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94 Cards in this Set
- Front
- Back
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Which of the following is the primary barrier to penetration of a chemical?
- stratum corneum - basement membrane at the dermoepidermal junction - lipid barrier in the capillary walls, between the epidermis and the blood stream |
stratum corneum:
- keratinaceous bricks - lipid mortar |
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Skin of which of the following region has the highest hydrocortisone penetration ratio? the lowest?
- palm - ventral arm - back - scalp - axilla - forehead - scrotum |
scrotum > forehead > axilla > scalp > back > ventral forearm > palm
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Classification of the skin type depend on which layers of the skin?
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- stratum corneum
- epidermis |
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Which area of skin is the thickest?
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back
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Which area of the skin has the thickest stratum corneum?
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Thick skin: palms and soles
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According to Fick's Law, the flux is driectly dependent on which of the following factors?
- concentration gradient - chemical characteristics - thickness of skin - surface area exposed |
all except the thickness of skin
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Chemicals possess which types of properties penetrate the skin best?
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Those with some lipid solubility and some water solubility.
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What properties help chemical cross skin barriers?
- molecular size - charge - solubility |
- small size
- noncharged - mixed lipid and water solubility |
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Topical drugs with half lives of just several hours only need to be applied once daily. Why?
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Skin's reservoir function:
- affinity, binding of chemicals (Km, partition coefficient) |
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What phases of chemical metabolism take place in the skin?
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Same spectrum as liver
Phase I: oxidation, reduction Phase II: conjugation |
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In which layers of skin does phase I and II drug metabolism take plase?
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- mainly in the epidermis
- also in dermis and hair follicles |
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T/F: Skin metabolism of drugs is highly inducible.
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T. have some first pass effect, but not as much as in liver.
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How does temperature affect skin metabolism of chemicals?
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heat can excercise can skin blood flow which faciliates chemical absorption.
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How does vehicle affect chemical absorption through skin?
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- solubility of chemical in vehicle: slightly acqueous vehicle better
- rate of release - hydration of stratum corneum - interaction of chemical and vehicle (ie DMSO) |
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How does skin metabolism of chemicals facilitate its rate of penetration through skin?
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formation of water soluble metabolites which can be easily cleared.
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What material faciliate drug absorption through skin by increase hydration of the skin?
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- emollients: improve barrier property to water (decrease water loss.
- humectants: attract water to the skin |
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Give an example of an emollient.
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prevent water loss to help chemical absorption
- petrolatum |
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Give an example of an humectant.
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attract water to help chemical absorption
- propylene glycol (glycerol) - aloe |
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What are emollients and creams most useful for?
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chronically irritated skin with scaling and lichification
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What are lotions, powders, and tinctures most useful for?
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acutely irritated, oozing and vesiculated skin
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What skin preparation is this?
soften skin by forming an occlusive oil film |
emollients: alpha-keri, ureacin cream, lac-hydrin
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What skin preparation are these?
alpha-keri, ureacin cream, lac-hydrin |
emollients: soften skin by forming an occlusive oil film
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What skin preparation is this?
a semisolid preparation in an oil base that may provide better penetration than a cream and may cause less irritation to sensitive skin. |
ointments
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What skin preparation is this?
a semisolid emulsion frequently in propylene glycol or isopropyl alcohol. |
Gels
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What skin preparation is this?
gauze or a towel containing a lotion or cream. |
wet dressing
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What skin preparation is this?
an oil in water emulsion |
cream
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What skin preparation is this?
solution of powder in water |
lotion
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What skin preparation is this?
a solid or liquid colloid where the media is gas |
aerosol
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What skin preparation is this?
a simple mixture made from wetting a powder |
pastes
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What skin preparation is this?
aggregation of small solid particles |
powders
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What skin preparation is this?
alcoholic solution |
tincture
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How much skin surface does 2grams of topical drug cover?
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- head or
- face or - two hands |
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How much topical drug does it take to cover the whole body?
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30 grams
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How much topical drug does it take to cover one arm or one side of the trunk?
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3 grams
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Where is the priming dose located in a transdermal patch?
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adhesive layer
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What is the name of the transdermal patch for motion sickness? Side effects?
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- Scopolamine: first patch approved.
- few side effects |
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What is the name of the transdermal patch for angina? Side effects?
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- nitroglycerin: source of nitric oxide.
- side effect: tolerance if left on for 24 hrs. Apply in the morning for 12-16 hrs |
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What is the name of the transdermal patch for HTN? Side effects?
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- Clonidine (Catapres_TTS): alpha2 agonist.
- side effect: immune response in the skin |
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What is the name of the transdermal patch for surgical menopause? Side effects?
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- Estradiol: many different patches
Climara vivelle Estraderm Alora Esclim |
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What is the name of the transdermal patch for menopause? Side effects?
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Estradiol/progesterone (Combipatch), estraiol/norethindrone: may reduce uterine cancer risk
change twice a week |
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What is the name of the transdermal patch for contraception? Side effects?
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- Progestin/estrogen (ortho vera), norelgestromin/ethinyl estradiol: replaced weekly
- side effects: blood clots and stroke |
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What is the name of the transdermal patch for post operative pain? Side effects?
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- Fentanyl (Duragesic, actiq): binds opiate receptor in CNS.
- overdose: heart attack, respiratory problems |
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What is the name of the transdermal patch for smoking cessation? Side effects?
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Nicotine, requires additional motivation, delivers for 16-24 hrs.
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What is the name of the transdermal patch for potency? Side effects?
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Testosterone: avoids first pass, applied to scrotum or back
Testoderm Androderm Intrinsa |
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What is the name of the transdermal patch for postherpetic neuralgia from herpes zoster? Side effects?
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Lidocaine (Lidoderm): local effect
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What is the name of the transdermal patch for overreactive bladder? Side effects?
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- Oxybutynin (oxytrol): antispasmodic, antocholinergic. Good for 3-4 days
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What is the name of the transdermal patch for ADHD? Side effects?
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- methylphenidate (Daytrana): apply to alternating hips for 9 hrs.
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What is the name of the transdermal patch for major depression? Side effects?
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- selegiline (EMSAM): MAOI, avoid dietary restrictions at lowest dose.
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What is the name of the transdermal patch for early Parkinsons? Side effects?
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- Rotigotine (Neupro): DA agonist
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What is the name of the transdermal patch for mild dementia? Side effects?
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- Rivastigmine (Exelon)
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Name a topical antibacterial against gram + and most anaerobic organisms. Side effects?
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- bacitracin: interfere with cell wall
- urticaria, resistance, sensitization or rare nephrotoxicity, compromised skin barrier |
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Name a topical antibacterial against gram - organisms. Side effects?
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- Polymyxin B: membrane phospholipids and increases permeability.
- neurotoxicity, nephrotoxicity |
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Name a topical antifungal for vaginal or cutaneous candiadiasis, and superficial fungal infections. Side effects?
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- Miconazole: interferes with fungal membrane (P450 enzyme)
- side effects: irritation, pruritis |
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Name a topical antiviral for herpes viruses. Side effects?
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- Acyclovir: guanine derivative that interferes with viral DNA replication
- side effect: mild pruritis, mild pain |
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Name a topical ectoparasiticide for scabies(cream) amd lice infections(shampoo). Side effects?
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- Lindane: absorbed through exoskeleton of parasites causing CNS stimulation and death.
- neurotoxicity in infants |
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Name a topical corticosteroid for atopic dermatitis, seborrheic dermatitis, irritant and allergic reactions. Side effects?
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- hydrocortisone: inhibit synthesis of mediators of inflammation, vasoconstriction.
- side effects: minimal itching or burning |
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Name a topical keratolytics for acne vulgaris, psoriasis, seborrheic dematitis, verruca vulgaris. Side effects?
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- salicylic acid: desquamation of horny layer
- side effect: irritation |
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Name a topical keratolytics for actinic keratosis, superficial basal cell carcinoma. Side effects?
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- 5-fluorouracil: interfere with DNA synthesis (thymidylate synthase)
- side effets: photosensitivity,swelling, irritation. |
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Name a topical immune response modifier for warts and superficial basal cell carcinoma. Side effects?
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- Imiqiomod: induces interferon
- side effects: none |
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Name two topical drug that treats superficial BCC.
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1. 5-fluorouracil (keratolytics): also for AK
2. imiquimod (immune response modifier): also for warts. |
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Name the topical drug that can treat both AK and superficial BCC.
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5-flurouracil
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Name the topical drug that can treat both warts and superficial BCC.
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imiquimod
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Name a topical antipuritic agent for atopic dermatitis, eczema, lichen simplex chronicus. Side effects?
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- Doxepin cream
- side effects: burning/stinging |
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Name a topical hair growth agent for allopecia. Side effects?
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- Minoxidil(Rogaine): activate hair follicle directly, stimulate microcirculation(K+pump)
- side effects: headache, scalp irritation |
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What is the difference in classification of cosmeceuticals and OTC?
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cosmeceuticals: no claim of function
OTC: must list active ingredients, claim of function |
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What are the active ingredients of cosmetics?
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1. Hormone
- estrogen - prgesterone: now used for bone loss, baldness, arthritis, migraines 2. exfoliants - alpha hydroxy (fruit, dairy products): glycolic, lactic, citric, tartaric, maleic acids - beta hydroxy: salicylic acid 3. free radical scavengers (vitamine derivatives/ antioxidants) - vit A,C,D,E derivatives - lycopene (tomatoes) - aplpha lipoic acid - Retin A (tretinoin) - retinol |
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What is the active ingredient in eyelash conditioner?
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prostaglandins (side effects from glaucoma medicine)
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Which of the following has the largest surface area?
- lung - GI - skin |
GI
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Which of the following has the thinest barraier thickness?
- lung - GI - skin |
lung
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Which of the following has the highest blood flow rate?
- lung - GI - skin |
lung
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Which of the following is the most likely occupational toxin exposure route?
- vapors - immersion - aerosol - splash - contaminated surface - contaminated clothing |
- splash
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What are some environmental toxin exposure route?
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- soil
- foliage - suface water |
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What are some household toxin exposure route?
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- household products
- showing, bathing, handwashing in contaminated water. |
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Local toxicity can cause what types of skin problems?
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- irritant contact dermatitis
- allergic contact dermatitis - corrosion: pH - cancer: hydrocarbons, coal tar, creosote for animals. |
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What is the most common occupational skin disease?
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irritant contact dermatitis
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Does irritant contact dermatitis involve an immune response?
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No.
- PMN migration - epidermal necrosis - dermal inflammation |
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Differences between ICD and ACD.
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ICD
- affect everyone - no immune response ACD - does not affect everyone - immune response (type IV hypersensitivity): induction and elicidation. - heredity and hapten formation required |
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What are some sensitizing agents that cause ACD?
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- antibiotics
- antihistamines - para-amino compounds - rubber/latex - glucocorticoids - metals - plants |
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What chemicals can cause skin cancer in humans?
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none found so far!
only some for animals: creosote, coal tar, hydrocarbons, PAHs. |
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What are some chemicals that cause systemic toxicity through skin?
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- pesticides (more in developing countries)
- acids - dichlorophenol - dimethyl mercury - chemical warfare agents - phenols - hexochlorophene - salicylic acid - agents that cause cancer: benzidine, arsenic. |
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Name 2 acids that cause systemic toxicity.
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- hydrofluoric acid
- monochloroacetic acid |
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What is the effect of dichlorophenol?
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- systemic toxin: uncouples oxidative phosphorylation
- inhaled |
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What is the effect of dimethyl mercury?
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- systemic toxin: penetrates latex and PVC gloves, bind to S-containing amino acids and kills nerve cells.
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Name a systemic toxin that penetrates latex and PVC gloves.
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dimethyl mercury
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What are some chemical warfare agents?
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Nerve agents
- sarin - tabun - soman - VX * all lethal through skin |
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What is the effect of phenol?
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- systemic toxin: was used as antiseptic, may cause death by protein denaturation
- inhaled |
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What is the effect of hexochlorophene?
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- systemic toxin: antibacterial, cause encephalopathy and ulcers in skin.
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What is the effect of salicylic acid?
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- can be toxic when applied to large areas for a long time
- caues nausea, confusion, hallucination. |
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List 2 systemic toxins that cause cancers from skin exposures.
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- benzidine
- arsenic |
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What are the effects of petroleum?
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- CNS depression
- kidney and other cancers - liver lesions - skin irritation |
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What are the effects of solvents?
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- CNS depression
- kidney and liver cancer - leukemia - DNA damage - cardiac arrhythmias |
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What are the effects of inorganic chemicals?
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- variety of cancers
- CNS effects - cholinesterase inhibition - metabolic effects |
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What is green tobacco sickness?
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nicotine poisoning from dermal contact: headache, nausea, dizziness
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What are the effects of TCDD?
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- cause systemic morbidity (as seen in Ukranian president candidate).
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