Professional Documents
Culture Documents
1.
2.
Concentration gradient
3.
Dosing schedule
-the local half life may be long enough to permit
once daily application of drugs with short
systemic half lives
4.
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and ointments
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Antibacterial agents
Bacitracin poorly
absorbed through the
skin, systemic toxicity is
rare
Gramicidin: systemic
toxicity limits its use
Mupirocin
Treatment of impetigo
Intranasal mupirocin for
eliminating nasal
carriage of S. aureus
Polymixin B
Sulfate
Gram(-) organisms,
Pseudomona aeroginosa, E.
coli, Enterobacter, Klebsiella
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Topical antibiotics in
acne
Clindamycin phosphate
Erythromycin base
Metronidazole
Sulfacetamide
Effectiveness of Topical
< systemic
administration
Suitable in mild to
moderate cases of
inflammatory acne
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Clindamycin
Propionibacterium acnes
10% absorbed, rare cases of bloody diarrhea and
pseudomembranous colitis
Hydroalcoholic vehicle and foam formulation
maycause drying and irritation of the skin(burning
and stinging)
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10
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11
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Topical
Clotrimazole
Miconazole
Econazole
Ketoconazole
Oxiconazole
Sulconazole
Ciclopirox
Olamine
Naftifine
Terbinafine
Butenafine
Tolnaftate
Oral
Griseofulvin
Terbinafine
Ketoconazole
Fluconazole
itraconazole
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13
Topical azoles
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Ciclopirox
olamine
15
Butenafine
Tolnaftate
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Nystatin and
amphotericin B
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Oral Azoles
Derivatives
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Griseofulvin
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19
Terbinafine
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Acyclovir (Zovirax)
Valacyclovir
Penciclovir
Famciclovir
Synthetic guanine analogs with inhibitory
activity against members of the herpes virus
family
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21
22
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Atopic dermatitis
Inhibit T-lymphocyte activation and prevent
release of inflammatory cytokines and
mediators from mast cells in vitro after
stimulation by antigen-IgE complexes
Most common side effect: burning sensation
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25
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26
Permethrin
Lindane
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27
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Crotamiton
Sulfur
Malathion
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29
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30
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31
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32
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33
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35
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36
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Benzophenones
Oxybenzones
Dioxybenzones
Sulisoenzone
Broader
nm
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39
Dibenzoylmethanes
Parasol
and eusolex
Absorb wavelengths throughout the longer UVA
range, 320 nm to 400 nm, with maximum
absorption at 360 nm
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40
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41
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42
or all-trans-retinoic acid
Is the acid form of vitamin A
Effective topical treatment for acne vulgaris
Vitamin A alcohol: physiologic form of Vitamin A
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43
Stabilizes lysosomes
Increases RNA polymerase activity
Increases prostaglandin E2, cAMP, cGMP
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44
Action in acne
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45
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48
Erythema
Dryness
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49
Adapalene (Differin)
Tazarotene (Tazorac)
Acetylenic retinoid
Treatment of mild to moderately severe facial acne
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50
Isotretinoin
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51
Isotretinoin
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52
Benzoyl Peroxide
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53
Benzoyl Peroxide
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54
Tazarotene
Topical
Synthetic
vitamin D3 derivative
Effective in the treatament of plaque-type
psoariasis vulgaris of moderate severity
Improvement is noted following 2 wks of tx
Biologic agents
A.
B.
C.
B.
-
C.
-
Alefacept
Immunosuppressive dimeric fusion protein
Interferes with lymphocyte activation
Efalizumab
Immunosuppressive recombinant humanized IgG kappa isotype
monoclonal antibody that binds to CD11a subunit of leukocyte
function antigen-1
Adverse effect: immune-mediated thrombocytopenia
Etanercept
Dimeric fusion protein consisting of the extracellular ligandbinding portion of the human TNF receptor linked to the Fc
portion of human IgG
Binds specifically to TNF and and blocks interaction with
cell surface TNF receptors that play a role in the inflammatory
process of plaque psoriasis
Anti-inflammatory Agents
Topical corticosteroids
Hydrocortisone,
adrenal cortex
Are only minimally absorbed following
application to normal skin
Penetration is increased several fold in the
inflamed skin of atopic dermatitis and in severe
exfoliative diseases such a erythrodermic
psoriasis
Anti-inflammatory Agents
Topical corticosteroids
Ointment bases tend to give better activity to
the corticosteroid than do cream or lotion
vehicles
Solubility of the corticosteroid in the vehicle is a
significant determinant of the percutaneous
absorption of a topical steroid
Anti-inflammatory Agents
Table 62-1
Anti-inflammatory Agents
Table 62-2
Anti-inflammatory Agents
Adverse effects
Possess
Anti-inflammatory Agents
Corticosteroids
Contraindicated
Anti-inflammatory Agents
Tar Compounds
Used
Salicylic acid
Propylene glycol
Urea
Podophyllum resin and podofilox
Fluorouracil
Nonsteroidal anti-inflammatory drugs
Aminolevulinic acid
Salicylic Acid
Solubilize
Propylene Glycol
40-70%
concentrations
Effective keratolytic agent for removal of
hyperkeratotic debris
Effective humectant and increases the water
content of the stratum corneum
Uses:
Urea
Softening
corneum
Increases the water content of the stratum
corneum, as a result of the hygroscopic
characteristics of this naturally occurring
molecule
Keratolytic : alterations in prekeratin and keratin
leading to increased solubilization
May break hydrogen bonds that keep the stratum
corneum intact
Fluorouracil
Treatment
NSAIDs
Diclofenac
1
: actinic keratoses
Aminolevulinic Acid
Endogenous
precursor of photosensitizing
porphyrin metabolites
Photosensitization of actinic keratoses using
ALA(Levulan Kerastick) and illumination with a
blue light photodynamic therapy
illuminator(BLU-U) is the basis for ALA
photodynamic therapy
Antipruritic Agents
Doxepin
Potent H1 and H2
receptor antagonist
Adverse effects:
Pramoxine
Topical anesthetic
Minoxidil
Reverse
Finasteride
5
Eflornithine
Irreversible