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MBChB - Y2 - Dermatology > Dermatology, Pharmacology and Prescribing > Flashcards

Dermatology, Pharmacology and Prescribing Flashcards

1
Q

Who liscences medication in scotland?

A

SMC - Scottish medicines consortium

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2
Q

What are the causes of prescription errors?

A

•Lack of knowledge

–About the patient, the medication, allergies

  • Mistake writing/generating the prescription
  • Poor communication
  • No local or national guidelines
  • Pharmacy/medicine info service
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3
Q

What is the definition of pharmacokinetics and pharmacodynamics?

A

Pharmacokinetics - the effect of the body on the drug

Pharmacodynamics - the effect of the drug on the body

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4
Q

What are the factors that should be considered since pharmacodynamics are different in different patients?

A

Factors include:

–Age of patient

–Pregnancy risk (some drugs may be teratogenic)

–Drug interactions

–Pharmacogenetics

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5
Q

Who is more likely to stick to their medication?

A

–Female

–Married

–Employed

–Not paying for their prescriptions

–Increasing age

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6
Q

What factors are associated with poor adherence?

A
  • Psychiatric co-morbidities
  • Slower acting agents
  • Multiple applications per day
  • Lack of patient education
  • Cosmetic acceptability of treatments
  • Unintentional non-adherence
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7
Q

What is the vehicle?

A

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

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8
Q

What factors affect absorption?

A
  • Concentration
  • Base/vehicle
  • Chemical properties of the drug
  • Thickness and hydration of stratum corneum
  • Temperature
  • Skin site
  • Occlusion
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9
Q

What are types of vehicle?

A

Solution

Paste

Cream

Spray powder

Lotion

Shampoo

Gel

Ointment

Foam

Paint

Tape

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10
Q

Give examples of drugs administered topically

A

Corticosteroid

Chemotherapy

Antibiotic

Parasiticidals

Antiviral

Coal Tar

Dithranol

Anti-inflammatory

Vitamin analogues

Salicylic acid

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11
Q

What is the function of topical steroids?

A

Anti-inflammatory

Immunosuppressice

Also vasoconstrict

Also inhibit vascular permeability

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12
Q

What is the finger tip unit?

A

About 0.5 grams - should treat the area double the size of one hand

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13
Q

What are the side effects of topical steroids?

A
  • Thinning /atrophy
  • Striae
  • Bruising
  • Hirsutism
  • Telangiectasia
  • Acne/rosacea/perioral dermatitis
  • Glaucoma
  • Systemic absorption
  • Cataracts
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14
Q

What skin condition can arise after stopping a course of topical steroids?

A

Perioral dermatitis

Treatment for which is stopping steroids and using emolium

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15
Q

What are the systemic treatments in dermatology?

A

Retinoids

Traditional immunosuppressants

Biologics (also immunosuppressive)

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16
Q

What are retinoids and what are their function?

A

Vitamin A anologues

They normalise keratinocyte function

Anti-inflammatory and anti-cancer effects

17
Q

What are the four different oral agents (retinoids) and their uses

A

Acne - Isotretinoin

Psoriasis - acitretin

Cutaneous T cell lymphoma - bexarotene

Hand eczema - alitretinoin

18
Q

What are the risks associated with retinoids?

A

Teratogenic

Cheilitis (dry lips)

Xerosis (dry skin)

Increase in transaminases

Increase in triglycerides

Rarely psychiatric, eye, bone side effects

19
Q

What are the immunosuppressants used for the treatment of inflammatory skin disorders?

A
  • Oral steroids
  • Azathioprine
  • Ciclosporin
  • Methotrexate
  • Mycophenolate mofetil
20
Q

What are the risks associated with immunosuppressants?

A

Malignancy

Serious unfection

21
Q

What are the blood tests needed in association with using immunosuppressants?

A

–FBC (esp in methotrexate and azathioprine)

–Renal function (esp ciclosporin)

–Liver function (esp methotrexate)

22
Q

How are biologics made?

A

Genetically engineered proteins derived from human genes

Designed to inhibit specific portions of the immune system

23
Q

What do the suffix’es cept and mab mean?

A

cept - genetically engineered fusion protein

mab - monoclonal antibodies

24
Q

What are the infixes that immediately precede mab?

A

zu - humanised

ix - chimeric

u - fully human

li/l - immunomodulator

•E.g.adalimumab = immunomodulator fully human monoclonal antibodies

25
Q

Give an example of a biologic that is used to treat plaque psoriasis in the UK

A

Etanercept

Adalimumab

Infliximab

For chronic spontaneous utricaria - omalizumab

26
Q

What are the risks associated with biologic agents?

A

•Risk of infection

–TB reactivation

–Serious infection

–Avoid live vaccines

  • Risk of malignancy
  • TNF inhibitors – risk of demyelination
27
Q

Biologics have been described as revolutionary for what condition?

A

Melanoma - ~20% 5 year survival in stage 4 disease

28
Q
A

MBChB - Y2 - Dermatology (11 decks)

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