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2ND YEAR SYSTEMS: Dermatology > Dermatology Pharmacology and Prescribing > Flashcards

Dermatology Pharmacology and Prescribing Flashcards

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Dermatology Board Prep flashcards
1
Q

Which bodies approve use of medication in the UK?

A

MHRA - Medicines and healthcare products regulatory agency

EMA - European Medicines agency

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2
Q

What is the SMC? What is it’s role?

A

Scottish medicines consortium.

They provide NHS Scotland with a single source of advice about the value of each new
medicine.

Only assess medicines that have already been licensed by the MHRA and EMA.

The purpose of SMC is to assess the comparative clinical-effectiveness and cost- effectiveness
of new medicines and accept for use those that clearly represent good value for money to
NHS Scotland.

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3
Q

What are the 3 terms for medicine without licence

A

Unlicensed - not approved for use in UK

Off label - A licensed medication that is being used for an unlicensed indication

Specials - unlicensed dermatological preparations

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4
Q

Causes of prescription errors? (5)

A

Lack of knowledge - about patient, medication or allergies

Mistake writing/generating the prescription

Poor communication

No local or national guidelines

Pharmacy/medicine info service

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5
Q

What things need to be considered in pharmacokinetics (4)

A

Route of administration - topically where possible

Distribution of drug - where it goes

Metabolism - liver disease?

Excretion - esp in renal disease

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6
Q

What does the term Pharmacodynamics mean

A

The effect of the drug on the body

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7
Q

What needs to be considered in Pharmacodynamics

A

Age of patient
Pregnancy risk
Drug interactions
Pharmacogenetics

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8
Q

Name some things that can affect adherence to medication

A 
Cost
Gender
Employment
Age
Patient education 
Psychiatric co-morbidities
Dosage/no of times a dat
Unintentional non-adherence
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9
Q

What makes up topical therapy

A

Vehicle and active drug

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10
Q

What is a vehicle in medication terms?

A

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

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11
Q

Factors that affect absorption

A 
Concentration
Base/vehicle
Chemical properties of the drug
Thickness and hydration of stratum corneum
Temperature
Skin site
Occlusion
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12
Q

Types of vehicles (11)

A 
Solution
Cream
Lotion
Gel
Foam
Tape
Paste
Spray powder
Shampoo
Ointment
Paint
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13
Q

Examples of some topical drugs (10)

A 
Corticosteroid			Chemotherapy
Antibiotic			Parasiticidals
Antiviral				Coal Tar
Dithranol			
Anti-inflammatory
Vitamin analogues		Salicylic acid
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14
Q

Action of topical steroids

A

Regulate pro inflammatory cytokines

Suppress fibroblast, endothelial, and leukocyte function

Vasoconstriction

Inhibit vascular permeability

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15
Q

What is the finger tip unit

A

Measurement used for topical steroid medication

About 0.5g

One unit describes the amount of cream squeezed out of its tube onto the end of the finger.

Useful in young children

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16
Q

Side effects of topical steroids (10)

A 
Thinning /atrophy
Striae
Bruising
Hirsutism - excessive body hair
Telangiectasia - threadlike red lines or patterns on the skin
Acne/rosacea/perioral dermatitis
Glaucoma
Systemic absorption
Cataracts
17
Q

Systemic treatments in dermatology (3)

A

Retinoids

Traditional immunosuppressants

Biologics (also immunosuppressive)

18
Q

Action of vitamin A analogues (retinoids)

A

Normalise keratinocyte function

Anti-inflammatory and anti cancer effects

19
Q

What are the 4 different retinoids used orally in dermatology?

A

Isotretinoin - acne

Acitretin - psoriasis

Bexarotene - Cutaneous T cell lymphoma

Alitretinoin - Hand eczema

20
Q

Examples of immunosuppressants (5)

A 
Oral steroids
Azathioprine
Ciclosporin
Methotrexate
Mycophenolate mofetil
21
Q

What are the risks associated with immunosuppressants

A

Serious infection

Malignancy

22
Q

What are biologics

A

The next generation in treatment of inflammatory conditions

Genetically engineered proteins derived from human genes
designed to inhibit specific components of the immune system

Very effective, but expensive

23
Q

Prefixes of biologics that immediately precede -mab

A

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

E.g Adalimumab - immunomodulator fully human monoclonal antibodies

24
Q

What does the suffix mab mean

A

Monoclonal antibodies

25
Q

What does the suffix cept mean

A

Receptor fusion -

26
Q

Risks associated with biologics

A

Infection - TB reactivation, serious infection

Malignancy

TNF inhibitors - risk of demyelination

2ND YEAR SYSTEMS: Dermatology (11 decks)

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