Dermatology Pharmacology and Prescribing Flashcards
(24 cards)
Who must medication be approved by to be licensed in the UK for dermatology?
MHRA (Medicines and Healthcare Products Regulatory Agency)
EMA (European Medicines Agency)
What are the different kinds of medicines without liscence?
- Unlicensed
- Not approved for use in UK
- ‘Off label’
- Licensed medication that is being used for an unlicensed indication
- ‘Specials’
- Unlicensed dermatological preparations
- No strong evidence base but clinically effective
What does ‘off label’ medication mean?
Licensed medicatio that is being used for an unlicensed indication
What is pharmacology?
Is the uses, effects and modes of action of drugs
What is pharmacokinetics?
The effect of the body on the drug
What is pharmacodynamics?
The effect of the drug on the body
What are the 4 things that should be considered in relation to pharmacokinetics? ADME
Absorption
Distribution
Metabolism
Excretion
What is meant by pharmacodynamics being the effect of the drug on the body?
Think about Individual variation in response
What is topical medication?
What does topical medication contain? and what does each mean?
- Medication applied to the skin
- Vehicle + Active drug
Vehicle: Chemically stable substance that carries the Active Drug
Active drug: the medication you want to deliver
What properties do topical steroids have?
Anti-inflammatory and immunosuppressive properties:
- Regulate pro inflammatory cytokines
- Suppress fibroblast, endothelial and leukocyte function
- Vasoconstriction
- Inhibit vascular permeability
What is a ‘finger tip’ unit? useful in …..?
About 0.5g
Should be used to treat an area the size of one hand
Useful in young children
What are some systemic treatments used in dermatology?
- Retinoids
- Traditional immunosuppressants
- Biologics (also immunosuppressive)
What are retinoids? and what is their effect?
These are vitamin A analogues:
They:
- Normalise keratinocyte function
- Have Anti-inflammatory and anti-cancer effects
What are retinoids useful to treat?
-
Acne
- Isotretinoin
-
Psoriasis
- Acitretin
-
Cutaneous T cell lymphoma
- Bexarotene
-
Hand eczema
- Alitretinoin
Why must patients be selective careful for retinoids?
They are teratogenic : cause birth defects
What are immunosuppressants used to treat?
Inflammatory skin disorders
What are some examples of immunosuppressants?
- Oral steroids
- Azathioprine
- Ciclosporin
- Methotrexate
- Mycophenolate mofetil
What are the risks of taking immunosuppressants?
Malignancy and serious infection
What are biologics?
They are Genetically engineered proteins derived from human genes, which are designed to inhibit specific components of the immune system.
What are the 2 suffixes of biologics?
-cept: if ends with cept, it means it is a genetically engineered fusion protein.
-mab : it means Monoclonal antibodies
What are some infixes of biologics that immediately preced -mab?
- –zu (humanised)
- –ix (chimeric)
- –u (fully human)
- –li-/-l- (immunomodulatory)
Example: Adalimumab: immunomodulator fully human monoclonal antibodies
Infliximab: immunomodulator chimeric monoclonal antibodies
What is a licenced biologic for chronic spontaneous urticarial?
Omalizumab
What is a licenced biologic for eczema?
Dupilumab
When taking biologics, what are you at risk of?
Risk of infection:
- TB reactivation
- Serious infection
- Avoid live vaccines
Risk of malignancy : not too high risk, but the risk of cancer increases
TNF inhibitors cause risk of demyelination
