Corticosteroid 働き３つ
Class I-IV -> Never use for — & —
Corticosteroids side effect ３つ (non-systemic)
体全体に必要な塗り薬の量(g)
指の関節一つ分の塗り薬の量(g)
コラーゲンの生成が妨げられることによる症状４つ
Corticosteroidが効かない時に考えられること２つ
Corticosteroids’ “systemic” A/E – ２つ
Oral (systemic) antifungal med – indications ３つ
Antifungal meds NOT in pregnancy ２つ
Do NOT recommend this “oral” antifungal med —– ->FDA warning
for liver damage risk -> liver function test must be every — months.
High drug-drug interaction risk med: —- r/t metabolized by CYP3A4
Xerese 何の薬？indication –
Oral retinoid – indications & contraindications
Patient with psoriasis who use biologics –> risk for ———–
Patient who is going to be on biologics -> screening on ——-
答え
Corticosteroid 働き３つ – reduction of the inflammatory response, vasoconstriction, decrease in collagen synthesis
Class I-IV -> Never use for face & genitals. Do not use stronger class ones for breasts or axillae as well.
S/E – contact dermatitis, acne-like eruptions, hypo-pigmentation
体全体に必要な塗り薬の量(g) – 30g r/t scabies treatment requires x2
指の関節一つ分の塗り薬の量(g) – 0.5g (1g=10cm x 10cm)
コラーゲンの生成が妨げられることによる症状４つ – strie, tissue atrophy, telangiectasia, purpula (epidermis thinning)
Corticosteroidが効かない時に考えられること２つ – tachyphylaxis, fungal/yeast infection
Topical corticosteroids systemic A/E – growth restriction and glaucoma
Oral (systemic) antifungal med – indications ３つ – when tinea widespread to the body, nails involvement, scalp involvement
Antifungal meds NOT in pregnancy ２つ – terbinafine (category B), itraconazole (category C) — category Bですが、教科書にはpregnancyにはnot recommendとなっていて…。
Do NOT recommend this “oral” antifungal med —– ->FDA warning
Nizoral (ketoconazole) oral tablet r/t serious liver damage risk
for liver damage risk -> liver function test must be every 6 mo.
High drug-interaction — itraconazole
Xerese 何の薬？indication – topical antiviral for recurrent helpes labialis (cold sores) – for preventing “ulcerative” cold sores – combination of acyclovir + hydrocortisone)
Oral retinoid (e.g. isotretinoin/Accutane) – indications – severe acne (creamやgelが効かない人に), wrinkles, psoriasis ———— & contraindications – Pregnancy – both oral and topical — tetragenic and monthly pregnancy check is required.
Patient with psoriasis who use biologics –> risk for infection or malignancy. (Biologics – e.g. infliximab, adalimumab)
Patient who is going to be on biologics -> screening on TB, Hep-B. Patient who is on biologics are considerd to be “immunocompromized patient” and can not receive live vaccines. If live vaccines are needed, receive them 2 weeks – 1 month before starting treatment with biologic agents.