Management of skin disease Flashcards
Give some examples of emollients?
Indications? How do they help?
Aqueous creams
Emulsifying ointment
Paraffin
E45, Diprobase
Dry scaling skin, eczema, psoriasis
They rehydrate skin and re-establish the surface lipid layer
Ointment vs cream?
Ointment: oil based
Cream: water based
Give some examples of topical steroids in order of potency?
Hydrocortisone: mild
Eumovate: moderate
Betnovate: potent
Dermovate: very potent
Give some indications of topical and oral steroids? How do they help?
Allergic and immune reactions
Inflammatory skin conditions
Blistering disorders
Vasculitis
They have anti-inflammatory and anti-proliferative effects
Side effects of topical steroids?
Skin atrophy Telangiectasia Mask or exacerbate skin infections Acne Dermatitis
Give example of oral steroid used?
Side effects of these?
Prednisolone
Cushing’s syndrome Immunosuppression Hypertension Diabetes Osteoporosis Steroid induced psychosis
What virus does aciclovir treat?
Herpes simplex and zoster
Give examples of anti-histamines? Which are sedating and which aren’t?
Non-sedative
- Cetirizine
- Loratidine
Sedative
- Chlorpheniramine
- Hydroxyzine
Indications of anti-histamines and how do they help?
Side effects?
Hypersensitivity reactions
Eczema
They block histamine receptors, reducing itch
Sedating anti-histamines can have anti-cholinergic effects (dry mouth, urinary retention, constipation)
List some topical antibiotics.
List some oral antibiotics used in skin conditons?
Topical:
- Fusidic acid
- Neomycin
Oral:
- Tetracycline (acne)
- Penicillins
- Many!
What type of drug is isotretinoin?
What about acitretin?
Both are oral retinoids
Give examples of oral retinoid drugs?
Indications?
Isotretinoin
Acitretin
Used in acne, psoriasis and disorders of keratinisation
Side effects of oral retinoid drugs? What needs to be monitored?
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
How long should women not get pregnant after stopping a course of isotretinoin? What about acitretin?
Isotretinoin: at least one month
Acitretin: 2 years
Mechanism of action of steroids in
- nucleus
- cytoplasm?
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