Podcast
Questions and Answers
What is the predominant organism responsible for cellulitis in outpatient settings?
What is the predominant organism responsible for cellulitis in outpatient settings?
- E. coli
- MRSA
- MSSA
- β-hemolytic streptococcus spp. (correct)
Which of the following is true about the first line treatment for cellulitis?
Which of the following is true about the first line treatment for cellulitis?
- Penicillin VK is an effective option for treating Strep. spp. (correct)
- Doxycycline is the primary treatment option.
- Amoxicillin/clavulanic acid targets exclusively MRSA.
- Cephalexin does not inhibit cell wall synthesis.
What mechanism of action do beta-lactams like Penicillin VK use?
What mechanism of action do beta-lactams like Penicillin VK use?
- Inhibits DNA replication
- Disrupts metabolic pathways
- Inhibits cell wall synthesis via peptidoglycan (correct)
- Inhibits protein synthesis
In patients with moderate cellulitis, what is the typical recommendation for treatment?
In patients with moderate cellulitis, what is the typical recommendation for treatment?
Why is MRSA coverage usually unnecessary in the general population when treating cellulitis?
Why is MRSA coverage usually unnecessary in the general population when treating cellulitis?
What is a notable side effect of topical treatments?
What is a notable side effect of topical treatments?
Which medication is indicated for use in cases of both pyrantel pamoate allergy and vice versa?
Which medication is indicated for use in cases of both pyrantel pamoate allergy and vice versa?
Which is NOT a side effect associated with Atovaquone?
Which is NOT a side effect associated with Atovaquone?
What is the mechanism of action for Praziquantel?
What is the mechanism of action for Praziquantel?
In which condition should Praziquantel be avoided?
In which condition should Praziquantel be avoided?
What type of infection is cellulitis classified as?
What type of infection is cellulitis classified as?
Which of the following conditions is NOT classified under fungal infections?
Which of the following conditions is NOT classified under fungal infections?
Which adverse effect is most commonly associated with the treatment of dermatologic infections?
Which adverse effect is most commonly associated with the treatment of dermatologic infections?
Varicella belongs to which category of dermatologic infections?
Varicella belongs to which category of dermatologic infections?
What characterizes acute bacterial skin and skin structure infections (ABSSSI)?
What characterizes acute bacterial skin and skin structure infections (ABSSSI)?
Which of the following represents a notable interaction with dermatologic medications?
Which of the following represents a notable interaction with dermatologic medications?
Which of the following infections is caused by a viral agent?
Which of the following infections is caused by a viral agent?
What is a primary consideration when selecting treatment for bacterial skin infections?
What is a primary consideration when selecting treatment for bacterial skin infections?
Which of the following conditions is primarily associated with the treatment of endoparasitic infections?
Which of the following conditions is primarily associated with the treatment of endoparasitic infections?
Which of the following best describes the mechanism of action for antifungal medications?
Which of the following best describes the mechanism of action for antifungal medications?
What is the mechanism of action of Sulfamethoxazole/trimethoprim?
What is the mechanism of action of Sulfamethoxazole/trimethoprim?
Which of the following is a potential adverse effect of linezolid when used for a prolonged duration?
Which of the following is a potential adverse effect of linezolid when used for a prolonged duration?
What should be monitored when prescribing Sulfamethoxazole/trimethoprim to a patient on warfarin?
What should be monitored when prescribing Sulfamethoxazole/trimethoprim to a patient on warfarin?
In which circumstance is clindamycin indicated for use?
In which circumstance is clindamycin indicated for use?
What condition must be considered when prescribing linezolid due to potential drug interactions?
What condition must be considered when prescribing linezolid due to potential drug interactions?
Which antibiotic is recommended for treating severe purulent skin infections?
Which antibiotic is recommended for treating severe purulent skin infections?
How should clindamycin be used cautiously?
How should clindamycin be used cautiously?
Which of the following organisms can be treated with clindamycin?
Which of the following organisms can be treated with clindamycin?
What is the primary mechanism of action for Permethrin and pyrethrins in treating lice?
What is the primary mechanism of action for Permethrin and pyrethrins in treating lice?
Which treatment for lice is contraindicated in patients with a Chrysanthemum allergy?
Which treatment for lice is contraindicated in patients with a Chrysanthemum allergy?
How does Spinosad cause its neurotoxic effects?
How does Spinosad cause its neurotoxic effects?
What measure should be taken after treating a lice infestation?
What measure should be taken after treating a lice infestation?
What is the treatment of choice for scabies?
What is the treatment of choice for scabies?
What should be done regarding nits after lice treatment?
What should be done regarding nits after lice treatment?
Which of the following is NOT a feature of topical Permethrin treatment?
Which of the following is NOT a feature of topical Permethrin treatment?
What is the role of Piperonyl butoxide in lice treatment?
What is the role of Piperonyl butoxide in lice treatment?
Study Notes
Learning Objectives
- Describe medications for skin disorders: mechanism of action, key adverse effects, contraindications, and notable drug-drug interactions.
- Formulate a treatment plan based on patient case scenarios.
Dermatologic Infections
-
Categories of Infections: Bacterial, Fungal, Viral.
-
Bacterial Infections Include:
- Cellulitis
- Furuncle/Carbuncle
- Erysipelas
- Impetigo
- Leprosy
- Cutaneous Anthrax
-
Fungal Infections Include:
- Tinea group
- Candidiasis
- Histoplasmosis
- Blastomycosis
- Paracoccidioidomycosis
- Sporotrichosis
- Coccidioidomycosis
-
Viral Infections Include:
- Herpes simplex
- Varicella
- Endoparasitic infections such as babesiosis and schistosomiasis.
Cellulitis
-
Predominant Organism: β-hemolytic streptococcus spp. (Strep pyogenes) (57-75%).
-
First-Line Treatment: Oral Beta-lactams (Penicillin VK, Amoxicillin/clavulanic acid, Cephalexin).
-
Mechanism of Action for Beta-lactams: Inhibit cell wall synthesis via peptidoglycan.
-
Alternatives:
- Dicloxacillin: Covers Strep spp., MSSA.
- Doxycycline: Covers Strep spp., MSSA, limited MRSA (inhibits 30S ribosomal subunit).
-
MRSA Coverage: Generally unnecessary in the general population; moderate cases may require inpatient IV antibiotics.
Drug Options for Cellulitis
- Sulfamethoxazole/trimethoprim (SMX-TMP): Inhibits dihydrofolate reductase; be cautious with sulfa allergies.
- Clindamycin: Limited coverage for Strep spp.; can cause C. difficile infections.
- Linezolid: Inhibits protein synthesis (50S ribosomal subunit); risk of serotonin syndrome with MAOIs.
Severe Cellulitis Treatment
- Severe/Inpatient Management: Vancomycin, Daptomycin, Linezolid, Ceftaroline.
Endoparasitic Infections
- Atovaquone: Selectively inhibits mitochondrial electron transport; may cause GI disturbances.
- Praziquantel: Disrupts ion transport; avoid in ocular cysticercosis and during pregnancy.
Treatment for Ectoparasites
-
Lice Treatment:
- Preferred: Topical Permethrin 1% or Pyrethrins, Spinosad (causes neurotoxicity).
- Mechanism: Disrupts sodium transport in neuronal membranes leading to paralysis.
- Precautions: Contraindicated in Chrysanthemum allergies; treat bedding and clothing.
-
Scabies Treatment:
- First-Line: Topical Permethrin or Spinosad, Oral Ivermectin.
- Mechanism: Disrupts sodium transport across neuronal membranes, causing neurotoxicity and paralysis.
Key Pearls
- For lice and scabies, proper combing and environmental disinfection are crucial.
- Repeat treatments for lice after 7 days; handle potential skin irritation from topical agents.
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Description
Test your knowledge on pharmacology related to dermatology in the MSK II course for Fall 2024. This quiz covers mechanisms of action, adverse effects, contraindications, and drug interactions for medications used in treating skin disorders. Additionally, you will formulate treatment plans based on patient scenarios.
