Pharm -Mata Flashcards

Question 1

Q

Which medication vehicles are best for hairy areas?

Answer

A

Lotions and solutions

Question 2

Q

Where should you avoid using ointments? What type of medication vehicle should be used in these regions?

Answer

A

intertriginous (skin contacts skin–> armpit, groin, pannus)

Use creams instead

Question 3

Q

What are the components of writing a topical prescription? (6)

Answer

A

Generic name
Vehicle
Concentraion
Sig (signa=”write on label” =BID, PRN, etc)
Amount
Refills

Example: Desonide cream 0.05% apply to affected area (face) BID PRN for scaling #15 grams RF 3

Question 4

Q

How do corticosteroids work (3 mechanisms)?

Answer

A

activate genes encoding beta2 adrenergic receptors and anti-inflammatory proteins
inhibit transcription factors like NF-kB and AP-1
Modulate signal transduction pathways through interaction between the T cell receptor and interference with the JNK signal

Question 5

Q

What determines the efficacy of topical medications?

Answer

A

strength (potency), location, vehicle and concentrations

Question 6

Q

What are some local side effects of topical steroid use? How are these affected by the potency?

Answer

A

skin atrophy
Telangiectasias
Striae

-higher potency==> more likely SE

Question 7

Q

What are some systemic SE of topical steroids?

Answer

A

Glaucoma
hypothalamic pituitary axis suppression
Cushing’s syndrome
HTN
Hyperglycemia

Question 8

Q

How long should you use super high potency corticosteroids to limit SE? High and medium potency?

Answer

A

super high = < 3 weeks

high and medium= <6-8 weeks

Question 9

Q

What percentage BSA is the size of your palm?

Answer

A

1%

if measuring on a pt, use their hand, not yours

Question 10

Q

What is 1 fingertip unit in mg? How much BSA can this cover?

Answer

A

1 Fingertip unit (FTU)= 500 mg = treats 2% BSA

Question 11

Q

How many grams should be given to cover 2 palms of area (2% BSA), 2 times per day for 1 month?

Question 12

Q

Why do kids have a higher risk for systemic absorption of topically applied meds than adults?

Answer

A

they have a higher SA: body ratio

Question 13

Q

What 4 processes have a role in the formation of acne lesions?

Answer

A

inflammatory mediators released into skin (PLC/ PKC inducing IL-1 and other inflammatory reactions)
alteration of keratinization –> comedones
increased and altered sebum production (under androgen control) (PI3K/Akt and Shh/MC5R pathway inducing terminal sebocyte differentiation)
follicular colonization by P. andes

Question 14

Q

What are topical antibiotics be given with for the treatment of inflammatory papules and pustules? Why?

Answer

A

Benzoyl peroxide

- prevent the development of antibiotic resistance

Question 15

Q

How does Benzoyl peroxide work?

Answer

A

-antibacterial: form highly reactive ROS that oxidize bacterial cell membranes (and yeasts)

Question 16

Q

What do topical retinoids target? What should they not be given with?

Answer

Study These Flashcards

A

comedones

- should not be given with benzoyl peroxide because benzoyl peroxide will oxidize it

Question 17

Q

How long does it take topical acne treatment to take effect?

Answer

Study These Flashcards

A

2-3 months

patient education is crucial

Question 18

Q

What are the side effects of oral tetracyclines? How do these affect birth control pills?

Answer

Study These Flashcards

A

GI upset and photosensitivity (except Minocycline)

Minocycline=vertigo and hyperpigmentation

take with water to avoid esophageal erosions
do NOT interfere with birth control

Question 19

Q

What is oral Isotretinoin used to treat? What are some side effects?

Answer

Study These Flashcards

A

used to treat severe nodulocystic scarring acne or acne resistant to other therapies
TERATOGENIC –> contraindicated in pregnant and MUST use 2 forms of contraception
Xerosis (dry skin)
Cheilitis (chapped lips)
Elevated liver enzymes
hyper triglyceridemia
severe acne sufferers might suffer mood changes –> monitor for depression
Pseudotumor cerebri (–> HA from inc ICP)

Question 20

Q

Which class of antihistamines are better for anti-histaminic properties?

Answer

Study These Flashcards

A

2nd generation (Cetirizine, Loratadine, fexofenadine)

- 1st generation work through sedative functions (Diphenhydramine, Hydroxyzine and Chlorpheniramine)

Question 21

Q

Why are topical vitamin D analogs used for treatment of Psoriasis?

Answer

Study These Flashcards

A

-Calcipotriene inhibits keratinocyte proliferation
(SE=skin irritation)

-Calcitriol also inhibits keratinocyte proliferation, inhibits T cell proliferation and stimulates keratinocyte differentiation (less skin irritation)