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Science
Medicine
Dermatology
Self Care and Derm Top 300
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Terms in this set (13)
Adapalene
- Differin, Plixda
- Drug class: Retinoid, Antiacne
- Indications: Acne vulgaris
-MOA: Adapalene exhibits retinoic acid-like activity, reducing important features of the pathology of acne vulgaris by normalizing the differentiation of follicular epithelial cells and keratinization to prevent microcomedone formation. Adapalene enhances keratinocyte differentiation without inducing epidermal hyperplasia and severe irritation, which is associated with retinoic acid. Adapalene decreases formation of comedones, and inflammatory and noninflammatory acne lesions
- Drug interactions: photosensitizing agents
- common adverse reactions: Dry skin, scaly skin, erythema, burning/stinging
Rare but serious ADR: angioedema
Efficacy monitoring: improvement in acne
Toxicity monitoring: severe dry skin or sever skin irritation
Patient counseling points: Avoid contact with eyes, lips, angles of nose and mucous membranes. Do not apply on cuts, abrasions, eczematous or sunburned skin. wash hands and affected area prior to application. Use of moisturizers may be necessary for relief of dry skin or irritation. Avoid products that can dry or irritate skin further. If cutaneous reactions occur and are sever, the frequency should be reduced or adapalene discontinued. Other topical preparations should not be used prior to using topical adapalene. Adapalene causes sun-sensitivity. Avoid sun exposure and tanning beds. Protective clothing and application of sunscreen are recommended when sun exposure cannot be avoided. Cold temperature or wind may also increase skin irritation during drug therapy. Symptomatic improvement may not be seen for up to 12 weeks
Brimonidine
- Alphagan P, Lumify
- Drug class: Adrenergic Agonist, Anti-glaucoma Agent
- Indications: Occular hypertension, open-angle glaucoma, Ocular redness
- MOA: Brimonidine, a relatively selective α-adrenergic agonist, reduces aqueous humor production and increases uveoscleral outflow. It is used to lower IOP in open-angle glaucoma or ocular hypertension.
- Drug Interactions: MAOIs
- Common ADR: Allergic conjunctivitis, conjunctival discoloration, drowsiness
- Rare by serious ADR: Syncope, arrhythmias, bradycardia
- Efficacy Monitoring: Reduction in IOP
Toxicity Monitoring: Seek medical attention if syncope occurs or if symptoms of ocular irritation are severe
- Patient counseling points: Wash your hands and remove contact lenses before using the medicine. Lie down and tilt head back and with index finger pull down the lower lid of the eye to form a pocket. Hold the dropper close to eye with the other hand and drop the correct number of drip into the pocket made between lower lid and eyeball. Then gently close eyes and place index finger over the inner corner of your eye for 1 minute. Do not rinse or wipe the proper or allow it to touch anything including the eye. Put the cap on the bottle right away. Reinsert contacts after 15 minutes. Separate administration of other ophthalmic agents by 5 mins
Clindamycin topical
- Cleocin T, Clindagel, Clindesse, Evoclin
- Drug Class: Lincosamide Antibiotic
- Indications: Acne Vulgaris, Bacterial Vaginosis
-MOA: Clindamycin is a semisynthetic 7-chloro-7-deoxylincomycin derivative that is active against most gram-positive organisms except enterococci and C. difficile. Gram-negative aerobes are resistant, but most anaerobes are sensitive. It inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit; it is bactericidal or bacteriostatic depending on the concentration, organism, and inoculums.
- Drug Interactions: None
- Common ADR: Dry skin
Rare but serious ADR: none
Efficacy Monitoring: resolution of acne lesions
Toxicity Monitoring: Seek medical attention if blistering skin rash
Patient Counseling: Wash and dry face prior to application. Use on skin only, avoid eyes and mucous membranes, avoid cut or broken skin. Shake well before use. Liquid is flammable; avoid smoking while applying or exposure to heat or open flame. For the foam, apply to tissue and use that to apply to face
Clobetasol
- Impoyz, Temovate
- Drug Class: topical corticosteroid
- Indications: skin disorders, corticosteroid responsive and plaque psoriasis
-MOA: Clobetasol has anti-inflammatory, antipruritic, and vasoconstrictive properties. Corticosteroids are thought to act by the induction of phospholipase A2-inhibitory proteins, lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
- Drug Interactions: none
- Common ADR: Pruritis at the site of administration
- Rare but serious ADR: hypothalamic axis suppression has been reported when used with occlusive dressings, over larger surface areas
- Efficacy Monitoring: Improvement in clinical signs of skin disorder
- Toxicity Monitoring: Seek medical attention if severe skin irritation or symptoms worsen after administration
- Patient counseling points: apply thin layer to affected area of skin. Wash hands after administration. kin should be clean and intact at site of application. Avoid contact with eyes and do not ingest by mouth. Avoid occlusive dressings or tight-fitting clothes over site of administration
Clotrimazole/Betamethasone
- Lotrisone
- Drug class: anti-infective/anti-inflammatory combination
- Indications: Tinea
- MOA: Clotrimazole inhibits biosynthesis of ergosterol or other sterols, damaging the fungal cell wall membrane and altering its permeability. Betamethasone dipropionate is a corticosteroid that stimulates synthesis of enzymes thought to be responsible for anti-inflammatory effects.
- Drug Interactions: None
- Common ADR: none
- Rare but serious ADR: Rash, HPA suppression has been reported in children, therefor not recommended in children less than 12 years of age
- Efficacy Monitoring: Resolution of erythema and puritus. Improvement in erythema and pruritus usually occurs within 3-5 days. If not improvement is seen after 1 week of treatment for tines cruris or tines corporals, or after 2 week of treatment of tinea pedis, then the diagnosis should be reviewed
Toxicity monitoring: seek medical attention if severe skin irritation or rash
- Key counseling Points: apply thin layer to affected area. if using lotion, shake well before use
Crisaborole
- Eucrisa
- Class: Phosphodiesterase-4 Enzyme Inhibitor
- Indication: Atopic Dermatitis
-MOA: Inhibits phosphodiesterase 4, resulting in increased intracellular cyclic adenosine monophosphate (cAMP) levels and subsequently cytokines that cause itching.
- Drug Interactions: Riociguat
- Common ADR: none
Rare but serious ADR: Urticaria
Efficacy Monitoring: Improvement in rash, itching, skin appearance
Toxicity Monitoring: hypersensitivity, rash, worsening of skin condition
- Key counseling points: Discontinue use and contact HCP if worsening of skin condition or signs of allergic reaction (rash, hives). Patients should be advised exacerbating factors, including excessive bathing, dry environments and stress
Epinephrine Auto-Injector
- Adrenaclick, Auvi-Q, EpiPen, EpiPen Jr
- Class: Alpha/Beta Agonist, Anaphylaxis Agent
- Indication: Emergency treatment of acute anaphylaxis due to allergic reactions
-MOA: timulates α- and β-adrenergic receptors. Alpha agonism results in vascular smooth muscle constriction which increased BP. Beta-1 agonism will increase HR and contractility. Beta-2 agonism results in bronchial smooth muscle relaxation thus alleviating bronchospasm, wheezing, and dyspnea.
Drug Interaction: Cardiac glycosides, beta-blockers, alpha-blockers, TCA, MAOIs, linezolid
- Common ADR: Anxiety, apprehension, headache, nausea, palpitations, pale complexion, restlessness, sweating, tremor, nausea
Rare but serious ADR: Angina, autonomic hyperreflexia, cardiac dysrhythmia, pulmonary edema, ventricular fibrillation
Efficacy monitoring: Resolution of symptoms of anaphylaxis (dyspnea, pruritus, urticaria, angioedema).
Toxicity monitoring: Seek medical attention after emergency use and monitor for signs of cardiac toxicity and HTN.
Key counseling points: Instruct patient on proper administration technique. Immediately seek medical assistance, even if the patient feels better after epinephrine use. Inject into the anterolateral aspect of thigh, and not into buttock, digits, hands, or feet. Leg should be held firmly during injection. Autoinjector for IM or sq administration—should not be used IV.
Fluclinonide topical
- Lidex, Vanos
-Indications: Skin disorders, plaque psoriasis, atopic dermatitis
- MOA: Fluocinonide is an anti-inflammatory, antipruritic, and vasoconstrictive corticosteroid. Corticosteroids are thought to act by the induction of phospholipase A2-inhibitory proteins, lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
- Drug Interactions: none
- Common ADR: none
- Rare but serious ADR: HPA suppression has been reported when used with occlusive dressings over larger surface areas
- Efficacy monitoring: Improvement in clinical signs of skin disorder (reduced inflammation, pruritus).
- Toxicity monitoring: Severe skin irritation or symptoms worsen after administration.
- Key counseling points: Apply thin layer to affected area of skin. Skin should be clean and intact at site of application. Avoid contact with eyes and do not ingest by mouth. Avoid occlusive dressings or tight-fitting clothes over site of administration.
Imiquimod
- Zyclara, Aldara
- Class: Immune Response
- Indication: Actinic Keratosis, Condyloma acuminatum, Superficial basal cell carcinom
- MOA: Toll-like receptor 7 agonist that induces cytokines, including interferon-alpha and others.
- Drug Interactions: None
- Common ADR: Local itching, burning, pain, erythema, xeroderma
- Rare but serious ADR: Exfoliative dermatitis
- Efficacy monitoring: Resolution of skin lesions.
- Toxicity monitoring: Seek medical attention if signs/symptoms of severe rash, burning, or itching.
- Key patient counseling points: Apply at bedtime and leave on skin for 8 h; when you get up, wash the treated skin area with mild soap and water. Do not cover treated skin areas with bandages. Do not use cosmetics or other skin care products on the treated skin areas. Apply on same days of each week. May increase sensitivity to sun.
Ketoconazole Topical
- Nizoral
- Class: Imidazole Antifungal
- Indication: Candidiasis of skin, Dandruff, Pituriasis versicolor, Seborrheic dermatitis, Tinea corporis, Tinea curis, Tinea pedis
- MOA: Ketoconazole inhibits biosynthesis of ergosterol or other sterols, damaging the fungal cell wall membrane and altering its permeability.
- Drug interaction: none
- Common ADR: Application site reaction with foam
- Rare but serious: Rash, hair loss
- Efficacy monitoring: Resolution of erythema and pruritus. Improvement in erythema and pruritus usually occurs within 3-5 d. If no improvement is seen after 1 wk of treatment for tinea cruris or tinea corporis or after 2 wk of treatment for tinea pedis, then the diagnosis should be reviewed.
- Toxicity monitoring: Seek medical attention if severe skin irritation or rash.
- Key counseling points: Apply thin layer to affected area of skin. Skin should be intact. Do not get it in your eyes, nose, mouth, or vagina. Do not wash the areas where you applied this medicine for at least 3 h after application. Cosmetics (makeup or sunscreens) may be put on the affected areas 20 min after application. Topical products are alcohol based and flammable immediately after application.
Nystatin (topical)
- Mycostatin, Nyamyc, Nystop
- Drug Class: Polyene Antifungal
- Indications: Candidiasis
- MOA: Nystatin binds to the sterols in fungal cell walls, damaging the fungal cell wall membrane and altering its permeability allowing for leakage of cellular contents.
- Drug interaction: None
- Common ADR: none
- Rare but serious ADR: Rash, hypersensitivity reaction, Stevens-Johnson syndrome
- Efficacy monitoring: Resolution of clinical symptoms.
- Toxicity monitoring: Severe skin irritation or rash.
- Key counseling points: Apply to affected area of skin. Skin should be intact. Do not get it in eyes, nose, or mouth. Avoid occlusive dressings, tight-fitting diapers, and plastic pants if using on diaper area of children.
Triamcinolone Topical
- Drug class: Topical corticosteroid
- Indications: Skin disorders
- MOA: Triamcinolone has anti-inflammatory, antipruritic, and vasoconstrictive properties. Corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid.
- Drug Interactions: None
- Common ADR: None
- Rare but serious ADR: HPA suppression has been reported when used with occlusive dressings over larger surface areas
- Efficacy monitoring: Improvement in clinical signs of skin disorder.
- Toxicity Monitoring: Seek medical attention if severe skin irritation or symptoms worsen after administration.
- Key counseling points: Apply thin layer to affected area of skin. Skin should be clean and intact at site of application. Wash hands before and after application. Avoid contact with eyes and do not ingest by mouth. Avoid occlusive dressings or tight-fitting clothes over site of administration.
Hydrocortisone topical
- Class: Topical Corticosteroid
- Indication: skin disorders
- MOA: Hydrocortisone has anti-inflammatory, antipruritic, and vasoconstrictive properties. Corticosteroids are thought to act by the induction of phospholipase A2-inhibitory proteins, lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
- Drug interactions: none
- Common ADR: None
- Rare but serious ADR: HPA suppression has been reported when used with occlusive dressings or when applied over larger surface areas
- Efficacy Monitoring: Improvement in clinical signs of skin disorder.
- Toxicity Monitoring: Seek medical attention if severe skin irritation or symptoms worsen after administration.
- Key patient counseling points: Apply thin layer to affected area of skin. Skin should be clean and intact at site of application. Avoid contact with eyes and do not ingest by mouth. Avoid occlusive dressings or tight-fitting clothes over site of administration. Wash hands after application.
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