Dermatology Pharmacology and Prescribing Flashcards
Which bodies approve use of medication in the UK?
MHRA - Medicines and healthcare products regulatory agency
EMA - European Medicines agency
What is the SMC? What is it’s role?
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.
What are the 3 terms for medicine without licence
Unlicensed - not approved for use in UK
Off label - A licensed medication that is being used for an unlicensed indication
Specials - unlicensed dermatological preparations
Causes of prescription errors? (5)
Lack of knowledge - about patient, medication or allergies
Mistake writing/generating the prescription
Poor communication
No local or national guidelines
Pharmacy/medicine info service
What things need to be considered in pharmacokinetics (4)
Route of administration - topically where possible
Distribution of drug - where it goes
Metabolism - liver disease?
Excretion - esp in renal disease
What does the term Pharmacodynamics mean
The effect of the drug on the body
What needs to be considered in Pharmacodynamics
Age of patient
Pregnancy risk
Drug interactions
Pharmacogenetics
Name some things that can affect adherence to medication
Cost Gender Employment Age Patient education Psychiatric co-morbidities Dosage/no of times a dat Unintentional non-adherence
What makes up topical therapy
Vehicle and active drug
What is a vehicle in medication terms?
A pharmacologically inert, physically and chemically stable substance that carries the active drug
Factors that affect absorption
Concentration Base/vehicle Chemical properties of the drug Thickness and hydration of stratum corneum Temperature Skin site Occlusion
Types of vehicles (11)
Solution Cream Lotion Gel Foam Tape Paste Spray powder Shampoo Ointment Paint
Examples of some topical drugs (10)
Corticosteroid Chemotherapy Antibiotic Parasiticidals Antiviral Coal Tar Dithranol Anti-inflammatory Vitamin analogues Salicylic acid
Action of topical steroids
Regulate pro inflammatory cytokines
Suppress fibroblast, endothelial, and leukocyte function
Vasoconstriction
Inhibit vascular permeability
What is the finger tip unit
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
Side effects of topical steroids (10)
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
Systemic treatments in dermatology (3)
Retinoids
Traditional immunosuppressants
Biologics (also immunosuppressive)
Action of vitamin A analogues (retinoids)
Normalise keratinocyte function
Anti-inflammatory and anti cancer effects
What are the 4 different retinoids used orally in dermatology?
Isotretinoin - acne
Acitretin - psoriasis
Bexarotene - Cutaneous T cell lymphoma
Alitretinoin - Hand eczema
Examples of immunosuppressants (5)
Oral steroids Azathioprine Ciclosporin Methotrexate Mycophenolate mofetil
What are the risks associated with immunosuppressants
Serious infection
Malignancy
What are biologics
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
Prefixes of biologics that immediately precede -mab
zu - humanised
ix - chimeric
u - fully human
li/l - immunomodulator
E.g Adalimumab - immunomodulator fully human monoclonal antibodies
What does the suffix mab mean
Monoclonal antibodies
