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11 Cards in this Set

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What is the most common question for which minocycline is the answer?
Best oral antibiotic for severe acne that is not controlled by topical antibiotics or topical vitamin A derivatives, such as tretinoin. Other indications:
Nocardia
Actinomycoses
Rosacea
How does minocycline work?
Minocycline is a tetracycline antibiotic that inhibits protein production in bacteria.
What are the most common adverse effects of minocycline?
Minocycline can cause bluish discoloration of the skin but does not cause a photosensitivity rash as doxycycline can cause. Minocycline can bring on vertigo by causing vestibular dysfunction.
A woman comes in with mild acne. She has a few comedones with an occasional inflamed papule or pustule.
What is the treatment?
How does it work?
What are the adverse effects?
Mild disease is treated with topical benzoyl peroxide and a topical antibiotic, such as erythromycin or clindamycin. Benzoyl peroxide is both antibacterial and comedolytic. Topical antibiotics will eliminate the causative organism Propionibacterium acnes from the comedones.
A man has failed initial therapy for acne and has numerous papules and pustules with mild scarring.
What is the treatment?
How does it work?
What are the adverse effects?
Moderate to severe acne resulting in scarring. In addition to benzoyl peroxide, the patient should be treated with a topical vitamin A derivative (tretinoin). An oral antibiotic, such as minocycline should be used.
Your patient is very distressed and depressed because of numerous large cysts on the face, neck, and trunk. He is severely scarred.
What is the treatment?
How does it work?
What are the adverse effects?
Severe cystic acne. An oral antibiotic and oral vitamin A (isotretinoin) are needed. Isotretinoin will decrease sebum production but is extremely teratogenic and can cause severe depression, dry skin, and hyperlipidemia.
An adolescent boy comes to see you for treatment of a long-standing itchy, eczematous rash on his face, hands, and feet in the flexural areas. The skin is lichenified from scratching. He also has seasonal rhinitis and occasional urticaria.
What is the best therapy to treat the itching?
Atopic dermatitis is treated with antihistamines, such as fexofenadine, cetirazine, or loratadine. Hydroxyzine and diphenhydramine are more potent but much more sedating. Doxypine is a tricyclic with extensive antihistamine effects.
An adolescent boy comes to see you for treatment of a long-standing itchy, eczematous rash on his face, hands, and feet in the flexural areas. The skin is lichenified from scratching. He also has seasonal rhinitis and occasional urticaria.
What is the best long-term therapy?
Atopic dermatitis symptoms can be lessened in the long term by moisturizing the skin, avoiding harsh soaps, and treating skin infections. Although topical steroids are effective to control symptoms acutely, in the long term, they lead to skin atrophy. topical calcineurin inhibitors, such as tacrolimus and pimecrolimus, can control atopic dermatitis in the long term without using steroids.
An adolescent boy comes to see you for treatment of a long-standing itchy, eczematous rash on his face, hands, and feet in the flexural areas. The skin is lichenified from scratching. He also has seasonal rhinitis and occasional urticaria.
What are the other indications for his therapy?
Antihistamines, such as fexofenadine, are also used for the following conditions:
Allergic/seasonal rhinitis
Angioedema
Urticaria
A woman comes to the office for pruritic, silvery, scaly lesions of the knees, elbows, and hands. The lesions are on the extensor surfaces.
What is the best therapy for localized disease of this type?
Localized psoriasis is treated with topical steroids. To prevent skin atroophy, treatment with calcipotriene, a vitamin D analog, should be used. Topical tazarotene, a vitamin A analog, is also used. Tacrolimus and pimecrolimus are used as well to control the disease.
A woman comes to the office for pruritic, silvery, scaly lesions of the knees, elbows, and hands. The lesions are on the extensor surfaces.
What is the best therapy for extensive disease of this type?
Widespread disease is treated with UV light. The most effective systemic therapy is methotrexate, but it also has the most adverse effects. Biological agents, such as etanercept, alefacept, and efalizumab, are used as alternatives to methotrexate.