Dermatology Pharmacology and Prescribing

Question 1

What is ‘off labels’ medicine?

Answer 1

Licensed medication that is being used for n unlicensed indication

Question 2

What is a ‘specials’ medicine?

Answer 2

Long history of use, no strong evidence base nut clinically effective

Question 3

What are some of the causes of prescribing errors?

Answer 3

Lack of knowledge
Mistake writing/generating prescription
Poor communication
No local or national guidelines

Question 4

What is pharmacokinetics?

Answer 4

The effect of the body on the drug

Question 5

What is pharmacodynamics?

Answer 5

The effect of the dug on the body

Question 6

What must be considered with pharmacodynamics?

Answer 6

Age of patient
Pregnancy risk
Drug interactions
Pharmacogenetics

Question 7

What are some influences in adherence to medication?

Answer 7

Female 
Married 
Employed 
Not paying for their prescription
Increasing age

Question 8

What are some factors associated with poor adherence?

Answer 8

Psychiatric co-morbidites 
Slower acting agents 
Multiple applications per day 
Lack of patient education 
Cosmetic acceptability of treatment

Question 9

What is a vehicle?

Answer 9

Pharmacologically inert, physically and chemically stable substance that carries the active drug

Question 10

What are the factors that effect absorption?

Answer 10

Concentration 
Temperature 
Skin site 
Chemical properties of the drug 
Vehicle 
Thickness and hydration of stream corneum 
Occlusion

Question 11

What are the different types of vehicles?

Answer 11

Solution 
Cream 
Paste 
Lotion 
Gel 
Foam 
Ointment 
Spray 
Shampoo

Question 12

What are some examples of drugs which are used topically?

Answer 12

Corticosteroid 
Salicylic acid 
Coal tar 
Chemotherapy 
Antibiotic 
Antiviral 
Dithranol 
Vitamin analogues 
Anti inflammatory

Question 13

What effect will anti inflammatory and immunosuppressive drugs have?

Answer 13

Vasoconstriction
Inhibit vascular permeability
Suppress fibroblast, endothelial and leukocyte function

Question 14

How much should a finger tip unit treat?

Answer 14

Area double the size of one hand

Question 15

What are the side effects of topical steroids?

Answer 15

Thinning/atrophy 
Striae 
Bruising 
Hirsutism 
Telangictasia 
Acne/rosacea/ perioral dermatitis 
Glaucoma 
Cataracts 
Systemic absorption

Question 16

What are retinoids?

Answer 16

Vitamin A analogues

Question 17

What are the 4 common oral retinoids used in dermatology?

Answer 17

Isotretinoin
Acitretin
Betarotene
Alitretinoin

Question 18

What are the contraindications of retinoids?

Answer 18

Teratogenic (cardiac and neural birth defects)

Question 19

What are the side effects of retinoids?

Answer 19

Chelitis and xerosis

Increases transaminases, increases triglycerides

Question 20

What are some examples of immunosuppressants used in dermatology?

Answer 20

Oral steroids 
Azathiprine 
Ciclosporin 
Methotrexate 
Mycophenolate mofetil

Question 21

What are the contraindications of immunosuppressants?

Answer 21

Risk of malignancy and serious infection

Question 22

What are biologics?

Answer 22

Genetically engineered proteins derived from human genes

Question 23

What biologics are licensed for psoriasis treatment?

Answer 23

Etanercept 
Inflixamab 
Ustekinumab 
Secukinumab 
Adalimumab

Question 24

What biologic is licensed for chronic spontaneous urticaria?

Answer 24

Omalizumab

Question 25

What are the contraindications of biologics?

Answer 25

Risk of infection (TB reactivation, avoid live vaccines)
Risk of malignancy
Risk of demyelination (TNF inhibitors)

Question 26

What biologics are used in melanoma treatment?

Answer 26

Vemurafenib

Dabrafenib