Pharmacotherapy - Dermatology I

A vocabulary-style set of flashcards covering the key concepts from the notes: fungal infections and self-care suitability, OTC antifungals, nonpharmacologic strategies, wart treatments and counseling, insect bite medications, pediculosis therapies, scabies treatments, exclusions, and prevention strategies.

Tinea Capitis

Fungal infection of the scalp; not appropriate for self-care treatment.

Tinea Cruris

Fungal infection of the groin; treatable with self-care antifungals.

Tinea Corporis

Fungal infection of the body; treatable with self-care antifungals.

Tinea Pedis

Fungal infection of the feet (athlete’s foot); treatable with self-care antifungals.

Tinea Unguium (Onychomycosis)

Nail fungal infection; not suitable for self-care treatment.

Miconazole

OTC topical antifungal (brand examples include Lotrimin AF); used for up to 6 weeks; may cause skin irritation, burning, or stinging.

Terbinafine

OTC topical antifungal (brand Lamisil AT); gel/cream; use up to 4 weeks (often with resolution within 1 week); may irritate, burn, itch, or dry skin.

Clotrimazole

OTC topical antifungal (brand Lotrimin AF Cream); use up to 6 weeks; may cause skin irritation, burning, or stinging.

Butenafine

OTC topical antifungal (brand Lotrimin Ultra Cream); use up to 4 weeks; fast-acting; side effects are rare.

Tolnaftate

OTC antifungal (brand Tinactin; cream, powder, spray); use up to 8 weeks; slow-acting; may cause stinging on broken skin.

Aluminum acetate (Domeboro)

Astringent foot soak used for fungal infections; soak feet 15–30 minutes up to 3 times daily; avoid deep fissures and limit use to about 1 week.

Nonpharmacologic: Separate towel

Use a separate towel to dry the affected area to prevent spread.

Nonpharmacologic: Do not share towels or clothing

Do not share towels, clothing, or personal items to avoid transmission.

Nonpharmacologic: Wash contaminated clothing in hot water

Hot-water laundering to kill fungi and reduce reinfection.

Nonpharmacologic: Cleanse skin daily with soap and water

Daily cleansing to reduce fungal burden.

Nonpharmacologic: Protective footwear

Wear protective footwear to avoid contact and keep feet dry.

Nonpharmacologic: Dust with medicated or nonmedicated foot powder

Applying powder to keep feet dry and reduce moisture.

Nonpharmacologic: Odor-controlling insoles (change every 3–4 months)

Insloes changed periodically to reduce moisture and odor.

Nonpharmacologic: No wool or synthetic fibers in footwear

Avoid fabrics that wick moisture and keep skin wet.

Wart treatment – Salicylic acid (generic; brands include Compound W One Step Pads, Dr. Scholl’s Clear Away One Step, Compound W Fast Acting Wart Removal Gel)

Keratolytic agent that softens and helps remove wart tissue; used for OTC wart removal.

Cryotherapy (DMEP)

Cryotherapy using Dimethyl Ether to freeze warts; causes tissue destruction and immune response.

DMEP (Dimethyl Ether)

Cold-treatment agent used in wart removal; causes rapid freezing and tissue destruction.

DMEP + Salicylic acid

Combination wart treatment: freeze with DMEP, wait, then apply salicylic acid twice daily for 2 weeks; up to 4 cycles.

Salicylic acid – counseling steps

Initial steps: wash hands and soak wart 5 minutes; wash and dry area before applying.

Pyrethrins + Piperonyl Butoxide (brand examples: A-200, RID, Pronto Lice)

Lice treatment that kills lice by blocking nerve impulse transmission.

Permethrin 1% (Nix Cream Rinse)

Lice treatment that disrupts nerve cell membranes (sodium channels) causing paralysis.

Ivermectin 0.5% (Sklice Lotion)

Lice treatment that kills live lice by acting on chloride channels, causing paralysis.

Dimethicone (LiceMD)

Physical lice treatment that coats and suffocates lice.

Counseling: Pyrethrins directions

Apply to dry hair for 10 minutes, rinse; reapply 9 days later to kill nits; may cause skin irritation.

Lice nonpharmacologic: Lice combs

Fine-comb method to remove lice and nits, used with or after pharmacologic treatment.

Lice nonpharmacologic: Cleaning of personal items

Wash bedding, hats, clothing, and towels to prevent reinfestation.

Lice nonpharmacologic: Vacuuming

Vacuum living areas to remove lice and eggs.

Lice nonpharmacologic: Head shaving

Option to remove lice by shaving hair.

Lice nonpharmacologic: Avoid use of insecticides on living areas

Minimize chemical exposure when treating lice.

Cetaphil (miscellaneous pediculosis item)

Gentle cleanser sometimes used in pediculosis care routines.

Vamousse (pediculosis)

Lice-control product used as part of nonpharmacologic management.

Pediculosis – Special populations

Exclusions include <2 years for pyrethrins and <2 months for permethrin; pregnancy/breastfeeding considerations.

Dimethicone (pediculosis)

Silicone-based occlusive treatment used to suffocate lice.

Scabies – First-line treatments

Topical permethrin and oral ivermectin are first-line options.

Topical permethrin – counseling points

Safe in pregnancy and children ≥2 months; apply after washing; gently scrub off crusts before application.

Ivermectin – counseling points

Oral first-line option; not FDA-approved for scabies but CDC-endorsed; single dose, repeat 1–2 weeks; take with food; avoid in pregnancy or under 15 kg; possible edema, tachycardia, GI effects, LFT elevations.

Sulfur (scabies)

Alternative topical scabicide; apply to entire body; leave on 24 hours and reapply for next 2 days.

Crotamiton (scabies)

Topical scabicide option; apply as directed.

Lindane (scabies)

Topical scabicide; use with caution due to toxicity concerns.

Nonpharmacologic prevention (scabies)

Evaluate close contacts in past 30 days; identify items; isolate in healthcare settings; remove infested children from school; avoid insecticides; isolation ends 24 hours after starting treatment.