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37 Cards in this Set
- Front
- Back
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agents for acne
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ketolytics, abx, retinoids
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agents for verruca
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keratolytic, immunostimulator
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agents for tinea
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antifungal
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agents for tinea versicolor
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antifungal
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serborrheic derm agents
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antifungal, antiinflammatory
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agents for atopic derm/ dermatitis
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antiinflammatory
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agents for psoriasis
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anti-inflammatory, anti-proliferative
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agents for rosacea
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anti-inflammatory
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list the keratolytics
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salicylic acid
benzoyl peroxide |
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how does salicylic acid work?
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reduction of corneocyte adhesion- unroof pustules and let skin heal below
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forms of salicylic acid
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wash, gel, plaster (zinc oxide)
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benzoyl peroxide forms, dosages
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wash, lotion, cream, gel
2.5%-10% |
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benzoyl peroxide which are more active?
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gels. water-based gels are less irritating
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pearls about benzoyl peroxide
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5% absorbed through skin
metabolized to benzoic acid in skin rapid systemic renal clearance => no drug accumulation/toxicity used for acne, foliculotis |
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benzoyl peroxide activity/ mechanism
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broad spectrum bactericidial agent
oxidizing activity inhibits triglyceride hydrolysis, dec inflammation, keratolytic, comedolytic enhanced activity in combo with clindamycin or erythromycin may oxidize tretinoin if applied together |
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benzoyl peroxide AEs
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irritant dermatitis, burning, peeling, erythema, dryness
contact allergy |
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clindamycin
-deriviative of: -forms: -___ systemically absorbed |
der. of lincomycin (streptomyces)
alcohol solution, lotion, gel lotion is less irritating, less drying 4-5% systemically absorbed |
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clindamycin-activity
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bactericidal/static
broad spectrum- aerobic gram (+) and anaerobic gram (+)/(-) irreversible binding of the bacterial 50s ribosome subunit inhibits bact protein synthesis |
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clindamycin- AEs
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local reactions due to vehiclie
pseudomembranous colitis |
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erythromycin-
-forms -mechanism -type of bacteria |
macrolide abx- S. erythraeus
alcohol soln, gel, ointment bactericidial binds 50s ribosomal subunit preventing protein synthesis gram (+) bact |
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metronidazole
-type -mechanism -formulations -which bact used commonly for what? |
synthetic nitroimidazole abx
DNA disruption, inhibition of nucleic acid synthesis gel/cream gram (+)/(-) + anaerobes used more commonly for rosacea |
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3 retinoids
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tretinoin
adapalene tazarotene |
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tretinoin
MOA therapeutic effect AEs |
-gene transcription affects growth and differentiation; normalizes follicular epithelial differentiation
-comedolysis -irritation, erythemia, desquamation |
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Adapalene
-MOA -therapeutic effect -AEs |
-normalizes differentiation of follicular epithelial cells
comedolysis- unroof keratin top -irritation, erythema, desquamation, pruritis, burning |
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tazarotene
-MOA -therapeutic effect |
-blocks induction of ornithidine decarboxylase with less cell proliferation, suppresses MRPB- psoriasis inflammation, inhibitis corneocyte accumulation in skin
-comedolysis, normalization of differentiation and proliferation of epidermal keratinocytes in psoriasis |
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imiquimod
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immunoenhancing drug
binds toll 7 receptor potent inducer of cytokines antiviral, antitumor activity negligible systemic absorption |
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4 anti-inflammatory drugs
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corticosteroids
calcineurin inhibitors vitamin D Analogs antibiotics |
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topical corticosteroids
-potency determined by ____ -formulations |
-potency determined by vasoconstrictor assay
-correlates well with clinical efficacy -reproducibile -gel, alcohol solution, cream, ointment, foam, shampoo |
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corticosteroid MOA
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-diffuses into cell and binds GCR in cytoplasm
-corticosteroid-GCR complex undergoes conformational changes -active complex traverses into nucleus and binds to DNA -gene regulation and transcription of specific mRNA -GCR found in almost all mammalian cells |
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corticosteroid antiinflammatory effects
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-affects every aspect of cutaneous inflammation
-inflammatory cells -chemical mediators -tissue responses |
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corticosteroid AEs
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irreversible thinning of skin
thick striae systemic: suppression of HPA axis, Cushing's syndrome, growth retardation local: epidermal atrophy, rebound, tachyphylaxis, perioral dermatitis occular cataract, narrow angle glaucoma |
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corticosteroids: antiproliferative and atrophogenic
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reduction of epidermal mitotic activity: flattening of basal layer, thinning of stratum corneum, keratinocyte ultrastructure
inhibition of fibroblast proliferation, migration, chemotaxis, protein synthesis- synthesis of glycosaminoglycans and collagen inhibited, late: reduction of elastin and collagen fibers |
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tacrolimus/pimecrolimus
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macrolide lactone
no alteration of collagen synthesis no atrophy direct effect on T lymphocytes- inhibit IL-2 transcription -> reduces responsiveness to foreign antigen with fewer side effects, doesn't work as well. good for maintaining skin, not clearing skin |
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vit D analogs used for
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psoriasis
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what are the two vit D analogs?
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calcipotriene
calcitrol |
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calcipotriene- description
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synthetic analog of calcitriol
binds VDR with same affinity as calcitrol but less active on calcium metabolism |
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Vit D description
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binds VDR to regulate cell growth, differentiation, and immune function
also calcium and phosphorus metabolism VDR belongs to family of nuclear receptors including corticosteroid, and retinoic acid receptors inhibits keratinocyte proliferation and modulates epidermal diffrentiation inhibits production of IL-2, IL-6, IFN-gamma, GM-CSF inhibits cytotoxic and natural killer T cell activity |
