Pharm Exam Topical Medications Sara Procak

Out of creams, ointmens, gels, solutions, and aerosols. What has the lowest frequency of application? greatest?

ointment

aerosols

What is the M/C topical med for rashes, eczema, psoriasis, dermatitis?

Topical corticosteroid

Topical corticosteroid are classified by their ____________ properties of the small vessels in the dermis, this determines their potency.

vasoconstrictive

Topical corticosteroid are classified from 1-7.

Group 1=

Group 7=

Group 1 = MOST POTENT

Group 7 = LEAST POTENT

(always start with the least potent)

What are the AE of topical steroids?

1. suppress the hypothalamic adrenal axis

2. Skin atrophy, Striae, telangiectasia

What type of steroid do we not put on our face?

Fluorinated steroids

It a patient has a rash all over the body, what type of steroid will you use?

PO steroid

What are topical antibiotics used to treat?

1. bacterial infections (gram positive)

2. wounds burns and abrasion

What organisms does bacitracin cover?

staph, strep, gram+ organisms

What does prolonged use of bacitracin do?

decrease effectivenss

What topical will you use to tx impetigo (S. Aureus) ?

Mupirocin (Bactroban)

What is the MOA of Mupirocin (Bactroban)?

blocks protein synthesis of bacteria by

binding to tRNAsynthetase

The MOA is unknown but is thought to damage the cell wall & membrane therefore suppressing growth.

Silver Sulfadiazine (Silvadene)

What is Silver Sulfadiazine (Silvadene) used for?

2nd and 3rd degree burns

What are the CI of silver sulfadiazine?

1. Sulfa allergy

2. Late pregnancy

3. Children less than 2 months

4. Nursing mothers

Do not use Silvadene on the face due to cause _____ of the skin

staining

What are the AE of silver sulfadiazine?

stain skin

impair liver/renal

temporary leukopenia

What does tinea mean?

Fungal (Dermatophyte) infection

_______ infect and live in the dead keratin of the Stratum Corneum, hair and nails.

Dermatophytes

What is the MCC of yeast infections?

C. Albicans

Fungal infection are classified by body region... name them.. Tinea..

A. Corporis

B. Cruris

C. Pedis

D. Versicolor

A. Head

B. Groin/ Jock itch

C. Feet

D. trunk & proximal extremities

The MOA of this medication is to Inhibit CYT p450 which inhibits synthesis of ergosterol that damages cell membrane resulting in cell death

Azols Antifungals

What is the indication Azols Antifungals?

Superficial fungal infections

What are the Imazoles antifungals?

1. Clotrimazole

2. Triazoles (terconazol, Naftinfine(naftin))

This anti fungal is indicated to tx Tinea that is caused by M. FurFur & C. Albicans candidiasis

Clotrimazole

Nystatin (mycostatin) & ______ (lamisil) are considered antifungals

Terbinafine

What mite causes scabies?

Sarcoptes

scabiei

True/False

Scabies & Lice is Highly contagious and common in those that live in close contact (camp, school)

True

How long is the mite cycle for scabies?

When does the femaile burrow into the skin?

30 days (symptoms arise then)

within 1 hr

How does someone with scabies present?

burrows in finger webs, flexors of wrist, axilla, groin

What is the treatment for Scabies, Lice, crabs, ticks, fleas ?

Permethrin

Acts on the parasites nerve cell membrane by disrupting the sodium channel current and slowing repolarization, causing paralysis of the pests

Permethrin

1. How do we administer permethrin on adults?

2. infants?

1. massages into skin head to toe (8-14 hours then wash off)

2. treat the hair line, neck, scalp ,temple forehead (leave in 8-14 hours and wash out)

What are the CI to permethrin?

- Chrysanthemums or pyrethrin hypersensitivity

- seizure disorders

What CAs does permethrin increase risk of?

pulmonary and liver adenomas

What should we use if the lice is resistant ?

ovide (malithione)

What is the MOA of ovide (malithione)?

cholinesterase inhibitor

What is oflaxacin used for?

bacteria of extrenal auditory canal (pseudomonas)

What is the MCC of Otitis externa ?

How do we tx ?

pseudomonas

Oflaxacin (Floxin)

What is the MOA of Oflaxacin (Floxin)?

not exactly known but ihibits the DNA

replication

What prego class is oflaxacin?

If youre allergic to this drug you cannot take it,what is it?

C

- Quinalones

This decreases swelling while inhibiting bacterial protein synthesis and is used to tx inflammation in the external auditory canal

Cortisporin otic suspension/solution

What are some cautions for Cortisporin otic suspension/soluton ?

A. May cause burning

B. Do not administer if there is also a Herpes infection

C. Only use a solution if suspected perforation of the TM

What is aceticacid propylene glycol diacetate (Volsol) used for?

Superficial fungal infection of external ear

What is the CI for use of volsol?

perforated TM

What is the use for antipyrine with benzocaine in glycerine (auralgan) used for?

analgesia for oralgia and otitis externa

What CI is there for Antipyrine with benzocaine in glycerine (Auralgan)?

perforated TM

What is carbamide peroxide (Debrox) used for?

impacted cerumen

What CI is there for carbamide peroxide?

perforated TM

What is Nystatin (mycostatin) used for?

-thrush

-prophylaxis for immunocompromised patients

(Swoosh & Swallow)

What is the MOA of Nystatin (mycostatin)?

binds ergosterol forming pores in fungi then death

What is the AE of Nystatin (mycostatin)?

N/V/D and oral irritation

What is the MOA of pencyclovir?

DNA polymerase inhibitor

DNA polymerase inhibitor, it is a pro-drug which is metabolized into famcyclovir in the liver

Pencyclovir(Denavir)

What is the use of Pencyclovir (Denavir)?

herpes labalis

What is Chlorhexidine oral rinse (Peridex) used for?

gingivitis

Both bacteriostatic and bacterialcidal. It kills by disrupting the cell membrane. It can kill bacteria within 30 seconds.

Chlorhexidine oral rinse (Peridex)

What are the side effects of chlorhexidine oral rinse?

1. dry mouth/teeth/tongue

2. staining & tarter build up

3. irritation mouth/ throat

What is magic mouthwash a mix of?

1. Benadryl

2. Maalox

3. Viccous lidocaine

What is the MAO of magic mouthwash ?

1. Antibiotic to kill bacteria

2. antihistamine/ anesthetic to reduse pain

3. antacid to help coat the mouth

What is the indication for magic mouthwash?

1. Gingival stomatitis

2. hand foot and mouth disease

3. Intra/peri oral lesions

What is the MOA of clotrimazole?

Breaks down the cell wall of the fungus

and dissolves it

What do we use clotrimazole for?

vaginal candidiasis

What are the AE of clotrimazole?

1. burning

2. itching

3. irritation

What is the MOA of clindamycin phosphate?

bacteriostatic that stops protein synthesis

When is clindamycin phosphate indicated ?

susceptible vaginal infections esp. bacterial vaginosis

What is the MOA of Clindamycin phosphate?

Inhibits bacterial protien synthesis by

binding to the RNA on the ribosome. It is

bacteriostatic.

What is the MOA of metronidazole gel?

bacteriocide, inhibits nucleic acid synthesis by disrupting DNA

What is the indication for metronidazole gel?

BV

What is the MOA of imuquimod (aldara)?

immune modualtor

- causes inflammation followed by apoptosis

What is the indication for Imiquimod?

condyloma

What are some cautions when using Imiquimod?

inflammation, scabbing and scaring

What is TRI Chlor acetic acid used for?

HPV

Podophyllin is also used to tx?

HPV

Whats its MOA of Podophyllin?

What is the AE?

-Cytotoxic agent for tx of genital warts

arrests mitosis in metaphase

-Burning

What is the MOA of OTC Replense, Luvena moisturisor and Kyovule?

bioadhesive polymer that attaches to vaginal walls

What are the indications for Replense, Luvena moisturisor and Kyovule?

vaginal atrophy

What is the MOA of vaginal estrogen cream?

Returns the anatomy to pre atrophic form and creates more flexibility in the tissue

What are the indications for vaginal estrogen?

Pain, burning, frequency ,UTI

What is Trimosan jelly used for?

pessary users

What is the MOA of trimosan?

maintain the pH of vagina

What she said she does..

1. For women with pain, discomfort during sex, and no UTI → start with _______

2. If they are having UTI’s → she uses ______

Moisturizers

vaginal estrogen