Dermatology pharmacology and prescribing

Question 1

unlicensed

Answer 1

not approved for use in UK

Question 2

off label

Answer 2

A licensed medication being used for an unlicensed indication

Question 3

Specials medication

Answer 3

unlicensed dermatological preparations

clinically effective but lack of evidence

Question 4

Pharmacokinetics

Answer 4

effect of body on the drug

Question 5

Pharmacodynamics

Answer 5

Effect of drug on the body

Question 6

Causes of prescription errors

Answer 6

lack of knowledge - patient, medication, allergy
unintentional error in writing of prescription
no guidance
poor communication

Question 7

Pharmacology

Answer 7

branch of medicine concerned with uses, effects and modes of actions of drugs

Question 8

What is the preferred route of administration?

Answer 8

topically

Question 9

Distribution

Answer 9

where the drug gets

Question 10

Metabolism - disease of what organ important?

Answer 10

liver

Question 11

Excretion - disease of what organ important?

Answer 11

kidneys

Question 12

4 factors influencing pharmacodynamics

Answer 12

age
drug interactions
pregnancy risk
pharmacogenetics

Question 13

Factors which make it more likely the patient will adhere to medication?

Answer 13

female, increasing age, working, married, not paying for prescription

Question 14

Factors associated with poor adherence to medication

Answer 14

psychiatric 
unintentional 
cosmesis implications 
slower acting agents 
multiple times a day 
lack of education

Question 15

2 components of a topical therapy

Answer 15

vehicle and active drug

Question 16

What is a vehicle?

Answer 16

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

Question 17

Factors affecting absorption of a topical therapy

Answer 17

skin site 
thickness and dehydration 
location 
occlusion 
concentration 
vehicle 
temperature 
chemical properties

Question 18

List some examples of vehicles

Answer 18

creams, ointments, shampoo, patches, oils, gel, foam, paste, lotion, spray, paint

Question 19

Some examples of medications given topically

Answer 19

steroids, NSAIDS, salicylic acid, antiviral, antibiotic, chemotherapy, coal tar, vitamin analogues, parasiticidals

Question 20

How do topical steroids work?

Answer 20

regulate pro-inflammatory cytokines
suppress fibroblasts, endothelial and leukocyte function
vasoconstriction and inhibit vascular permeability

Question 21

Is % or potency of a topical CCS more important?

Answer 21

potency

Question 22

What is a finger-tip unit?

Answer 22

0.5g - enough to cover childs hand twice

Question 23

side effects of topical steroids

Answer 23

thinning/atrophy 
hirsutism 
striae 
bruising 
glaucoma
acne 
rosacea
cataracts
telangiectasia

Question 24

3 systemic treatments in dermatology

Answer 24

retinoids
immunosuppressants
biologics

Question 25

What are retinoids?

Answer 25

vitamin A analogues

Question 26

How do retinoids work?

Answer 26

normalise keratinocyte function | anti-inflammatory and anti-cancer

Question 27

Conditions which use retinoids

Answer 27

acne, psoriasis, cutaneous T cell lymphoma, hand eczema

Question 28

Disadvantages/side effects of retinoids

Answer 28

teratogenic psynchiatric, eye, bone - rare dry lips and dry skin increase TAG

Question 29

Risks of immunosuppressives

Answer 29

malignancy and infection

Question 30

3 important blood tests for those on immunosuppressives

Answer 30

FBC renal function liver function

Question 31

Biologics - what are they?

Answer 31

genetically engineered proteins derived from human genes designed to inhibit specific parts of immune system

Question 32

Cept

Answer 32

receptor fusion protein

Question 33

mab

Answer 33

monoclonal anti-body

Question 34

zu

Answer 34

humanised

Question 35

ix

Answer 35

chimeric

Question 36

u

Answer 36

fully human

Question 37

il

Answer 37

immunomodulatory

Question 38

2 conditions biologics used in

Answer 38

psoriasis | chronic spontaneous urticaria

Question 39

Risks of infection consequences of biologics

Answer 39

reactivation of TB avoid live vaccines serious infection

Question 40

2 other disadvantages of biologics

Answer 40

risk of malignancy | TNF inhibitor - risk of demyelination

Question 41

Biologics in melanoma

Answer 41

poor prognosis - help to improve this BRAF 600 mutation immunotherapies

Question 42

5 year survival for melanoma

Answer 42

20%