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Dermatology > Lecture 2 Dermatology Pharmacology and Prescribing > Flashcards

Lecture 2 Dermatology Pharmacology and Prescribing Flashcards

1
Q

Name licensing boards in the UK

A

MHRA
EMA
SMC

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2
Q

Define unlicensed

A

Not approved for use in the UK

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3
Q

Define off label

A

– A licensed medication that is being used for an unlicensed indication
– Paediatric use- does not have license for this use but is licensed

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4
Q

Define Specials

A

– unlicensed dermatological preparations

– Long history of use, no strong evidence base but clinically effective.

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5
Q

What are some causes of prescription errors

A

• Lack of knowledge
– About the patient, the medication, allergies
• Mistake writing/generating the prescription
• Poor communication
• No local or national guidelines
• Pharmacy/medicine info service

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6
Q

What is pharmokinetics

A

The effect of the body on the drug

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7
Q

What is pharmacodynamics

A

The effect of the drug on the body

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8
Q

Factors associated with poor adherence of drugs

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 topical therapy

A

Vehicle combined with active drug

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10
Q

Name 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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11
Q

What forms does vehicles come as

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

Drugs used Topically

A
  • Corticosteroid
  • Chemotherapy
  • Antibiotic
  • Parasiticidals
  • Antiviral
  • Coal Tar
  • Dithranol- effective treatment in psoriasis
  • Anti-inflammatory
  • Vitamin analogues
  • Salicylic acid
  • Topical immunodilators- JAK Inhibitors
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13
Q

What is the mechanism of Topical steroids

A

– Regulate pro inflammatory cytokines
– Suppress fibroblast, endothelial, and leukocyte function
– Vasoconstriction
– Inhibit vascular permeability

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14
Q

What is the finger-tip unit

A
  • About 0.5 g
  • Should treat area double the size of one hand
  • Useful in young children
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15
Q

Side effects of topical steroids

A
  • Thinning /atrophy
  • Striae
  • Bruising
  • Hirsutism
  • Telangiectasia
  • Acne/rosacea/perioral dermatitis
  • Glaucoma
  • Systemic absorption
  • Cataracts
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16
Q

What are Retinoids

A

Systemic treatment
• Vitamin A analogues
– Normalise keratinocyte function
– Anti inflammatory and anti cancer effects

17
Q

What retinoid is used to treat acne

A

Isotretinoin (1 month to eave system)

18
Q

What retinoid is used to treat Psoriasis

A

Acitretin (takes 3 years to leave system)

19
Q

What retinoid is sued to treat cutaneous T cell lymphoma

A

Bexarotene

20
Q

What retinoid is used to treat Hand eczema

A

Alitretinoin

21
Q

Side effects of Retinoids

A

– Cheilitis(dry lips) and xerosis (dry skin)
– ↑transaminases, ↑triglycerides
– Rarely psychiatric, eye, bone side effects

22
Q

Name Immunosupressants

A
  • Oral steroids
  • Azathioprine
  • Ciclosporin
  • Methotrexate
  • Mycophenolate mofetil
23
Q

Precautions when using immunosuppressants

A

• Risk of malignancy and serious infection
• Need regular blood test monitoring, in particular
– FBC (esp in methotrexate and azathioprine)
– Renal function (esp ciclosporin)
– Liver function (esp methotrexate)
– Sun protection

24
Q

Suffix ‘cept’ means

A

It is a receptor fusion

25
Q

Suffix ‘mab’ means

A

monoclonal antibodies

26
Q

‘zu’ in biologics means

A

Humanised

27
Q

‘ix’ in biologics means

A

Chimeric

28
Q

‘u’ in biologics means

A

Fully human

29
Q

‘li/I’ in biologics means

A

Immodulator

30
Q

What targeted treatments can be used to treat melanoma

A

Biologics:
• Vemurafenib
• Dabrafenib

– Immunotherapies
• Ipilumumab
• Pembrolizumab

Dermatology (11 decks)

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