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Flashcards in Medication + Investigations Deck (38)
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1

How do you investigate skin disease

Charcoal swab + MC+S
Viral swab PCR of vesicle / bull
Fungal nail clipping / hair sample + CULTURE
Biopsy

2

When would you not do a charcoal swab

Cellulitis as infection in blood
Venous ulcer

3

How affected absorption of topical medication

Concentration
Vehicle - pharmacologically inert but chemically stable substance that carriers active drug
Chemical properties
Striatum thickness
Temperature
Skin site

4

What topical agents is there to treat skin disease

Steroids
Vit A Analogue
Antibiotics / fungals / viral
Parasitidicies
Chemo
Coal tar
Dithranol

5

What do steroids do

Anti-inflammatory + immunosuppressive
Suppress fibroblasts / leucocytes
Vasoconstrict
Regulate cytokines
Inhibit vascular permeability

6

How do you measure amount of topical agent

Finger tip unit (0.5g)
Potency over %
Mild = hydrocortisone
Mod = Eumovate
Potent = Betonovate
Highly potent = Dermovate

7

What are the SE of steroids

Thinning / atrophy of skin
Striae
Hirsutism
Telengiectasia
Acne
Peri-oral dermatitis
Allergic contact dermatitis
May exacerbate skin infection

If systemic
- Glaucoma / Cataract
- Cushing
- DM
- Immunosuppression
- HTN
- Osteoporosis

8

What are common systemic agents

Retinoids
Immunosuppressant
Biologics

9

What are retinoids

Vit A analogues

10

What do retinoids do

Normalise keratinocyte function
Anti-inflammatory
Decrease skin turnover

11

What are the SE of retinoids

Dry lips and skin
TERATOGENIC - must be on contraceptive
Increased transaminase / abnormal LFT - monitor with regular blood test
Psychiatric / bone / eye = rare

12

When are retinoids indicated

Acne
Psoriasis
T cell lymphoma
Hand eczema

13

What are common immunosuppressants

Steroid
Cyclosporin
Azathropine
Methotrexate
MMF

14

What is needed if on immunosuppressants and why

Regular blood monitoring - FBC, U+E, LFT
Risk of malignancy / infection

15

What are biologics

Genetically engineered proteins which inhibit specific parts of the immune system
Expensive

16

What have biologics revolutionised the Rx of

Melanoma

17

If biologic end in - cept

Receptor fusion protein

18

If biologic end in -mab

Monoclonal Ab

19

What are the SE of biologics

Infection
Malignancy
TB reactivation
TNF inhibitor so risk of demyelination

20

What are types of monoclonal Ab

HUmanised
Chimeric
Fully human
Immunomodualtory

21

When are biologics used

Melanoma
Urticaria
Plaque psoriasis

22

What must you avoid if on a biologic

Live vaccine

23

What are examples of emollients

Aqueous cream
Emulsifying ointment
Liquid parafin

24

What is indication

Rehydrate skin
Used for dry scaling conditions and as soap substitute

25

What are SE

Can have irritant or allergic reaction if preservative/ perfume in cream

26

What are SE of oral acyclovir

GI upset
Raised liver enzyme
Haemaotlogical disorder
Reversible neurological

27

What are SE of anti-histamine

Sedation
Anti-cholinergic - blurred vision / dry mouth / retention and constipation

28

Types of anti-histamine

Sedating
- CHlorphenamine
Non-sedating
- Cetrizine
- Loritidine

29

When are they used

Type1 hypersensitvity
Eczema
Pruritus as block histamine receptors

30

What are topical Ax

Fusidic acid
Neomycin
Dapsone