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what are some common medications that have an associated risk for induction/exacerbation of psoriasis?
beta blockers, lithium, nsaids, antimalarials, fluoxetine, corticosteroid withdrawal
what are the moderate and high potency topical steroids?
augmented betamethasone dipropionate 0.05%, betamethasone dipropionate 0.05%, betamethasone valerate 0.1-0.12%, fluocinolone acetonide 0.01-0.025%, fluocinonide 0.05, fluticasone propionate 0.005-0.05%, hydrocortisone valerate 0.2%, mometasone furoate 0.1%, triamcinolone acetonide 0.025-0.5%
what type of rosacea involves flushing in the center of the face that is easily irritated?
erythematotelangiectatic
what type of rosacea involves persistent redness with transient papules/pustules?
papulopustular
what type of rosacea involves skin thickening and rhinophyma?
phytamous
what type of rosacea involves watery, bloodshot eyes?
ocular
what are some common medications that have an associated risk for photosensitivity?
quinolones, bactrim, doxycycline, furosemide, thiazides, chlorhexidine, hexachlorophene, coal tar
which skin layer includes the moisture film with perspiration, water, sebum, and lipids?
hydrolipid film
which skin layer prevents moisture evaporation?
intercellular lipids
which skin layer is a type of keratinocyte and is regularly replaced?
corenocytes
which skin layer is the primary epidermal cell that produces keratin and is key for skin repair?
keratinocytes
what are some appropriate skin protectants that prevent burns in photosensitive reactions in adults?
avoid sun, protective clothing, sunscreen, protective supplements
with an acute wound, what is something to look for to prevent infection?
tetanus vaccine history
when should antibiotics be administered prior to a surgical incision?
60 minutes
antibiotics for surgery should be given for no longer than....
24 hours
in what phase does healing stall in chronic wounds?
inflammatory
chronic wounds can be caused by what pharmacologic agents?
hydroxyurea, chemo, corticosteroids
compression is recommended for _________________ (arterial or venous) wounds
venous
DRESS is typically caused by...
allopurinol, anti-infectives, anti-epileptics, NSAIDs
both TEN and DRESS are...
dermatologic emergencies
long-term effects for TEN include...
GI obstruction, lung effects
what are some exclusions for self-treatment for atopic dermatitis?
involvement of face or skin folds, infected skin, < 1 years of age, large body area, moderate-severe condition w/ intense pruritis
what is the first line treatment for atopic dermatitis?
topical corticosteroids
what is the first line treatment for acne?
OTC/non-pharm interventions
what are some appropriate OTC therapies for acne?
benzoyl peroxide, topical retinoids
what are some appropriate therapies for moderate-severe acne?
oral antibiotics, isotretinoin, combined oral contraceptives
AEs of oral isotretinoin include...
dryness, photosensitivity, elevated AST/ALT, TG, arthralgia, hair thinning, mental; category X
NIX should be used in patients 2 _______________ of age and up
months
RID should be used in patients 2 ________________ of age and up
years
RID is for __________________ lice(s)
head, pubic
NIX is for ___________________ lice(s)
head
what types of lice are self-treatable?
head, pubic
what types of warts can be self-treated?
common, plantar
what wart patients should be referred to a podiatrist?
diabetics
what are treatment options for common/plantar warts?
cryotherapy, salacylic acid
what are some risk factors for allergic rhinitis?
genetic predisposition, birth during pollen season, first-born, male, higher socioeconomic class, early antibiotic exposure, maternal smoking, indoor allergen exposure, serum IgE > 100 IU/mL before age 6, allergen-specific IgE
allergic rhinitis is an ____________________________, ______________________, ________________________ hypersensitivity immune response mediated by IgE antibodies
adaptive, humoral, Type I immediate
_____________________ to an allergen occurs after initial exposure
sensitization
antigen-specific ________ is produced after sensitization and attached to mast cells
IgE
subsequent allergen exposure following sensitization triggers mast cell _________________________
degranulation
what three substances cause allergy symptoms?
histamine, leukotrienes, inflammatory cytokines
what are the preferred glucocorticoid agents for allergic rhinitis?
fluticasone, mometasone, ciclesonide
__________________ is a mast cell stabilizer and is less effective than glucocorticoids
cromolyn sodium
_____-generation antihistamines are preferred in most patients
second
what allergic rhinitis therapy should be used first in older adults?
steroid nasal sprays
what is the first line option for allergic rhinitis in pregnant patients?
avoidance
___________________________ desensitizes overactive allergic response by exposing immune system to successively larger doses of allergen and produces a lasting effect
specific immunotherapy
adverse drug reactions can be further classified as drug ___________________ and_______________ reactions
hypersensitivity, allergic
immunologic drug hypersensitivity reactions are classified by the ______________________ system
Gell and Coombs
non-immunologic reactions can be classified as ______________________ and ________________________
predictable, non-predictable
epinephrine is dosed at _______________
0.01 mg/kg
epinephrine may be repeated every ________________ in the setting of an anaphylactic reaction
5-15 minutes
cephalosporins and PCNs __________________ (may or may not) be able to be taken together
may
if a drug is critically important to treat a disease state, __________________ would be most useful for a patient with a confirmed IgE-mediated reaction
rapid drug desensitization
induction of tolerance or desensitization protocols result in __________________________
temporary tolerace
pharmacists play an important role in drug desensitization by...
preparing stock solution, labeling, ensuring pre-medication is used at appropriate times
chronic autoimmune inflammatory disease of collagen in skin, joints, and internal organs
systemic lupus erythematosus
a chronic autoimmune disease characterized by inflammation of various parts of the body
lupus
cutaneous lupus is limited to the skin; evidenced by a characteristic rash, especially on the face, neck, and scalp; treatments include...
topical steroids, vitamin D
lupus nephritis is a serious complication of lupus that commonly presents with CV effects; treatments include...
statins, ACEis, ARBs
neurologic lupus is inflammation related to the central, peripheral, or autonomic nervous systems; treatments include...
anticonvulsants, antidepressants
the pathophysiology of lupus includes activation of the...
complement cascade
the immune/inflammatory response for lupus causes the formation of ___________________that attack healthy tissue
autoantibodies
the primary treatment goal for lupus is...
remission
non-pharm treatments for lupus include...
social support, sun protection, smoking cessation, exercise, weight control, counseling
drug induced lupus can be caused by...
procainamide, hydralazine
what medication is the cornerstone of lupus treatment?
hydroxychloroquine
the majority of organ donations are from __________________ donors
cadaveric
the leading diagnosis for kidney transplants is...
diabetes
the leading diagnosis for liver transplants is...
alcoholic liver disease
the leading diagnosis for heart transplants is...
cardiomyopathy
the leading diagnosis for lung transplants is...
restrictive lung disease
pre-transplant screenings include...
blood typing, HLA matching, crossmatching
what are risk factors for higher reactivity for panel reactive antibody testing?
prior pregnancies, prior transplant, prior blood transfusions
hyperacute rejection presents within ______________ of transplants
minutes
acute cellular rejection occurs within ________________ following transplants
months
acute cellular rejection in the kidney is characterized by...
abrupt rise in SCr
acute cellular rejection in the liver is characterized by...
increased bilirubin/transaminases
acute cellular rejection in the lungs is characterized by...
eosinophilia, lyphocytosis
acute cellular rejection in the heart is typically...
asymptomatic
antibody mediated rejection is characterized by...
microvascular injury
chronic rejection is a major cause of...
graft loss
chronic rejection is ________________________ (reversible or irreversible) with current therapy
irreversible
chronic rejection of kidney transplants is characterized by...
hypertension, proteinuria, progressive decline in kidney function
chronic rejection of liver transplants is characterized by...
obliterative arteriopathy, gradual loss of bile ducts
chronic rejection of heart transplants are characterized by accelerated intimal thickening and is treated with...
statins
chronic rejection of lung transplant is characterized by...
FEV1 reduction by > 20%
the primary goal of immunosuppressive therapy is to...
prevent graft rejection
inductive immunosuppressive therapy includes
antibody therapy, corticosteroids
antibody therapy for transplants
antithymocyte globulin, alemtuzumab, basiliximab
corticosteroids for transplants
methylprednisolone
maintenance immunosuppressive therapy includes...
corticosteroids, calcineurin inhibits, antimetabolites, mTOR inhibitors
calcineurin inhibitors
cyclosporine, tacrolimus
co-stimulatory inhibitor
belatacept
antimetabolites
azathioprine, mycophenolate
mTOR inhibitors
sirolimus, everolimus
Note 
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