Dermatology Pharmacology and Prescribed Flashcards
What makes up a topical therapy?
Vehicle and active drug
What is a vehicle?
A pharmacologically inert, physically and chemically stable substance that carries the active drug
Factors that affect absorption
Concentration Base/vehicle Chemical properties of the drug Thickness and hydration of strateum corneum Temperature Skin site Occlusion
What can be used as a vehicle?
Solution Cream Lotion Gel Foam Tape Paste Spray powder Shampoo Ointment Paint
What do topical steroids do?
Anti-inflammatory and immunosuppressive properties
Regulates pro inflammatory cytokines
Suppress fibroblast, endothelial and leukocyte function
Vasoconstriction
Inhibit vascular permeability
How much is a finger tip unit?
Approx 0.5g
Side effects of topical steroids
Thinning/atrophy Striae Bruising Hirsutism Telangiectasia Acne / rosacea / perioral dermatitis Glaucoma Systemic absorption Cataracts
What is hirsutism?
A condition of unwanted, male pattern hair growth in women - coarse dark hair on face, chest and back
What is telangiectasia?
A condition in which whidened venules (tiny blood vessels) cause threadlike red lines or patterns on the skin - spider veins
What are the systemic treatments in dermatology?
Retinoids
Traditional immunosuppressants
Biologicals (also immunosuppressive)
What are retinoids?
Vitamin A analogues
What do retinoids do?
Normalise keratinocyte function
Anti-inflammatory and anti-cancer effects
What retinoid is used in acne?
Isotretinoin
What retinoid is used in psoriasis?
Acitretin
What retinoid is used in hand eczema?
Alitretinoin
What retinoid is used in cutaneous T cell lymphoma?
Bexarotene
Side effects of retinoids
Teratogenic Cheilitis Xerosis Increased transaminases Increased triglycerides Rare S/Es - psychiatric - eye - bone
Definition of cheilitis
Dry lips
Definition of xerosis
Dry skin
What immunosuppressants are used to treat inflammatory skin disorders?
Oral steroids Azathioprine Ciclosporin Methotrexate Mycophenolate mofetil
What is there a risk of when using immunosuppressants?
Malignancy
Serious infection
What tests need to be done in the regular monitoring when on immunosuppressants?
FBC
Renal function
Liver function
Risks when using biologics
Infection - TB reactivation - serious infection - avoid live vaccines Malignancy
Risks when using TNF inhibitors
Demyelination
