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Pharm 2 Exam 4 - Dermatological Agents
Terms in this set (23)
to protect underlying structures from trauma, temperature variations, harmful penetrations, moisture, dehydration, humidity, radiation, and micro-organisms
SKIN - the largest organ in the body (17% of BW)
Primary role -
Skin varies in thickness and permeability
Face, scrotum, armpit and the scalp all absorb medication well
Palms, soles of the feet and forearm are less permeable
Skin may act as a reservoir and extend the half life of medication
The vehicle therapeutic benefit (moistening, drying and occlusion)
When applying drugs directly to skin, consider the following
Solubility of the active agent in the vehicle
Rate of release of the agent from the vehicle
Ability of the vehicle to hydrate the stratum corneum, thus enhancing penetration
Stability of the therapeutic agent in the vehicle
Interactions, chemical and physical of the vehicle, stratum corneum, and active agent.
Vanished when rubbed in
Less greasy, drying effects.
Not occlusive, can sting, more likely to irritation (fragrances)
Most common vehicle; most are oil in water emulsions
for acute exudative inflammation, intertriginous areas
Lubricating, occlusive; greasy
Relieve dryness, brittleness and protect fissures
Not designed for hair covered areas
for smooth, non-hairy skin; dry, thick, or hyperkeratotic lesions damaged skin to provide occlusion
Avoid on hairy and intertriginous (where skin is in contact with skin, i.e. armpits, groin)
Preferred Use: Chronic inflammation with xerosis, scaling and lichenification
1. Irritant contact dermatitis
2. Allergic contact dermatitis
Most common dermatological condition in clinical practice.
Caused by direct contact with a primary irritant.
Absolute primary irritants: intrinsically damaging substances that injure on first contact any person's skin. (Ex. Strong acids, alkalis)
Relative primary irritants: less toxic than absolute primary irritants, and they require repeated or prolonged exposure to provoke a reaction (Ex: soaps, benzoyl peroxide, certain plant and animal substances.
Irritant contact dermatitis
Cause: Many plants and almost any chemical(Ex: Poison Ivy/Poison Oak)
Allergic contact dermatitis
Acute Stage: Wet lesions such as blisters or denuded and weeping skin, erythema, edema, vesicles, and oozing
Sub-acute: Crusts or scabs form over the previously wet lesions.
Chronic: Lesions become dry and thickened (i.e., lichenified)
General Phases of Contact Dermatitis
Pruritic disease of unknown origin that usually starts in early infancy, though an adult-onset variant is recognized.
First disease to present in a series of allergic diseases—including food allergy, asthma, and allergic rhinitis.
1st theory; a primary immune dysfunction resulting in IgE sensitization and a secondary epithelial-barrier disturbance.
2nd theory; proposes a primary defect in the epithelial barrier leading to secondary immunologic dysregulation and resulting in inflammation.
Atopic Dermatitis (Eczema)
Caused by Staphylococci (most cases) or Streptococci
Ensure that facial contact dermatitis is not impetigo before treatment
Most common skin disease of adolescence; affects about 85% of all people between the ages of 12 and 24
is caused by multiple factors
Increased sebum production - fatty lubricant secreted by sebaceous glands of the skin
Abnormal keratinization within the pilosebaceous canal
(These steps work together to plug the sebaceous follicle)
Bacterial colonization - Propionibacterium acnes (acne bacillus) a gram positive anaerobe organism can colonize the follicle
Immune-mediated inflammatory reaction.
Diet, psychological stress, cleanliness and sexual activity do not induce acne- controversial whether or not they aggravate
Androgens: activate acne
Sex hormone imbalances contribute to acne
What class of medication does this have impact on?
the severity of the condition
Therapy is considered an art and not a science and it is highly individualized
Unblocking the sebaceous duct
Decreasing the amount of sebum that is secreted
Changing the composition of the sebum to make it less irritating by decreasing the population of P. acnes
Treatment takes time so allow at least 1-2 months before modifying treatment
Cheeks, nose and chin have a rosy hue
Patient complains of burning or stinging and flushing
Difference from Acne V.
Age of patients usually 30-50 and no comedones
Affects women more than men
Triggers - hot liquids, spicy foods, alcohol, sunlight and heat
Astringents, skin care products containing alcohol, menthol, eucalyptus oil, clove oil, peppermint, witch hazel, or sodium lauryl sulfate
Patients should avoid
Identify subtype prior to treatment
Four subtypes of Rosacea
Body lice - Occur in people living in overcrowded conditions with poor hygiene
Pubic lice (crabs) - Generally spread by sexual transmission
Head lice - Epidemic in all children regardless of living conditions
Pediculosis (Lice infections)
Caused by human papillomavirus
About 100 types of HPV are known
About 30-40 types are considered STDs
Cervarix and Gardasil® -vaccine to prevent cervical CA and genital warts. Covers HPV 6, 16, 11, and 18
3 shot series.
causes scaly patches, red skin, and stubborn dandruff ( mainly affects the scalp)
AKA seborrheic eczema , seborrheic psoriasis , and dandruff
Can affect the face, upper chest, and back
Usually a long-term condition
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