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Dermatology > Dermatology - pharmacology and prescribing > Flashcards

Dermatology - pharmacology and prescribing Flashcards

1
Q

What are some institutions that approve use of medications in the UK?

A

Medicines and Healthcare products Regulatory Agency (MHRA).

European Medicines Agency (EMA)

Scottish Medicines Consortium (SMC)

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2
Q

What is meant by off label medications?

A

A licensed medication that is being used for an unlicensed indication.

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3
Q

What is meant by specials medications?

A

Unlicensed dermatological preparations e.g tar.

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4
Q

What is pharmacokinetics?

A

The effect of the body on the drug.

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5
Q

What is pharmacodynamics?

A

The effect of the drug on the body.

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6
Q

What are some key things to think about regarding pharmacokinetics?

A

Route of administration
Distribution
Metabolism - especially in liver disease
Excretion - especially in renal disease.

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7
Q

What are some key things to think about regarding pharmacodynamics?

A

Age of patient
Pregnancy
Drug interactions
Pharmacogenetics.

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8
Q

What are some factors associated with poor adherence?

A 
Psychiatric co-morbidities
Slower acting agents
Multiple applications per day.
Lack of patient education.
Cosmetic acceptability of treatments.
Unintentional non-adherence.
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9
Q

What is required for topical therapy?

A

Need a vehicle (pharmacologically inert, chemically and physically stable substance to carry an active drug) + and an active drug.

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10
Q

What are some factors the affect absorption?

A 
Concentration
Base
Chemical properties of the drug.
Thickness and hydration of stratum corneum.
Temperature. 
Skin site
Occlusion.
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11
Q

What are some examples of vehicles?

A 
Solutions
Cream
Lotion
Gel
Foam
Tape
Paste
Spray powder
Shampoo
Ointment
Paint
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12
Q

What are some examples of drugs used topically?

A 
Corticosteroid 
Antibiotics
Antiviral 
Dithranol
Vitamin analogues
Chemotherapy 
Parasiticidals
Coal tar
Anti - inflammatories
Salicyclic.
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13
Q

How do topical steroids work?

A

Anti-inflammatory and immunosuppressive properties : regulate pro inflammatory cytokines

Suppress fibroblast, endothelial and leukocyte function.

Vasoconstriction

Inhibit vascular permeability.

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14
Q

What are some side effects of topical steroids?

A 
Thinning/atrophy
Striae
Bruising 
Hirsutism
Telangiectasia
Acne
Rosacea
Perioral dermatitis
Glaucoma
Systemic absorption
Cataracts
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15
Q

What are the systemic treatments in dermatology?

A

Retinoids.
Traditional immunosuppressants.
Biologics.

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16
Q

What are the 4 oral retinoids used in Dermatology and what are they used to treat?

A

Isotretinoin - acne

Acitretin - psoriasis

Bexarotene - cutaneous T cell lymphoma

Alitretinoin - Hand eczema.

17
Q

What are some side effects of retinoids?

A 
Teratogenic
Cheilitis (dry lips) 
Xerosis (dry skin)
increased transaminases
increased triglycerides

Can also have psychiatric, eye and bone side effects although these aren’t as common.

18
Q

What are some examples of immunosuppressants?

A 
Oral steroids
Azathioprine
Ciclosporin
Methotrexate
Mycophenolate mofetil
19
Q

What are some side effects of immunosuppressants?

A

Malignancy
Serious infection

Need regular blood test monitoring: FBC ( esp in methotrexate and azathioprine) Renal function tests ( esp ciclosporin) Liver function tests ( esp methotrexate)

20
Q

What does the suffix -cept indicate?

A

Receptor fusion - genetically engineered fusion protein. e.g Etanercept

21
Q

What does the suffix -mab indicate?

A

Monoclonal antibodies

22
Q

What do the following infixes mean; zu, ix, u, li/l?

A

zu - humanised
ix - chimeric
u - fully human
li/l - immunomodulator

23
Q

What are some examples of licensed biologics in the UK?

A

Adamlimumab
Infliximab
Omalizumab
Dupilumab

24
Q

What are some side effects of biologics?

A

TB reactivation
Serious infection
Malignancy
TNF inhibitors so risk of demyelination.

25
Q

What are the biologics used in melanoma treatment?

A

If BRAF 600 mutation :
Vemurafenib
Dabrafenib

Immunotherapies:
Ipilumumab
Pembrolizumab
Nivolumab

Dermatology (4 decks)

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