "classes" that are divided into _ general groups. Class _ is the strongest, and Class _ is the weakest. Strength of the steroid depends on the _____________ type.

Back 34

7, 4, 1, 7, preparation

Front 35

The classes of steroids are divided into the following general groups:

Back 35

Group 1 = Class 1
Group 2 = Class 2 and 3
Group 3 = Class 4 and 5
Group 4 = Class 6 and 7

Front 36

Clobetasol is a class _ steroid. It has _____________ potency

Back 36

1, super high

Front 37

Betamethasone, fluocinonide, and triamcinolone are examples of class __ steroids, which have _____________ potency.

Back 37

2 and 3, high

Front 38

triamcinolone and hydrocortisone are examples of class __ steroids, which have_____________ potency.

Back 38

4 and 5, medium

Front 39

Betamethasone, triamcinolone and hydrocortisone are examples of class _ steroids, which have _____________potency.

Back 39

6 and 7, low

Front 40

Class 1 steroids are used for severe _____________ over _____________/_____________ areas, such as psoriasis, severe atopic dermatitis, severe contact dermatitis. It is especially useful over the _____________ and _____________, which tend to resist topical steroid penetration due to the thick stratum corneum

Back 40

Dermatoses, nonfacial/nonintertriginous, palms, soles

Front 41

Super high potency steroids may cause _____________ when used in children, over extensive skin surfaces or for long periods of time.

Back 41

Adrenal suppression

Front 42

Super high potency steroids should not be used on the _____________, _____________, _____________ or under _____________, except in rare situations and for short periods of time.

Back 42

Face, groin, axilla, occlusion

Front 43

Thin skinned, sensitive areas such as the axillae, groin, perianal region, breast folds and face should be treated with a _____________ potency steroid.

Back 43

Low

Front 44

Medium to high potency topical steroids are appropriate for mild to moderate _____________/_____________ dermatoses.

Back 44

Non-facial, non-intertriginous

Front 45

_____________ potency topical steroids are appropriate for the trunk, arms and legs, especially when large areas are to be treated.

Back 45

Low to medium

Front 46

The axillae, groin, breast folds, face and scalp are areas of _____________ penetration.

Back 46

High

Front 47

The limbs and trunk are areas of _____________ penetration.

Back 47

Medium

Front 48

The palms, soles, elbows and knees are areas of _____________ penetration.

Back 48

Low

Front 49

The more _____________ the vehicle for the steroid, the better the penetration.

Back 49

Lipophilic

Front 50

Lotions and creams are for _____________ lesions.

Back 50

Exudative

Front 51

Sprays and gels are for _____________ regions.

Back 51

Hairy

Front 52

Ointments are for _____________ lesions

Back 52

Chronic scaly

Front 53

The sudden/acute decrease in effectiveness of a drug following administration. This is a side effect of topical steroids use, where the skin develops tolerance to the vasoconstrictive action of topical steroids.

Back 53

Tachyphylaxis

Front 54

When using topical steroids, you must always look for signs of _____________ absorption.

Back 54

Systemic

Front 55

All agents can cause skin atrophy, striae, and acneiform eruptions when used for _____________.

Back 55

More than one month

Front 56

_____________ and reaction to _____________ and _____________ is also common with prolonged use of topical steroids.

Back 56

Contact dermatitis, preservatives, additives.

Front 57

Atrophy of the skin following prolonged use of topical steroids is reversible/irreversible.

Back 57

Reversible, but only after many months

Front 58

Striae is another word for _____________.

Back 58

Stretch marks

Front 59

Repeated use of topical steroids in intertriginous areas can result in _____________, which are reversible/irreversible.

Back 59

Striae, irreversible

Front 60

Prominence of underlying veins

Back 60

Telangiectasia

Front 61

_____________ can result from the overuse of mild topical steroids to combat facial redness. Over time, _____________ develops, resulting in the usage of a higher strength steroid. When the steroid is discontinued, _____________ facial redness and _____________ can occur.

Back 61

Rosacea, tolerance, intense, pusutles

Front 62

_____________, denoted by pustules and erythema, can occur shortly following several courses of a group III steroid to the lower face.

Back 62

Perioral dermatitis

Front 63

Symptoms of systemic absorption of topical steroids include _____________, fatigue, _____________, nausea and _____________. It may also cause _____________ like effects.

Back 63

Weakness, anorexia, fever, Cushing's syndrome

Front 64

_____________ and some creams are less irritating than gels because they don't contain _____________ or _____________.

Back 64

Ointments, preservatives, emulsifiers

Front 65

Ointments primarily consist of greases such as _____________ with little or no _____________.

Back 65

Petroleum jelly, water

Front 66

Ointments are _____________, which means they prevent water evaporation.

Back 66

Occlusive

Front 67

Hydration of the skin due to sweat accumulation is the _____________effect.

Back 67

Emollient

Front 68

_____________ are semi-solid emulsions of oil and water that may be used in nearly any area.

Back 68

Creams

Front 69

Creams are useful in exudative inflammation because of _____________ effect.

Back 69

Drying

Front 70

Creams are most useful in _____________ such as the groin, rectal area and axilla.

Back 70

Intertriginous

Front 71

_____________are greaseless mixtures of propylene glycol and water, perhaps some alcohol. They are useful for acute exudative inflammations like _____________.

Back 71

Gels, poison ivy

Front 72

Gels are useful in delivering medications to _____________ areas and for treating _____________.

Back 72

Hair bearing, acne

Front 73

The least potent topical therapies are _____________ and _____________.

Back 73

Solutions and lotions

Front 74

Solutions and lotions are useful for treating_____________ dermatoses and/or _____________. They cool and dry acute _____________ and _____________ lesions such as contact dermatitis, tinea pedis and tinea cruris.

Back 74

Most, acute inflammatory, exudative.