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Flashcards in Pharmacology and Prescribing Deck (32)
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1

When is medicine used without license?

• Unlicensed - not approved for UK use but no alternative
• Off label - licensed meds for unlicensed indication
• Specials - clinically effective but no evidence in clinical trials

2

What are causes of prescription error?

• Lack of knowledge
• Mistake writing/genrating the prescription
• Poor communication
• No local or national guidelines

3

What are the two actions of pharmacology?

• Pharmacokinetics - the effect of the body on the drug
• Pharmacodynamics - the effect of the drug on the body

4

What needs to be considered with pharmacokinetics?

• Route of administration - topic where possible, but it oral, optimal absorption important

• Distribution - where the drug goes
• Metabolism - esp. in liver disease
• Excretion - esp. in renal disease

5

Why is topical administration advantageous?

Prevents systemic side effects

6

What needs to be considered with the pharmacodynamics of drugs?

• Individual variation in response

• Age of patient
• Pregnancy risk
• Drug interactions
• Pharmacogenetics

7

Name factors 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

8

Describe topical administration

• Medication applied to the skin
• Vehicle + active drug

9

Describe vehicles used in topical therapy

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

10

Name seven factors that affect absorption

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

11

Name different types of vehicles

• Solution
• Cream
• Lotion
• Gel
• Shampoo

12

Give example of different drugs used topically

• Corticosteroid
• Antibiotic
• Chemo
• Coal tar
• Antiviral

13

What are the properties of topical steroids?

Anti-inflammatory and immunosuppressive properties

14

What are the actions of topical steroids?

• Regulate pro-inflammatory cytokines
• Suppress fibroblast, endothelial, and leukocyte function
• Vasoconstriction
• Inhibit vascular permeability

15

What measurement is used for topical steroids?

Finger tip unit

16

What are the features of the finger tip unit?

• About 0.5g
• Should treat area double the size of one hand
• Useful in young children

17

What are possible side effects of topical steroids

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

18

Name three systemic treatment in dermatology

• Retinoids
• Traditional immunosuppressants
• Biologics (also immunosuppressive)

19

What are retinoids?

Vitamin A analogues
• Normalise keratinocyte function
• Anti-inflammatory and anti-cancer effects



20

What are retinoids used to treat?

• Acne
• Psoriasis
• Cutaneous T cell lymphoma
• Hand eczema

21

What are the side effects of retinoids?

• Teratogenic

• Cheilitis (dry lips) and xerosis (dry skin)
• ↑transaminases, ↑triglycerides

22

What are immunosuppressants used to treat?

Inflammatory skin disorders

23

Give examples of immunosuppressants

• Oral steroids
• Azathioprine
• Ciclosporin
• Methotrexate
• Mycophenolate mofetil

24

What are possible side effects of immunosuppressants?

• Risk of malignancy and serious infection

Need regular blood test monitoring
• FBC
• Renal function
• Liver function

25

What are biologics used to treat?

Inflammatory conditions
• Inhibit specific components of immune system

26

What is indicated when drug name ends in '-cept'?

Indicates that it is a it is a receptor fusion

27

What is indicated when drug name ends in '-mab'?

Monoclonal antibodies

28

What is indicated when drug name includes series of infixes which immediately precede 'mab'?

• Zu - humanised
• Ix - chimeric
• U - fully human
• Li-/-l- immunomodulator

29

What is a licensed biologic used for psoriasis?

Infliximab

30

What biologic is used for chronic spontaneous urticaria?

Omalizumab