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MCPHS PA - Derm + ABX Pharm Exam 2: Questions With Proper Answers
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MCPHS PA - Derm + ABX Pharm Exam 2: Questions With Proper Answers
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MCPHS PA - Derm + ABX Pharm Exam 2: QuestionsWith Proper Answers
What conditions are low/medium dose topical steroids used for? Right Ans
- eczema, irritant dermatitis, seborrhea, atopic dermatitis
What conditions are high dose topical steroids used for? Right Ans -
psoriasis, lichen planus, allergic contact dermatitis
Examples of low strength topical steroids Right Ans - alclometasone,
hydrocortisone (base/acetate), desonide
Examples of intermediate strength topical steroids Right Ans - fluticasone,
hydrocortisone valerate, mometasone
Examples of high strength topical steroids Right Ans - amcinonide,
halcinonide
Examples of very high strength topical steroids Right Ans - clobetasol,
halobetasol
*Know that triamcinolone is a common topical steroid but the potency varies
depending on the strength* Right Ans - ...
What's a common ADR with topical steroid use? Right Ans - cutaneous
atrophy - can have telangiectases and purpura, resolves after months
What are other/serious ADRs with topical steroid use? Right Ans - striae,
acne, refractory rosacea, hypopigmentation, alopecia, glaucoma
What is an ADR associated with hormones with topical steroid use? Right
Ans - Adrenal suppression and iatrogenic cushing's - increased with
dose/duration/higher potency, increased with children
What are treatment considerations for topical steroid use? Right Ans - 1.
Use low doses on areas with increased absorption
2. Occlusive dressings - don't use with high/very high potency
3. Ointments have highest effects
, 4. Special considerations for very high potency: don't D/C abrupt but switch to
lower strength, total dose should not exceed 50g/week, max tx duration
should be 2-4 weeks
Remember the Rules of 3 Right Ans - -Ultra-high potency steroids: should
NOT be used for more than 3 weeks
-Low-high potency steroids should NOT be used for more than 3 months
What are some prescribing considerations with topical steroids? Right Ans
- 1. Hydration improves absorption (ex: apply post shower)
2. Most are once or twice daily
3. Fingertip method: half fingertip is 0.5g and covers whole area of hand
What are topical medications to treat psoriasis? Right Ans - 1.
Corticosteroids
2. Vitamin D analogues
3. Retinoids
4. Calcineurin Inhibitors
Info regarding Vitamin D Analogues Right Ans - -Photosensitivity
-Increased calcium levels
-Very irritating (causes stinging, burning, and peeling)
Info regarding Retinoids (ex: tazarotene) Right Ans - -Photosensitivity
-Pregnancy Cat X
-Tazarotene only retinoid approved for plaque psoriasis
-Very irritating (causes stinging, burning, and peeling)
Info regarding Calcineurin Inhibitors (ex: tacrolimus) Right Ans - -Local
stinging and burning but less than Tazarotene and Vit D Analogs
**Consider for facial or intertriginous psoriasis**
Info regarding steroid-free psoriasis treatments Right Ans - safe for long-
term use, can be used on any area of body (even thin skin)
Oral psoriasis drugs (non-biologics) Right Ans - 1. Methotrexate
2. Cyclosporine
3. Oral retinoid (Soriatane)
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