Dermatology, Pharmacology and Prescribing Flashcards Preview

Dermatology (Year 2 GM) > Dermatology, Pharmacology and Prescribing > Flashcards

Flashcards in Dermatology, Pharmacology and Prescribing Deck (28):
1

Who liscences medication in scotland?

SMC - Scottish medicines consortium

2

What are the causes of prescription errors?

•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

3

What is the definition of pharmacokinetics and pharmacodynamics?

Pharmacokinetics - the effect of the body on the drug

Pharmacodynamics - the effect of the drug on the body

4

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

Factors include:

–Age of patient

–Pregnancy risk (some drugs may be teratogenic)

–Drug interactions

–Pharmacogenetics

5

Who is more likely to stick to their medication?

–Female

–Married

–Employed

–Not paying for their prescriptions

–Increasing age

6

What factors are associated with poor adherence?

•Psychiatric co-morbidities

•Slower acting agents

•Multiple applications per day

•Lack of patient education

•Cosmetic acceptability of treatments

•Unintentional non-adherence

7

What is the vehicle?

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

8

What factors affect absorption?

•Concentration

•Base/vehicle

•Chemical properties of the drug

•Thickness and hydration of stratum corneum

•Temperature

•Skin site

•Occlusion

9

What are types of vehicle?

Solution  

Paste

Cream  

Spray powder

Lotion 

Shampoo

Gel 

Ointment

Foam 

Paint

Tape

10

Give examples of drugs administered topically

Corticosteroid 

Chemotherapy

Antibiotic 

Parasiticidals

Antiviral 

Coal Tar

Dithranol 

Anti-inflammatory

Vitamin analogues 

Salicylic acid

11

What is the function of topical steroids?

Anti-inflammatory

Immunosuppressice

 

Also vasoconstrict

Also inhibit vascular permeability

12

What is the finger tip unit?

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

 

13

What are the side effects of topical steroids?

•Thinning /atrophy

•Striae

•Bruising

•Hirsutism

•Telangiectasia

•Acne/rosacea/perioral dermatitis

•Glaucoma

•Systemic absorption

•Cataracts

14

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

Perioral dermatitis

 

Treatment for which is stopping steroids and using emolium

15

What are the systemic treatments in dermatology?

Retinoids

Traditional immunosuppressants

Biologics (also immunosuppressive)

16

What are retinoids and what are their function?

Vitamin A anologues 

 

They normalise keratinocyte function

Anti-inflammatory and anti-cancer effects

17

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

Acne - Isotretinoin

Psoriasis - acitretin

Cutaneous T cell lymphoma - bexarotene

Hand eczema - alitretinoin

18

What are the risks associated with retinoids?

Teratogenic

Cheilitis (dry lips)

Xerosis (dry skin)

Increase in transaminases

Increase in triglycerides

Rarely psychiatric, eye, bone side effects

19

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

•Oral steroids

•Azathioprine

•Ciclosporin

•Methotrexate

•Mycophenolate mofetil

20

What are the risks associated with immunosuppressants?

Malignancy

Serious unfection

21

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

–FBC (esp in methotrexate and azathioprine)

–Renal function (esp ciclosporin)

–Liver function (esp methotrexate)

22

How are biologics made?

Genetically engineered proteins derived from human genes

 

Designed to inhibit specific portions of the immune system

23

What do the suffix'es cept and mab mean?

cept - genetically engineered fusion protein

mab - monoclonal antibodies

24

What are the infixes that immediately precede mab?

zu - humanised

ix - chimeric

u - fully human

li/l - immunomodulator

 

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

25

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

Etanercept

Adalimumab

Infliximab

 

For chronic spontaneous utricaria - omalizumab

26

What are the risks associated with biologic agents?

•Risk of infection

–TB reactivation

–Serious infection

–Avoid live vaccines

•Risk of malignancy

•TNF inhibitors – risk of demyelination

27

Biologics have been described as revolutionary for what condition?

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

28