Dermatology Pharmacology and Prescribing Flashcards
What is an unlicensed medicine?
Not approved for use in the UK
What is an off label medicine?
Licensed medication used for unlicensed indication
What are medicine ‘specials’?
Unlicensed dermatological preparations
Long history of use, no strong evidence base
What are pharmacokinetics?
Effect of the body on the drug
What are pharmacodynamics?
Effect of the drug on the body
Why is a the method of drug excretion important information?
Renal disease
Why is a the method of drug metabolism important information?
Liver disease
Which factors are associated with poor medicine adherence?
Psychiatric issues Slower acting agents Multiple applications/day Lack of patient education Forgetting
What is a medication vehicle?
Pharmacologically inert, stable substance that carries the active drug
What factors affect skin absorption?
Concentration Vehicle Chemical properties Thickness and hydration of stratum corneum Temperature Occlusion Skin site
How do topical steroids work?
Suppress fibroblast, endothelial, leukocyte function
Vasoconstriction
Inhibit vascular permeability
Regulate proinflammatory cytokines
What is a fingertip unit?
0.5g
Treat area 2x size of hand
Useful for children
What side effects are associated with topical steroids?
Thinning/atrophy Striae Bruising Hirsutism Telangiectasia Acne/rosacea Perioral dermatitis Glaucoma Systemic absorption Cataracts
What are retinoids?
Vitamin A analogues
Which retinoid is used in acne?
isotretinoin
Which retinoid is used in psoriasis?
Acitretin
Which retinoid is used in cutaneous T cell lymphoma?
Bexarotene
Which retinoid is used in hand eczema?
alitretinoin
How do retinoids work?
Normalise keratinocyte function
Anti-inflammatory, anti-cancer effects
What side effects are associated with Retinoids?
Teratogenic Cheilitis (dry lips) Xerosis (dry skin) ↑transaminases, TAGs Psych, eye, bone
When are immunosuppressants used in dermatology?
Inflammatory skin diseases
What risks are associated with immunosuppressants?
Malignancy
Serious infection
What must also be done for patients on immunosuppressants?
Blood test monitoring:
FBC (methotrexate, azithioprine)
Renal function (ciclosporin)
Liver function (methotexate)
What does the suffix ‘-cept’ indicate for drugs?
Biologic - receptor fusion
