Common Dermatology Therapeutics

Question 1

What are you trying to achieve with dermatology therapeutics?

Answer 1

• Kill/repel parasites
  ○ Ectoparasiticides
• Control/cure microbial infection
  ○ Antimicrobials
• Control inflammation/ pruritus
  ○ Drugs for atopic dermatitis and autoimmune disease
• Moisturise/ improve skin barrier function
• Resolve scale
• Treat otitis externa

Question 2

What can be used to moisturise/improve skin barrier functions

Answer 2

Emollients
Moisturisers
Agents to improve skin barrier function

Question 3

What is an emollient?

Answer 3

Softens, lubricates and soothes skin
Occlusive (‘seal in’ water content of stratum corneum)
Reduce trans-epidermal water loss
Animal/plant oil-based
E.g. lanolin, coconut oil, Vaseline

Question 4

What is a moisturiser?

Answer 4

Increases water content of stratum corneum
E.g. Colloidal oatmeal, aloe vera, urea, glycerine, propylene glycol, sodium or ammonium lactate/lactic acid

Question 5

Examples of agents that improve skin barrier function

Answer 5

○ E.g. Essential fatty acids (orally or topically), some essential oils, ophytrium

Question 6

Limitations of chlorhexidine

Answer 6

Drys out skin
Use formulated with moisturiser

Question 7

How can you control scale?

Answer 7

Antiseborrhoeic agents

Question 8

Types of antiseborrhoeic agent

Answer 8

Keratolytic - reduce cohesion between cells of stratum corneum
Keratoplastic - restore normal epidermal epithelialisation and keratinisation

Examples:
* Sulphur
* Salicylic acid

Question 9

Methods for treating Otitis externa

Answer 9

Polypharmacy ear drops (POM-V)
Ear cleaners

Question 10

What do polypharmacy ear drops contain?

Answer 10

Glucocorticoid
Antifungal
Antibiotic

Question 11

What can you select a polypharmacy ear drop based on?

Answer 11

Organism present
Level of inflammatory activity
Potential for ototoxicity
Nature of exudate
Frequency/ease of application

Question 12

considerations for polymyxin-B

Answer 12

Inactivated by pus

Question 13

Cerumenolytic

Answer 13

Dissolve cerumen

Question 14

Surfactants

Answer 14

Emulsify debris

Question 15

Astringents

Answer 15

Dry ear canal

Question 16

Benefits of topical therapy

Answer 16

• Skin is ideally suited to topical therapy
• Less concerns about side effects associated with systemic drugs
  ○ E.g. antibiotics, glucocorticoids
• Direct delivery of drug to skin
• Can achieve higher concentration than with systemic therapy
• Can target therapy
  ○ E.g. achieve differing actions on different areas