dermatology pharmacology and prescribing Flashcards

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1
Q

What is pharmacokinetics

A

Effect of the body on the drug

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2
Q

What is pharmacodynamics

A

Effect of the drug on the body

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3
Q

What is topical therapy

A

Medication applied to the skin

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4
Q

What is a vehicle in topical therapy

A

How you get the drug on the skin

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5
Q

What affects topical absorption

A

Concentration
vehicle used
chemical properties of the durg
hydration of the stratum corneum - outer layer
temperature
skin site
occlusion

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6
Q

What is the function of topical steroids

A

Anti-inflammatory and immunosuppressive function

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7
Q

How do topical steroids work

A

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

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8
Q

What is a finger tip unit

A

Enough topical dosage on the fingertip should be around 0.5g and enough to treat double the size of a hand

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9
Q

What are the side effects of topical steroids

A

Skin thinning
Striae
bruising
hirsutism
Telangiectasia - dilatation of capillaries causing spider like appearance
Acne
Glaucoma
cataracts

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10
Q

Why do topical steroid doses have to be increased

A

The skin develops a tolerance to the topical steroids

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11
Q

What are the systemic treatments in dermatology

A

Retinoids

immunosuppressants

Biologics - can also be immunosuppresive

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12
Q

What are retinoids and what is their effect

A

Vitamin A analogues

Anti-inflammatory and anti-cancer effects

normalise the function of keratinocytes

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13
Q

What are retinoids effective in the treatment of

A

Acne - Isotretinoin
Psoriasis - acitretin
cutaneous T cell lymphoma - bexarotene
hand eczema - alitretinoin

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14
Q

What are retinoids contraindicated in

A

Pregnancy - they are teratogens

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15
Q

What are the side effects of retinoids

A

Cheilitis - dry lips
Xerosis - dry skin

Eye and bone side effects

Increased transaminases and triglycerides

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16
Q

What immunosuppressants are used to treat inflammatory skin disorders

A

Oral steroids
Azathioprine
ciclosporin
methotrexate - DMARD
mycophenolate mofetil

17
Q

What are the side effects of immunosuppressants

A

risk of malignancy and infection

18
Q

What is required during immunosuppressant therapy

A

Regular blood tests :

FBC - in methotrexate and azathioprine
Renal function - in ciclosporin
Liver function - in methotrexate

19
Q

What are the side effects of biologics

A

Risk of infection
TB reactivation
Increased malignancy risk
TNF inhibitors have the risk of demyelinations

20
Q

What should be avoided when on biologics

A

Live vaccines

21
Q

What is the new main treatment of melanoma

A

Biologics:

If BRAF 600 mutation : Vemurafenib and dabrafenib

Immunotherapies : iplumuumab and pembrolizumab