Pharmacology of Skin Flashcards

1
Q

which drugs cause a urticarial drug reaction

A

beta-lactam antibiotics
aspirin
opiates
NSAIDs

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2
Q

what response causes a urticarial drug reaction

A

IgE mediated response, type I hypersensitivity

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3
Q

which drugs cause a pustular/bullous drug reaction

A

glucocorticoids
androgens
hypertensives

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4
Q

glucocorticoids causes acneiform reactions true/false

A

true

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5
Q

describe the appearance of fixed drug eruptions

A

well demarcated round/oval plaques

red and painful usually found on hands, lips and genitalia

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6
Q

what types of drugs cause fixed drug eruptions

A

tetracyclines
paracetamol
NSAIDs
carbamazepine

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7
Q

what two conditions can arise due to severe cutaneous adverse drug reactions and which is more severe

A

steven-johnson syndrome and toxic epidermal necrolysis - more severe

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8
Q

how does toxic epidermal necrolysis present

A

flu-like symptoms with blistering, red rash around body causing skin to break down and expose to pathogens

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9
Q

which drugs cause toxic epidermal necrolysis

A

sulfonamides, cephalosporins, carbamazepine and NSAIDs

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10
Q

list some phototoxic drugs

A
fluoroquinolones, doxycycline 
thiazides 
quinine 
amiodarone 
porphrins
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11
Q

what are the three routes a drug can be administered through the skin

A

topical - for local effects
transdermal
subcutaneous - for systemic effect

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12
Q

what is the most important barrier for drug administration in the skin

A

stratum corneum

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13
Q

in the brick and mortar structure what makes up the brick and mortar

A

bricks - corneocytes

mortar - hydrophobic layer of intercellular lipids

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14
Q

the stratum corneum is hydrophilic or lipophilic

A

lipophilic

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15
Q

drug penetration of the stratum corneum is transcellular or intercellular

A

intercellular - travels between the corneocytes

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16
Q

what is a drug vehicle

A

a non-pharmacologically active substance that carries a drug

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17
Q

give examples of drug vehicles

A
creams
ointments 
gels 
lotions 
pastes
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18
Q

what two factors affect the absorption of a drug in the skin

A

movement of drug from stratum corneum

dissolved concentrations of drug in vehicle

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19
Q

hydrophobic drug in hydrophobic base

A

soluble in both so partitions between the two

20
Q

hydrophobic drug in hydrophilic space

A

more soluble in the skin so will move towards it - best movement

21
Q

hydrophilic drug in hydrophobic space

A

low solubility in vehicle and skin so little movement

22
Q

hydrophilic drug in hydrophilic space

A

soluble in vehicle but not skin, does not move

23
Q

when are topical glucocorticoids used

A

treatment of eczema, psoriasis and pruritus

24
Q

what are the actions of glucocorticoids

A

anti-inflammatory
anti-proliferative
vasoconstrictive

25
Q

give an example of a mild steroid

A

hydrocortisone

26
Q

give an example of a moderate steroid

A

betnovate or eumovate

27
Q

give an example of a potent steroid

A

beclometasone dipropionate

28
Q

give an example of a very potent steroid

A

clobetasol propionate

29
Q

list some side effects of long term steroid use

A
thinning of the skin 
steroid rebound - less effective 
increased risk of infection - immunosuppression 
steroid rosacea 
stretch marks
30
Q

describe a cream and what lesions it can be used for

A

semi-solid emulsion of oil and water containing preservative
used for moist, weeping lesions

31
Q

creams are non-greasy true/false

A

true

32
Q

describe an ointment and what lesions is can be used for

A

semi-solid mix of oil and soft paraffin

used for dry, scaly, lichenified lesions

33
Q

what is an advantage of an ointment

A

very good at restrictive transepidermal water loss

34
Q

what areas are lotions used for

A

dry hairy areas eg scalp

35
Q

describe a paste

A

finely powdered material, stiff and greasy so difficult to use

36
Q

what is the function of an emollient and which condition it is mainly used in

A

enhance hydration of epidermis

psoriasis

37
Q

when is a potassium permanganate bath used

A

treatment of exudative eczema and pompholyx

38
Q

give a list of antifungals and what conditions they are used to treat

A

clotrimazole and nystatin - candida infection

clotrimazole - ringworm infection

39
Q

give some examples of antipruitics

A

menthol, capsaicin, crotamiton

40
Q

what are keratolytics used for

A

soften kertain in viral warts and hyperkeratosis

41
Q

give an example of a keratolytic

A

salicylic acid

42
Q

what is the antibiotic of choice for rosacea

A

metronidazole

43
Q

psoriasis treatment is use of emollients plus 1 of which drugs

A
vitamin D analogue 
coal tar 
keratolytic 
glucocorticoid 
dithranol
44
Q

describe use of vitamin D analogue

A

clean, no smell but can cause irritation and can only use up to 100g a week
for localised plaques only

45
Q

describe the use of coal tar

A

can be used anywhere in the body but very messy and smelly

46
Q

describe the use of dithranol

A

very effective with short term use on localised plaques but can cause irritation and staining even on normal skin