Derm Meds

Question 1

How do moisturisers work in maintaining hydration of the skin?

Answer 1

1. Prevent trans epidermal water evaporation
2. Attract moisture from the environment
3. Fill in the cracks in the stratum corneum and improve smoothness of the skin

Question 2

What is Fick’s Law?

Answer 2

Rate of absorption or flux of any substance across a barrier is proportional to its concentration difference across that barrier

Question 3

Absorption of topical steroids/drugs is enhanced when _

Answer 3

applied on eroded skin

Question 4

What is the MOA of glucocorticoids?

Answer 4

1. Increased expression of anti-inflammatory proteins
2. Decreased expression of pro-inflammatory cytokines and molecules

Question 5

Which drug vehicle has the highest potency?

Answer 5

Ointment

Question 6

List some complications of topical glucocorticoids

Answer 6

1. Cutaneous atrophy
2. Purpura (redness)
3. Hypopigmentation
4. Acneiform eruptions
5. Impaired wound healing
6. Topical steroid withdrawal

Question 7

What is the MOA of topical calcineurin inhibitors?

Answer 7

Supress T cell activation and modulate the secretion of pro-inflammatory cytokines

Question 8

When is topical calcineurin inhibitors preferred over topical glucocorticoid?

Answer 8

1. Sensitive areas because there is no risk of cutaneous atrophy
2. Proactive therapy in atopic dermatitis to prevent flares

Question 9

What is the MOA of topical PDE inhibitors?

Answer 9

Phosphodiesterase 4 is found in keratinocytes, dendritic cells, monocytes and neutrophils.

PDE4 inhibition increases intracellular cAMP with downstream anti inflammatory effects.

Question 10

What is the MOA of Vitamin D analogues?

Answer 10

Inhibits proliferations and promoting differentiation of keratinocytes

Decreased production of inflammatory mediators

Question 11

For what disease is Vitamin D analogues (calcipotriol and calcitriol) used for?

Answer 11

Psoriasis

Question 12

What topical medication will you prescribe for a patient with psoriasis?

Answer 12

Vitamin D analogues like calcipotriol and calcitriol

Question 13

List the classes of drugs for dermatological pathologies (eg. eczema and psoriasis)

Answer 13

1. Topical corticosteroids (more specifically, glucocorticoids)
2. Topical calcineurin inhibitors
3. Topical PDE4 inhibitors
4. Vitamin D analogues
5. Coal tar

Question 14

What drugs would you use to treat eczema?

Answer 14

1. Topical corticosteroids (more specifically, glucocorticoids)
2. Topical calcineurin inhibitors
3. Topical PDE4 inhibitors

Question 15

What drugs would you use to treat chronic plaque psoriasis?

Answer 15

Vitamin D analogues ** - to control proliferation of keratinocytes

Systemic immunosuppression -> methotrexate and cyclosporine