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Flashcards in Pharmacology and Prescribing Deck (44):
1

what is an unlicensed drug

not approved for use in the UK

2

what is an off label drug

a licensed medication that is being used for an unlicensed indication

3

what are specials drugs

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

4

what are 4 causes of prescription error

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

5

what is the definition of pharmacokinetics

the effect of the body not the drug

6

what is the definition of pharmacodynamics

the effect of the drug on the body

7

what are the 4 factors to take into account in pharmacokinetics

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

8

what are the 5 factors to take into account in pharmacodynamics

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

9

what are 6 factors related to poor adherence of taking medication

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

10

what is the definition of topical therapy

medication applied to the skin

11

what are the two components in a topical medication

vehicle and active drug

12

what is the definition of the vehicle in topical medication

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

13

give examples of topical vehicles

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

14

what factors can affect absorption of topical medications

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

15

give examples of drugs than can be used topically

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

16

what are the main properties of topical steroids

anti-inflammatory and immunosuppressive

17

how do topical steroids work

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

18

what are the range of potencies of topical steroids

mild, moderate, potent, ultra potent

19

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

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

20

what are the side effects of topical steroids

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

21

name 3 groups of systemic treatments in dermatology

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

22

what are retinoids and what do they do

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

23

what retinoid is used for acne

isotrtinoin

24

what retinoid is used for psoriasis

acitretin

25

what retinoid is used for cutaneous T cell lymphoma

bexarotene

26

what retinoid is used for hand eczema

alitretinoin

27

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

it is teratogenic

28

what are the side effects of retinoids

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

29

what are immunosuppressants used for in dermatology

inflammatory skin conditions

30

give examples of immunosuppressants

Oral steroids
Azathioprine
Ciclosporin
Methotrexate
Mycophenolate mofetil

31

what are the risks of taking immunosuppressants

malignancy, serious infection

32

what monitoring is needed when on immunosuppressants

regular blood tests
- FBC
- renal function
- liver function

33

what are biologics

Genetically engineered proteins derived from human genes

34

what are biologics designed to do

designed to inhibit specific components of the immune system

35

in biologics what does the suffix -cept indicate

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

36

in biologics what does the suffix -mab indicate

used to denote Monoclonal AntiBodies

37

what do the following infixes which immediately precede -mab denote

-zu- = humanised
-ix- = chimeric
-u- = fully human
-li-/-l- = immunomodulator

38

name the comments of e.g. adaLImUMAb

-li- = immunomodulator
-u- = fully human
-mab = monoclonal antibodies

39

name the components of e.g. infLIXiMAB

-l- = immunomodulator
-xi- = chimeric
-mab - monoclonal antibodies

40

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

Etanercept Infliximab
Adalimumab* Ustekinumab
Secukinumab Ixekizumab

*also licensed for hidradenitis supportive

41

what biologic is licensed in the UK for chronic spontaneous urticaria

omalizumab

42

what are the risks associated with biologics

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

43

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

Vemurafenib
Dabrafenib

44

what biologics are used to as immunotherpies in melanoma

Ipilumumab
Pembrolizumab