Management of skin disease Flashcards

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1
Q

Give some examples of emollients?

Indications? How do they help?

A

Aqueous creams
Emulsifying ointment
Paraffin
E45, Diprobase

Dry scaling skin, eczema, psoriasis

They rehydrate skin and re-establish the surface lipid layer

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2
Q

Ointment vs cream?

A

Ointment: oil based
Cream: water based

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3
Q

Give some examples of topical steroids in order of potency?

A

Hydrocortisone: mild
Eumovate: moderate
Betnovate: potent
Dermovate: very potent

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4
Q

Give some indications of topical and oral steroids? How do they help?

A

Allergic and immune reactions
Inflammatory skin conditions
Blistering disorders
Vasculitis

They have anti-inflammatory and anti-proliferative effects

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5
Q

Side effects of topical steroids?

A
Skin atrophy
Telangiectasia
Mask or exacerbate skin infections
Acne
Dermatitis
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6
Q

Give example of oral steroid used?

Side effects of these?

A

Prednisolone

Cushing’s syndrome
Immunosuppression
Hypertension
Diabetes
Osteoporosis
Steroid induced psychosis
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7
Q

What virus does aciclovir treat?

A

Herpes simplex and zoster

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8
Q

Give examples of anti-histamines? Which are sedating and which aren’t?

A

Non-sedative

  • Cetirizine
  • Loratidine

Sedative

  • Chlorpheniramine
  • Hydroxyzine
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9
Q

Indications of anti-histamines and how do they help?

Side effects?

A

Hypersensitivity reactions
Eczema

They block histamine receptors, reducing itch

Sedating anti-histamines can have anti-cholinergic effects (dry mouth, urinary retention, constipation)

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10
Q

List some topical antibiotics.

List some oral antibiotics used in skin conditons?

A

Topical:

  • Fusidic acid
  • Neomycin

Oral:

  • Tetracycline (acne)
  • Penicillins
  • Many!
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11
Q

What type of drug is isotretinoin?

What about acitretin?

A

Both are oral retinoids

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12
Q

Give examples of oral retinoid drugs?

Indications?

A

Isotretinoin
Acitretin

Used in acne, psoriasis and disorders of keratinisation

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13
Q

Side effects of oral retinoid drugs? What needs to be monitored?

A

Mucocutaneous reactions (dry skin, lips, eyes)
Myalgia
Arthralgia
Depression

Monitoring needed due to risk of:
Disordered liver function
Hypercholesterolaemia

Pregnancy tests as these drugs are severely teratogenic

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14
Q

How long should women not get pregnant after stopping a course of isotretinoin? What about acitretin?

A

Isotretinoin: at least one month

Acitretin: 2 years

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15
Q

Mechanism of action of steroids in

  • nucleus
  • cytoplasm?
A

The lipid soluble drug molecules pass through cell membrane

Cytoplasm: bind with steroid receptors in cytoplasm

Nucleus: the steroid: receptor complex passes into nucleus, binds to nuclear DNA and increases transcription of relevant gene product

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16
Q

What two products do NSAIDs prevent production of?

A

Thromboxane A2

Prostaglandins

17
Q

Side effects of methotrexate? And what precautions should patient take to prevent these?

A

Teratogenic: use contraception

Pancytopenia caused by bone marrow suppression: take folate

Liver toxicity:

GI upset: take after meals

Pulmonary fibrosis (due to folate deficiency): take folate?

18
Q

Vitamin B9?

A

Folate / folic acid

19
Q

What topical drugs are used in psoriasis?

A

Calcipotriol - vitamin D derivative (Dovonex)

An anti-proliferative
Reducing abnormal proliferation of keratinocytes
Induces cell differentiation, normalising epidermal growth.

20
Q

What are retinoids and how do they help?

A

Retinoids - vitamin A derivatives

In acne:

Reduces sebum production
Shrinks the sebaceous glands
Reduces follicular occlusion
Inhibits growth of bacteria
Has anti-inflammatory properties.