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84 Cards in this Set
- Front
- Back
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Define keratolytic
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treatment to remove warts and other lesions in which the epidermis produces excess skin
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Define onychomyocsis
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also termed Tinea unguium, means fungal infection of the nails
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Define pemphigus/pemphigoid
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autoimmune disorder that causes blistering and raw sores on skin and mucous membranes
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Define pruritis
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itch
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Define urticaria
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skin condition, commonly caused by an allergic reaction, that is characterized by raised red skin welts
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What is bacitracin used for?
(which bugs) |
gram positive - strep and staph
also neisseriae, tetanus, diphtheria |
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What is Mupirocin used for?
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gram positive organisms
possible for eliminating intranasal MRSA recurrent skin and soft tissue infections surgical prophylaxis |
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Which topical ointment is useful against klebsiella, e. coli and pseudomonas - resistant to proteus and serratia.
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Polymixin B
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What kind of toxicity can occur with increased absorption of Polymixin B?
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Neuro and neurotoxicity
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Name 2 aminoglycosides (topicals)
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neomycin
gentamycin |
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What are the topical aminoglycosides used for?
(neomycin and gentamycin) |
Gram negative bugs
(e.coli, Klebsiella, enterobacter, pseudomonas) some activity against gram positives. |
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What kind of toxicity can occur with topical aminoglycosides?
(neomycin and gentamycin) |
oto and nephrotoxicity
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What is the bacteria that causes acne?
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propionibacterium acnes
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What are side effects of acne medication?
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burning, itching, dry skin
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Name 4 topicals for acne
and one oral |
clindamycin
erythromycin metronidazole sodium sulfacetamide oral - tetracyclines |
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Which topicals have activity against dermatophytes and yeasts?
They inhibit ergosterol in fungal cell walls. |
Azoles
(clotrimazole, ketoconazole, miconazole) |
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What topicals are used for vulvovaginal candidiasis?
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miconazole
clotrimazole |
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Which topicals are used for deratophytosis and candidiasis?
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ketaconazole cream or shampoo
clotrimazole cream |
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Which topical inhibits squalene epoxidase, therefore inhibiting ergosterol synthesis? (2)
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Naftifine and terbinafine
(activity against dermatophytes, less active against yeasts) |
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What can nystatin and amphotericn B be used for topically?
What are they ineffective for? |
candida ablicans
dermatophytes |
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Which drug is given for oral candidiasis - swish and spit?
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nystatin
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Which antifungals are used orally?
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Azoles
(Fluconazole, Itraconazole, Ketoconazole, Voriconazole, Posaconazole) |
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What is an antitrichogenic used for?
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Used to stop hair growth
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What is a trichogenic used for?
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Used to grow hair.
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Which drug was first widely used as an oral antifungal, but has multiple drug interactions and side effects?
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ketoconazole
SE: gynecomastia, increased LFT's, hepatitis |
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Which oral antifungal is the mainstay of azole therapy, per lecture?
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Fluconazole
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Which oral antifungals are used for more serious infections?
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Itraconazole, voriconazole, posaconazole
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Which oral antifungal inhibits fungal cell mitosis, binds keratin, and inhibits fungal invasion?
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Griseofulvin
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Which oral antifungal is active against dermatophytes, ineffective agains candida, and used for tinea infections?
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Griseofulvin
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What are the adverse effects of griseofulvin?
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headache, N/V/D, photosensitivity, neuritis, mental confusion
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What is oral terbinafine used for and what must be monitored?
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Onychomoycosis (nail infection)
LFT's must be monitored |
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Which antivirals are available as topicals?
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acyclovir and penciclovir
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Name 4 antiviral agents
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acyclovir, valacyclovir,
penciclovir, famciclovir |
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Which drug class inhibits viral DNA synthesis (inhibits herpes virus)?
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Antivirals
acyclovir, valacyclovir, penciclovir, famciclovir |
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What is Imiquimod used for?
(3) |
treatment of genetal warts, actinic keratosis, basal cell carcinoma of trunk, neck and extremities
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Which drug stimulates mononuclear cells to release interferon alpha, therefore stimulating production of interleukins and TNF?
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Imiquimod
requires frequent application |
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What kind of immunosuppresants are tacrolimus and pimecrolimus?
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Macrolide
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What are tacrolimus and pimecrolimus used for?
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Atopic dermatitis
short to intermed. duration |
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How do tacrolimus and pimecrolimus work?
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inhibit T-lymhpocyte activity, prevent release of pro-inflammatory substances
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Which drug inhibits sodium influx in parastes causing delayed repolarization, paralysis and death?
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Permethrin
active against pediculus humanus, pthirus pubis, and sarcoptes scabiei (scabies - leave on 8-14 hrs) |
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What drug stimulates nervous system, causing seizure and death to lice?
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Lindane
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What are cautions for use of Lindane?
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Children and pregnant women
SE: neurotoxicity and hematotoxicity it is sulfer and has unpleasant smell and staining of skin |
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What are hydroquinone, monobenzone, and mequinol used for?
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Reduce pigmentation of skin
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What drug inhibits tyrosinase, therefore inhibiting synthesis of melanin?
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hydroquinone, monobenzone, mequinol
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Which drug irriversably depigments skin?
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monobenzone
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What are trioxsalen and methoxsalen used for?
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repigmentation, vitiligo
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Name 3 main compounds in sunscreen.
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p-aminobenzoic acid
benzophenones dibenzoylmethanes |
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Which drug decreases cohesion of epithelial cells and increased epidermal cell turnover.
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Retinoic acid
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What drug is an absolute contraindication to PPI's?
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Colledra
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Which drug is acid from vitamin A?
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Retinoic acid
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How is Retinoic acid metabolized and excreted?
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meta - liver
excreted bile and urine (10% absorbed) |
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Name 2 derivatives of retinoic acid
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adapalene
tazarotene |
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All of these should be used with caution in women of child bearing age
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acne preparations
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Which acne prep is only used for severe cystic acne?
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Isotretinoin (accutane)
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Which drug inhibits sebacceous gland size and function?
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Isotretinoin (accutane)
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How is Isotretinoin taken?
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orally -- well absorbed
(accutane) |
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What are side effects of Isotretinoin?
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dryness, itching, H/A, corneal opacities, pseudotumor cerbri, IBD, anorexia, alopecia, muscle/joint pain, lipid abdnormalities, teratogenic.
(accutane) |
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Which topical drug releases free-radical oxygen, oxidizes bacterial proteins, and inhibits anaerobic growth?
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Benzoyl peroxide
(bleaches fabric) |
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Name 3 drugs for psoriasis
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acitretin
tazarotene calcipotriene |
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What is tazarotene also used for?
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acne (and psoriasis)
modulates differentiation and proliferation of epithelial tissue, anti-inflammatory |
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Which psoriasis med regulates skin cell production and proliferation and is a vitamin D analog?
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Calcipotriene
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What are alefacept, efalizumab, and etanercept used for?
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psoriasis
IV or IM given weekly |
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Which drugs bind TNF and inhibit inflamation?
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alefacept, efalizumab, and etanercept
biologic agents for psoriasis |
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What are side effects associated with alefacept, efalizumab and etanercept?
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IMMUNOSUPPRESSIVE
-malignancy, hematologic abnormalities, infection, risk with other immunosuppressive agents. |
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What decreases inflammation by suppression of polymorphonuclear cells and decreased capillary permeability?
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Topical corticosteroids
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What are side effects of corticosteroids?
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suppression of pituitary-adrenal axis
growth retardation in children immunosuppression topical - thinning of skin acne |
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Name 3 keratolytic and destructive agents.
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salicylic acid
propylene glycol gluorouracil |
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What are side effects of salicylic acid?
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with topical application - can raise serum salicylate levels -- cause urticaria, anaphylaxis, SJS
Dialysis can remove |
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What is a vehicle for many topical preparations but can be used alone as keratolyic compound?
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Propylene glycol
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Which keratolytic is a systemic treatment for malignancy and fungal infections?
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fluorouracil
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Which drug inhibits thymidylate synthestase, inhibiting DNA and RNA synthesis?
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Fluorouracil
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Can fluorouracil be used topically?
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yes, works by causing vesiculation, erosion, superficial ulceration, necrosis -- then reepithelialization
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How does Doxepin work?
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histamine antagonism (antipruritic agent)
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What are systemic effects of Doxepin?
who do you avoid in? |
drowsiness, avoid in patients with narrow-angle glaucoma or urinary retention
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What is Pramoxine used for?
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exzematous dermatosis
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What drug works by vasodilation, relaxing arteriolar smooth muscle, and increased blood flow.
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Minoxidil
used for hair loss and HTN reverses minimaturization of scalp hairs more effective for vertex balding cessastion causes hair loss in 4-6 months. |
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What is finasteride used for?
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Androgenic alopecia
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What drug inhibits conversion of testosterone to dihydrotestosterone, and is a 5 alpha reductase inhibitor?
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Finasteride
(for alopecia) |
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What are SE of Finasteride?
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decreased libido, ejaculation d/o, ED
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What drug should prego women not handle?
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Finasteride - can cause hypospadiasis in developing male fetus
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What is Eflornithine used for?
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Topical preparation to decrease hair growth
-irreversible inhibition of enzyme ornithine decarboxylase (ODC) |
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What is Alitretinoin used for?
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Topical application for Kaposi's sarcoma
binds to reinoid receptors should not be used with DEET |
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What is Bexarotene used for?
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cutaneous T-cell lymphoma
can cause teratogenicity |
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What determines the type of vehicle used for derm meds?
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moisture...
depends on the area to be treated. |
