Deck 14: Topical Products

Question 1

Your patient has been diagnosed with postherpetic neuralgia and presents with a prescription for extended-release 5% lidocaine topical patch. She should be advised to:

A) Expect application site reactions to be of moderate severity and permanent
B) Remove patch prior to MRI procedures to avoid burns
C) Reuse patches if needed
D) Apply one patch to the most painful area every 6 hours

Answer 1

B

Question 2

Which of the following MetroGel dosing regimens is appropriate for the treatment of bacterial vaginosis?

A) 500 mg by mouth TID
B) Apply topically and rub in a thin film twice daily to entire affected area
C) Insert one applicatorful intravaginally at bedtime for 10 days
D) Insert one applicatorful intravaginally twice daily for 5 days

Answer 2

D

Question 3

Which of the following is indicated for the treatment of impetigo?

A) Bactrim
B) Bactroban
C) Bacitracin
D) Baclofen

Answer 3

B

Question 4

All of the following statements are correct regarding Hibiclens 4% solution, EXCEPT:

A) Common adverse reactions include skin dryness and erythema
B) It is active against gram-positive and gram-negative organisms
C) Application to hairy areas is recommended to shorten product drying time
D) Avoid application to wounds that involve more than superficial layers of skin

Question 5

You are asked to provide patient counseling to a 17-year-old male who presents with a new Cleocin-T prescription for acne. You recommend the following:

A) Wash hands thoroughly prior to applying or wear gloves
B) Advise him to shave immediately after product application
C) Common side effects are dryness, burning, scaling, or peeling of skin
D) A and C

Question 6

Ketoconazole is used to treat a variety of cutaneous fungal infections. Which of the following statements is correct?

A) Shorter courses of treatment are generally recommended for tinea corporis and tinea cruris
B) Ketoconazole is thought to be fungicidal in action
C) Ketoconazole shampoo should be applied daily for four weeks
D) Ketoconazole products can also be used for ophthalmic, oral, or intravaginal use

Question 7

All of the following statements regarding Terazol are correct, EXCEPT:

A) Administration of intravaginal Terazol does not appear to affect progesterone concentrations in women using low-dose oral contraceptives.
B) Vaginal suppositories should be inserted at bedtime for 7 days for the treatment of vulvovaginal candidiasis.
C) Patients should refrain from sexual intercourse during period of treatment.
D) Terazol exhibits fungicidal activity against Candida albicans.

Question 8

Which of the following statements is true regarding the use of Jublia?

A) The duration of treatment for onychomycosis is 12 weeks.
B) It is safe for use in pregnant patients.
C) It is available as a 10% topical solution.
D) Monthly pedicures are recommended while using this product.

Question 9

All of the following statements are true regarding acne vulgaris, EXCEPT:

A) Tretinoin therapy has been shown to cure acne vulgaris.
B) Best results are usually seen when treatment starts in the early stages.
C) Tretinoin is a derivative of vitamin A.
D) Patients using tretinoin should be counseled to avoid exposure to sunlight.

Question 10

Select the correct product to treat tinea unguium.

A) Micatin
B) Nizoral
C) Kerydin
D) Lamisil

Question 11

Lotrisone is indicated for the treatment of athlete's foot. All of the following statements are correct, EXCEPT:

A) Keep the treated area bandaged and covered following application.
B) Notify the provider if there is no improvement after 2 weeks of use.
C) Do not exceed application of 45 grams per week of Lotrisone cream.
D) Advise patients to massage into affected area twice daily, morning and evening.

Question 12

Appropriate patient counseling for Temovate to treat scalp psoriasis includes the following:

A) Temovate is a low-potency synthetic fluorinated topical corticosteroid.
B) Temovate is recommended for application to face, groin, or axilla areas.
C) Treatment beyond 2 consecutive weeks is not recommended.
D) Apply thin film of shampoo to wet scalp once daily.

Question 13

Which of the following is NOT a brand name of hydrocortisone cream?

A) Hytone
B) Anusol-HC
C) Cortenema
D) Vanos

Question 14

A 30-year-old female purchases a tube of hydrocortisone 1% cream at your pharmacy for use on an itchy rash on her lower arm. Which of the following is NOT an appropriate counseling point?

A) She may safely use the over-the-counter cream for 2 weeks.
B) She should avoid exposing that arm to sunlight while using the hydrocortisone cream.
C) If her rash worsens or persists, she should discontinue use and call her physician.
D) She should not use occlusive dressings unless directed by her physician.

Question 15

Mometasone is available in all of the following preparations, EXCEPT:

A) Lotion
B) Topical powder
C) Cream
D) Ointment

Question 16

Which of the following topical corticosteroids is available as a dental paste to be used on oral lesions?

A) Mometasone furoate
B) Hydrocortisone valerate
C) Betamethasone dipropionate
D) Triamcinolone acetonide

Question 17

Which of the following dosing instructions for a topical corticosteroid is accurate?

A) Apply a thin film to open wounds twice daily.
B) Apply a generous amount to oral lesions and rub in vigorously.
C) Apply a ½-inch ribbon to lower eyelids nightly.
D) Apply a thin layer to areas of psoriasis once or twice daily.

Question 18

A thin, elderly woman with her three rowdy grandchildren presents to your pharmacy with a prescription for Lidoderm patches. The directions simply state "use as directed." When counseling the woman, she says that she doesn't remember the instructions the doctor gave her regarding patch use. What is an appropriate response?

A) Apply one patch daily and leave it on for 12 hours. Then, remove the patch and do not apply a new one for 12 hours.
B) If the patch is too large, it may be cut with scissors to an appropriate size.
C) There is no special disposal required. The patch may be placed in any trash can.
D) Both A and B

Question 19

What adverse effect(s) may be expected with topical metronidazole use?

A) Leukocytosis
B) Headache
C) Parasitic infection
D) Temporary skin discoloration

Question 20

Clindamycin phosphate may be used to treat an infection due to which of the following organism(s)?

A) Gardnerella vaginalis
B) Methicillin-resistant Staph aureus
C) Candida krusei
D) Both B and C

Question 21

All of the following medications may be appropriately used to treat bacterial vaginosis (BV), EXCEPT:

A) Clindesse
B) MetroGel
C) Elocon
D) Cleocin

Question 22

All of the following are common properties of topical corticosteroids, EXCEPT:

A) Anti-inflammatory
B) Anti-pruritic
C) Vasoconstrictive
D) Anti-platelet

Question 23

Which of the following products alters the release of substance P?

A) Terbinafine
B) Capsaicin
C) Permethrin
D) Lidocaine

Question 24

Counseling points for capsaicin cream include:

A) Avoid contact with eyes or mucous membranes
B) Do not apply to irritated skin
C) Stop use if redness or irritation develops
D) All of the above

Question 25

Metronidazole is available in which of the following dosage forms?

A) Topical cream
B) Topical gel
C) Vaginal gel
D) All of the above

Question 26

Identify the brand name product that contains metronidazole?

A) Temovate
B) Betasept
C) Nizoral
D) Vandazole

Question 27

Which drug is considered to be a treatment of choice for impetigo?

A) Bacitracin/Neomycin/Polymyxin B
B) Clobetasol
C) Mupirocin
D) Metronidazole

Question 28

Bactroban may be used for which of the following?

A) Elimination of MRSA colonization of the nasal airway
B) Treatment of burns infected with Pseudomonas aeruginosa
C) Bacterial conjunctivitis
D) Tinea infections on the trunk

Question 29

Which of the following is often an ingredient in surgical antiseptic skin preparations?

A) Docosanol
B) Erythromycin/Benzoyl peroxide
C) Mometasone
D) Chlorhexidine gluconate

Question 30

Which of the following organisms are killed by chlorhexidine gluconate?

A) Gram-positive bacteria
B) Gram-negative bacteria
C) Yeast
D) All of the above

Question 31

A patient presents to the pharmacy with a 1-inch diameter rash on his arm. He states that a few other people on his high school wrestling team have the same rash. It is erythematous and itchy, with a clearly defined circular border. His coach said that it was ringworm. Which product would you recommend?

A) Betamethasone cream
B) Hydrocortisone cream
C) Ketoconazole cream
D) Bacitracin cream

Question 32

Which of the following counseling points are incorrect for a patient using ketoconazole cream?

A) Discontinue use as soon as symptoms resolve.
B) For external use only.
C) Do not wash the application site for at least 3 hours after application.
D) Wash hands thoroughly before and after applying.

Question 33

When choosing a topical corticosteroid dosage form, the following recommendations are correct:

A) Ointments are best for weeping eruptions, especially in areas where chafing may occur
B) Gels and aerosols may be used on hairy areas, especially the scalp
C) Creams provide occlusive properties and are usually used for the treatment of dry, scaly lesions
D) All of the above

Question 34

Potential warnings for vaginal metronidazole gel include all of the following, EXCEPT:

A) Avoid alcohol for at least 3 days following use due to the risk of disulfiram-like reactions
B) Common side effects include headache, vaginal discharge, and burning
C) CBC with differential is recommended before and after therapy
D) Vaginal intercourse is permitted while undergoing treatment

Question 35

MB is a 66-year-old male who presents to the pharmacy with a new prescription for Axiron 2% solution. He has some questions on how to use this product. Select the most appropriate patient counseling point.

A) Side effects are generally mild and resolve within 2 weeks of use
B) Secondary exposure can lead to virilization in women and children
C) Apply Axiron prior to applying deodorant for better absorption
D) MB should have a prostate exam prior to starting Axiron