Term
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Definition
acne treatment
-synthetic retinoid administered orally
USE: reserved only for sever cystic acne not responding to standard therapy, reduces size and function of sebaceous glands
SE: hypervitaminosis A, dryness and itching of skin and mucous membranes, headache, corneal opacities, alopecia, muscle/joint pains, TERATOGENIC
TOX: suspend drug at least 1 month before discontinuing contraceptives, start contraceptives at least 1 month before beginning this drug and for at least 1 menstrual cycle following drug cessation |
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Term
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Definition
acne treatment
MOA: naphtoic acid derivative resembling retinoic acid in structure and effects
-unlike RA, photochemically stable and shows little decrease in efficacy in combo with benzoyl peroxide
-applied topically
-less irritant than tretoin
USE: pts with mild to moderate acne vulgaris |
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Term
| Retinoic acid (Tretinoin) |
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Definition
acne treatment
-acid form of Vit A
MOA: decreases cohesion between epidermal cells and increases their turnover -> transformation of closed comedones into open ones -> expulsion; stabilizes lysosomes, increases RNA polymerase activity, PGE2, cAMP levels, incorporation of thymidine into DNA
USE: topically for acne vulgaris (remains mostly in epidermis)
PK: during 1st 4-6 weeks make seem to make acne worse, but after 8-12 weeks condition will improve
TOX: slight erythema with mild peeling, skin irritation; must avoid sun because drug may increase UV light potential to produce skin tumors
-apply to dry skin only |
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Term
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Definition
sunshade
MOA: contains opaque compounds known to reflect UV light, little used
USE: infants-6 months to 2 yrs |
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Term
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Definition
sunscreen
MOA: contain chemical compounds to absorb UV light responsible for most erythema and tannning sun exposure
-for children greater than two years old, adults
-half-life of about 2 yrs |
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Term
| Psoralens (Trioxsalen, Methoxsalen) |
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Definition
repigmentation
MOA: photoactivated by long-wavelength UV light -> intercalate with DNA
USE: repigment depigmented macules of vitiligo
TOX: long-term use -> cataracts and skin cancer |
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Term
| Hydroquinone (reversible), Monobenzone (irreversible) |
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Definition
depigmentation
H-MOA: inhibt tyrosinase -> block synthesis of melanin
M-MOA: toxic to melanocytes
USE: reduce skin hyperpigmentation |
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Term
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Definition
antiectoparasiticide
USE: pediculosis capitis, corporis, pubis, scabies
-lack of systemic side effects makes it a safe alternative scabicide in infants and pregnancy
SE: skin staining, unpleasant odor |
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Term
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Definition
antiectoparasiticide
USE: pediculosis capitis, corporis, pubis, scabies
PK: shampoo or lotion prep
TOX: neurotoxicity and nephrotoxicity (some systemic absorption may occur after cutaneous use), concentrated in fatty tissue and brain
-not used during pregnancy, infants, seizure-prone individuals |
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Term
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Definition
antiviral
USE: recurrent orolabial HSV infections in immunocompromised pts
-cream applied at first signs of infection, reapplied every 2h for 4d reduces time of viral shedding and decreases healing time by one day |
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Term
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Definition
antiviral
USE: primary cutaneous HS and limited mucocutaneous HS in immunocompromised pts, decreases duration of viral shedding |
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Term
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Definition
antifungal
USE: fingernail and toenail onychomycosis (6 or 12 weeks-daily dose)
SE: pt monitored for hepatic dysfunction |
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Term
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Definition
antifungal
USE: common dermatophyte infections-tinea infections of scalp and nonhairy skin, fingernails and toenails-relapse is common
SE: diarrhea, photosensitivity, headaches
CI: porphyria, hepatic failure, long-term use requires periodic evaluation of liver, hematopoietic and liver function |
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Term
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Definition
antifungal
SE: may interfere with ventricular function -> thorough cardiac examination and monitoring
CI: with midazolam or triazolam b/c prolong the sedative and hypnotic effects; use with HMG-CoA reductase inhibitors increases risk of rhabdomyolysis |
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Term
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Definition
antifungal
USE: cutaneous infections cause by epidermophyton, microsporium, trichophyton fungi
TOX: gynecomastia, hepatitis, increased liver function enzymes, long-term use-periodic evaluation
CI: with midazolam or triazolam b/c prolong the sedative and hypnotic effects; use with HMG-CoA reductase inhibitors increases risk of rhabdomyolysis |
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Term
| Bacitracin, Clindamycin, Metronidazole, Mupriocin, Neomycin, Polymixin |
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Definition
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Term
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Definition
immunomodulator
MOA: stimulate IFN-a release from peripheral mononuclear cells and macrophages
USE: perianal and external genital warts
-applied topically
SE: inflammatory rxn at site of application |
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Term
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Definition
immunomodulator
MOA: block release by mast cells of various inflammatory mediators
USE: atopic dermatitis
SE: burning sensation at application site |
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Term
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Definition
trichogenic
-5-alpha reductase inhibitor
MOA: blocks conversion of testosterone to dihydrotestosterone
USE: promotes hair growth, prevents further hair loss
-treat for at least 3-6 months, continued treatment to sustain benefit
SE: decrease libido, ejaculation disorder, erectile dysfunction |
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Term
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Definition
trichogenic
-reverse progressive miniaturization of terminal scalp hairs
-effect is not permanent and cessation of txt leads to hair loss in 4-6 months
-percutaneous absorption in normal scalp is minimal, but possible effects on blood pressure (monitor pts with cardiac disease) |
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Term
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Definition
antipruitic
USE: relief in pruitis associated with atopic dermatitis or lichen simplex chronicus
MOA: unknown
SE: drowsiness, anticholinergic effects, allergic dermatitis
CI: pts with untreated narrow-angle glaucoma or tendency to urinary retention |
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Term
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Definition
keratolytic
topical-absorbed percutaneously -> excreted in urine
MOA: solubilize cell surface proteins that keep stratum corneum intact -> desquamation of keratotic debris
TOX: salicylism, if toxic use hemodialysis
-children at high risk, careful use in pts with diabetes or peripheral vascular disease
SE: urticarial, anaphylactic, erythema multiforme rxs in pts allergic to salicylates |
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Term
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Definition
anti-inflammatories, anti-pruitic
USE: psoriasis, dermatitis, lichen simplex, chronicus
SE: folliculitis, phototoxicity, allergic contact dermatitis
-in pts with erythrodermal or generalized pustular psoriasis -> risk of total body exfoliation |
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Term
| Betamethasone, Hydrocortisone |
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Definition
anti-inflammatories, corticosteroids
very responsive: atopic dermatitis, seborrheic dermatitis
less responsive: psoriasis of palms and soles, vitiligo
least responsive: intralesional therapy (keloids, cysts)
-topical prep-variable absorption from healthy skin, increased absorption in damaged skin
SE: depressed, cigarette-like skin, steroid rosacea |
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Term
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Definition
psoriasis treatment
MOA: immunosuppressive protein-blocks lymphocyte activation
USE: moderate-severe chronic plaque psoriasis
-administered IM
-not to be used in pts with clinically significant infection or history of cancer |
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Term
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Definition
psoriasis treatment
MOA: synthetic vit D3 derivative
USE: plaque-type psoriasis vulgaris of moderate severity
-improvement noted after 2 weeks of treatment, continued improvement up to 8 weeks
SE: burning, itching, dryness of treatment area, avoid facial contact, may produce ocular irritation |
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Term
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Definition
psoriasis treatment
MOA: acetylenic retinoid prodrug hydrolyzed to active form tazarotenic acid -> binds retinoic acid receptors resulting in modified gene expression
-MOA in psoriasis is unknown
-teratogenic effects
-cautin if used in women of childbearing potential
SE: burning, stinging skin sensation, erythema, localized edema-minimize skin exposure |
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Term
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Definition
psoriasis treatment
MOA: etretinate metabolite
-effective orally in psoriasis (esp. pustular form)
TOX: similar to those seen for isotretinoin-hypervitaminosis, teratogenic
-not used by pregnant females or those who may become pregnant during treatment or for at least 3 years after treatment is discontinued
-ETHANOL strictly prohibited during treatment and 2 months after discontinuing therapy
-3 yr restriction in blood donation |
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