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80 Cards in this Set
- Front
- Back
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Dermatologic Problem:
Infectious: Bacterial |
impetigo, folliculitis, vulgaris
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Dermatologic Problem:
Infectious:Fungal |
tina unguium/capitis/cruris/pedis; candidiasis monilia diaper rash
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Dermatologic Problem:
Infectious:Viral |
condylomata, herpes simplex/zoster
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Dermatologic Problem:
Non-infectious: Allergic |
Eczema, pururitus, urticaria, atopic dermatiti, contact dermatitis, diaper dermatitis, drug reactions
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Dermatologic Problem:
Non-infectious: Trauma |
insect, animal or human bites, wounds sunburn
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Dermatologic Problem:
Non-infectious: |
psoriasis, Basal cell ca, actinic keratoses, warts
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Which drug classes are used for non-infectious skin conditions?
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Steroids: decrease inflammation and pruritus
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How long of treatment is needed for Acne?
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6 weeks to turn over
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What is the first line treatment for Acne?
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Topical benzoyl peroxide
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What is 2nd line treatment for Acne?
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oral or topical antibiotics such as
tetracyclines or clindamycin |
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Which is more a more potent steriod - Fluorinated or non-fluorinated?
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Fluorinated
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Which diseases need high potency steriods?
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psoriasis, vitiligo and lupus
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What vehicle is used if drying is wanted?
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gels or lotions
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What vehicle is used if moisture is needed?
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creams or ointments
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What are big NO's when using steriod creams?
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1) do not occlusive dressings
2) do not put on face, groin or axillae |
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How do topical steriods affect children?
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Can cause adrenal problems - monitor adrenal fx
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What caution should be given to long term topical steriod users?
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Avoid abrupt discontinuation
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Benzoyl Peroxide: Action
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antibacterial
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Benzoyl Peroxide:Contra-indication
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external use only; d/c if rash
develops |
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Benzoyl Peroxide: Pharmacokinetics:
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no systemic absorption
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Benzoyl Peroxide:Common Side Effects:
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excessive drying, peeling,
inflammation, swelling, dermatitis |
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Benzoyl Peroxide:Serious side effects
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excessive scaling,
erythema/edema |
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Benzoyl Peroxide: Pregnancy Category
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C
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Tretinoin (Retin-A): Action:
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increases skin turnover
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Tretinoin (Retin-A):Contra-indication
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hypersensitivity
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Tretinoin (Retin-A): Pharmacokinetics
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metabolized by skin; excreted in
urine/feces |
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Tretinoin (Retin-A):Common Side Effects:
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skin irritation
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Tretinoin (Retin-A): Serious Adverse Effects:
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contact allergy (rare), inflamed,
swollen, blistered, or crusted skin, pigment changes, photosensitivity |
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Tretinoin (Retin-A): Pregnancy: Cat
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C - not reccommended for pregnant women
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When should Isotretinoin or Accutane be prescribed?
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for unresponsive acne
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Isotretinoin (Accutane):Action
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Unknown
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Isotretinoin (Accutane):Contraindications
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hypersensitivity
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Isotretinoin (Accutane):Precautions
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HA - intracranial; HTN
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Isotretinoin (Accutane):Pharmacokinetics:
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metabolized in the liver; 99% protein bound;
excreted in urine & bile |
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Isotretinoin (Accutane): Common side effects:
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dried mucous membranes, nosebleeds, cheilitis,
hand/foot peeling, dry eyes, dry mouth, N/V, abdominal pain, anorexia, weight loss, gum inflammation |
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Isotretinoin (Accutane): Serious Adverse Effects
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CNS effects; fatigue, headache, visual
disturbances, mild to moderate MS s/s |
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Isotretinoin (Accutane): Pregnancy: Cat
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X - known teratrogenic
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True or False - Patient needs to be enrolled in an education program prior to treatment with this drug?
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True
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Drugs that interact with Isotretinoin
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Vitamin A (retinoic Acid) Beta carotene OK
Tetracyclines (doxy & minocycline also - increases cranial pressrue and causes HA and blurred vision |
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What 4 things need to be monitored with pts taking Accutane?
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1) pregnancy test
2) Lipids - choles & trigl 3) Liver Fx tests 4) CBC, anemia, WBC & platlets |
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True or False? OCP (oral contraceptives) will not affect acne.
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False - most OCP will improve acne - Estrostep and ortho-tricyclen treat acne
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How long should pt stay on OCP to see improvement?
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6 months
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What topical antibiotics work for Acne?
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erythromycin, clindamycin, tetracycline can be combined with zinc, tretinoin or benzoyl peroxide
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What is mechanism of action for topical antibiotics?
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inhibition of inflammation caused by bacteria rather
than a direct bactericidal effect |
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What is biggest problem with use of topical antibiotics for acne?
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risk of
development of resistant strains of Propionibacterium acnes |
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Topical acne treatments forms of delivery?
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creams, ointments, powders, and sprays
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What should topical antibiotics be used on?
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minor cuts, scrapes, and burns
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What should topical antibiotics not be used on?
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large areas of skin or on open wounds
children under 2 years old |
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Can a topical antibiotic be used to treat an infection preexsiting in a wound?
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No - does not work well here, but it should be used only to
prevent infection in a fresh wound |
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Can a topical antibiotic ointment be used on a diaper rash?
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Should not be used to treat diaper rash in infants or incontinence
rash in adults |
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What are common side effects of topical antibiotics?
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itching or burning
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What side effects are serious and a providers should be notified for topical antibiotics?
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rash
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Should topical antibiotic creams and hydrocortisone creams be used together?
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No using certain topical antibiotics at the same
time as hydrocortisone may mask signs of infection or allergic reaction |
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Acne Rosacea: Treatment
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metronidazole (Flagyl) - topical or oral
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Urticaria: Treatment
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Varies with cause - minor antihistamine
Chronic: need allergy or dermatology referral |
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Bacterial Infections:Localized: Treatment
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Neomycin (cortisporin) can develop a sensitivity to this
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Bacterial Infections: Impetigo: Treatment
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Bacitracin or Bactroban (mupirocin which is bacteriocidal) if only few lesions
If spreading needs oral agent as well |
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Viral Infections: HSV1 Treatment
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Acyclovir (Zovirax)
Abreva (docosanol) |
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Burns - 1st & 2nd degree
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Silver sulfadiazine - cools & antimicrobial properties
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How do you treat a burn with Silver sulfadiazine on it?
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Use non-adherent dressings to decrease risk of infections
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How do you treat a sunburn?
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Just like any other 1st or 2nd degree burn
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When do you refer a burn?
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2nd degree over large portion of body or any 3rd degree burn
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Conjunctivitis: bacterial: Treatment
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antibacterial opthalmic drops or
ointments containing a quinolone antibiotic, tobramycin, sulfacetamide or erythromycin |
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What is a serious condition that can occur with Gonococcal ophthalmia?
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blindness or serious
damage to the eyes |
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What else can be seen with infants with Chlamydial conjunctivitis?
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chlamydial pneumonia
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What ophthalmic ointment should be used on all newborns within 2 hours of birth?
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Silver
Nitrate (AgNo3) or erythromycin 0.5% (Ilotycin) opthalmic ointment as prophylaxis |
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Allergic Conjunctivitis: Treatment
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1) mast cell stabilizers (cromolyn or nedocromil),
decongestant, prednisolone,or antihistamine drops 2) oral antihistaines |
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Dry Eyes: Treatment
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Hypotears or Muro
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Glaucoma: Treatment
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decrease ocular pressure or decrease aqueous humor
production, or allow for better outflow |
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Glaucoma Treatment: drugs
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Carbonic anhydrase inhibitor drops 2) Beta blocker drops: primarily for open angle glaucoma for both initial
and maintenance therapy to reduce intraoccular pressure 3) Miotic drops (makes pupils restrict |
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What are side effects of Beta blocker drops for glaucoma?
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Can cause stinging, conjunctivitis, blurred vision, photophobia, & dry eyes
Can cause systemic effects on heart and lungs |
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What is most common drop used for Glaucoma?
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Timoptic (timolol) decreases aqueous humor
production Isopto-carpine, miotic drops |
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Otitis Externa: Treatment
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Topical antibiotic most common - Corticosporin reduces inflammation & treats infection
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What cautions should be watched for when using corticosporin drops?
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Caution use with perforated eardrum
Watch for oto or nephrotoxicity in prolonged use; also problematic due to ~ 15% of pts having localized reactions |
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What is Floxin otic (Ofloxacin used for?
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both otitis externa & otitis media: not ototoxic
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Acute Otitis Externa: Treatment
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Oral antibacterial drugs needed if infection
extends to the pinna - Cipro in adults and Keflex in children |
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What serious side effect is seen in children taking Cipro (ciprofloxacin)?
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tendon rupture - do not give to pt under 18
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What is a common otic analgesic?
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Auralgan: combination of benzocaine and
antipyrine - do not use if chance of tympanic perforation |
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Cerumenosis: Treatment
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May be softened with cerumenolytic OTC
solution such as Cerumenex |
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True or False? topical application of meds can
lead to systemic side effects |
True
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