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DERMATOLOGY > Pharmacology and Prescribing > Flashcards

Pharmacology and Prescribing Flashcards

1
Q

what is an unlicensed drug

A

not approved for use in the UK

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2
Q

what is an off label drug

A

a licensed medication that is being used for an unlicensed indication

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3
Q

what are specials drugs

A

unlicensed dermatological preparations - long history of use, no strong evidence bas but clinically effective

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4
Q

what are 4 causes of prescription error

A
  1. lack of knowledge
  2. mistake writing generating prescription
  3. poor communication
  4. no local/national guidelines
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5
Q

what is the definition of pharmacokinetics

A

the effect of the body not the drug

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6
Q

what is the definition of pharmacodynamics

A

the effect of the drug on the body

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7
Q

what are the 4 factors to take into account in pharmacokinetics

A
  1. route of administration - affects absorption
  2. distribution - where the drug goes
  3. metabolism - esp in liver disease
  4. excretion - esp in renal disease
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8
Q

what are the 5 factors to take into account in pharmacodynamics

A
  1. individual variation in response
  2. age of patient
  3. pregnancy risk
  4. drug interactions
  5. pharmacogenetics
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9
Q

what are 6 factors related to poor adherence of taking medication

A
  1. Psychiatric co-morbidities
  2. Slower acting agents
  3. Multiple applications per day
  4. Lack of patient education
  5. Cosmetic acceptability of treatments
  6. Unintentional non-adherence
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10
Q

what is the definition of topical therapy

A

medication applied to the skin

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11
Q

what are the two components in a topical medication

A

vehicle and active drug

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12
Q

what is the definition of the vehicle in topical medication

A

pharmacologically inert, physically and chemically stable substance that carries the active drug

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13
Q

give examples of topical vehicles

A

solutions, creams, lotions, gels, foams, tapes, paste, spray powder, shampoo, ointment, paint

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14
Q

what factors can affect absorption of topical medications

A

concentration, base/vehicle, chemical properties of drug, thickness & hydration of stratum corneum, temperature, skin site, occlusion

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15
Q

give examples of drugs than can be used topically

A

corticosteroids, antibiotics, antivirals, dithranol, vitamin analogues, chemotherapy, parasiticidals, coal tar, anti-inflammatory, salicylic acid

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16
Q

what are the main properties of topical steroids

A

anti-inflammatory and immunosuppressive

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17
Q

how do topical steroids work

A
  1. regulate pro inflammatory cytokines
  2. suppress fibroblast, endothelial and leukocyte function
  3. vasoconstriction
  4. inhibit vascular permeability
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18
Q

what are the range of potencies of topical steroids

A

mild, moderate, potent, ultra potent

19
Q

how much is a finger tip unit and what area can it cover

A

about 0.5g - should treat area double the size of one hand

20
Q

what are the side effects of topical steroids

A 
Thinning /atrophy
Striae
Bruising
Hirsutism
Telangiectasia
Acne/rosacea/perioral dermatitis
Glaucoma
Systemic absorption
Cataracts
21
Q

name 3 groups of systemic treatments in dermatology

A
  1. retinoids
  2. traditional immunosuppressants
  3. biologics (also immunosuppressive)
22
Q

what are retinoids and what do they do

A

vitamin A analogues - normalise keratinocyte function, anti-inflammatory and anti cancer effects

23
Q

what retinoid is used for acne

A

isotrtinoin

24
Q

what retinoid is used for psoriasis

A

acitretin

25
Q

what retinoid is used for cutaneous T cell lymphoma

A

bexarotene

26
Q

what retinoid is used for hand eczema

A

alitretinoin

27
Q

what aspect of retinoids mean you must be careful in patient selection

A

it is teratogenic

28
Q

what are the side effects of retinoids

A
  1. Cheilitis(dry lips) and xerosis (dry skin)
  2. ↑transaminases, ↑triglycerides
  3. Rarely psychiatric, eye, bone side effects
29
Q

what are immunosuppressants used for in dermatology

A

inflammatory skin conditions

30
Q

give examples of immunosuppressants

A 
Oral steroids
Azathioprine
Ciclosporin
Methotrexate
Mycophenolate mofetil
31
Q

what are the risks of taking immunosuppressants

A

malignancy, serious infection

32
Q

what monitoring is needed when on immunosuppressants

A

regular blood tests

  • FBC
  • renal function
  • liver function
33
Q

what are biologics

A

Genetically engineered proteins derived from human genes

34
Q

what are biologics designed to do

A

designed to inhibit specific components of the immune system

35
Q

in biologics what does the suffix -cept indicate

A

is is a receptor fusion
eg
EtanerCEPT -genetically engineered fusion protein

36
Q

in biologics what does the suffix -mab indicate

A

used to denote Monoclonal AntiBodies

37
Q

what do the following infixes which immediately precede -mab denote

A
  • zu- = humanised
  • ix- = chimeric
  • u- = fully human
  • li-/-l- = immunomodulator
38
Q

name the comments of e.g. adaLImUMAb

A
  • li- = immunomodulator
  • u- = fully human
  • mab = monoclonal antibodies
39
Q

name the components of e.g. infLIXiMAB

A
  • l- = immunomodulator
  • xi- = chimeric
  • mab - monoclonal antibodies
40
Q

what are the current biologics licensed for plaque psoriasis in the uk

A

Etanercept Infliximab
Adalimumab* Ustekinumab
Secukinumab Ixekizumab

*also licensed for hidradenitis supportive

41
Q

what biologic is licensed in the UK for chronic spontaneous urticaria

A

omalizumab

42
Q

what are the risks associated with biologics

A
  1. risk of infection - TB reactivation, serious infections
  2. risk of malignancy
  3. risk of demyelination - TNF inhibitors
43
Q

what biologics are used to treat melanoma with the BRAF 600 mutation

A

Vemurafenib

Dabrafenib

44
Q

what biologics are used to as immunotherpies in melanoma

A

Ipilumumab

Pembrolizumab

DERMATOLOGY (11 decks)

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