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Dermatology > Medication + Investigations > Flashcards

Medication + Investigations Flashcards

1
Q

How do you investigate skin disease

A

Charcoal swab + MC+S
Viral swab PCR of vesicle / bull
Fungal nail clipping / hair sample + CULTURE
Biopsy

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2
Q

When would you not do a charcoal swab

A

Cellulitis as infection in blood

Venous ulcer

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3
Q

How affected absorption of topical medication

A 
Concentration 
Vehicle - pharmacologically inert but chemically stable substance that carriers active drug 
Chemical properties
Striatum thickness 
Temperature 
Skin site
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4
Q

What topical agents is there to treat skin disease

A 
Steroids 
Vit A Analogue
Antibiotics / fungals / viral 
Parasitidicies
Chemo
Coal tar
Dithranol
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5
Q

What do steroids do

A 
Anti-inflammatory + immunosuppressive
Suppress fibroblasts / leucocytes 
Vasoconstrict 
Regulate cytokines
Inhibit vascular permeability
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6
Q

How do you measure amount of topical agent

A 
Finger tip unit (0.5g) 
Potency over %
Mild = hydrocortisone 
Mod = Eumovate
Potent = Betonovate
Highly potent = Dermovate
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7
Q

What are the SE of steroids

A 
Thinning / atrophy of skin
Striae 
Hirsutism
Telengiectasia
Acne 
Peri-oral dermatitis 
Allergic contact dermatitis 
May exacerbate skin infection

If systemic

  • Glaucoma / Cataract
  • Cushing
  • DM
  • Immunosuppression
  • HTN
  • Osteoporosis
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8
Q

What are common systemic agents

A

Retinoids
Immunosuppressant
Biologics

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9
Q

What are retinoids

A

Vit A analogues

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10
Q

What do retinoids do

A

Normalise keratinocyte function
Anti-inflammatory
Decrease skin turnover

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11
Q

What are the SE of retinoids

A

Dry lips and skin
TERATOGENIC - must be on contraceptive
Increased transaminase / abnormal LFT - monitor with regular blood test
Psychiatric / bone / eye = rare

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12
Q

When are retinoids indicated

A

Acne
Psoriasis
T cell lymphoma
Hand eczema

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13
Q

What are common immunosuppressants

A 
Steroid 
Cyclosporin
Azathropine
Methotrexate 
MMF
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14
Q

What is needed if on immunosuppressants and why

A

Regular blood monitoring - FBC, U+E, LFT

Risk of malignancy / infection

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15
Q

What are biologics

A

Genetically engineered proteins which inhibit specific parts of the immune system
Expensive

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16
Q

What have biologics revolutionised the Rx of

A

Melanoma

17
Q

If biologic end in - cept

A

Receptor fusion protein

18
Q

If biologic end in -mab

A

Monoclonal Ab

19
Q

What are the SE of biologics

A

Infection
Malignancy
TB reactivation
TNF inhibitor so risk of demyelination

20
Q

What are types of monoclonal Ab

A

HUmanised
Chimeric
Fully human
Immunomodualtory

21
Q

When are biologics used

A

Melanoma
Urticaria
Plaque psoriasis

22
Q

What must you avoid if on a biologic

A

Live vaccine

23
Q

What are examples of emollients

A

Aqueous cream
Emulsifying ointment
Liquid parafin

24
Q

What is indication

A

Rehydrate skin

Used for dry scaling conditions and as soap substitute

25
Q

What are SE

A

Can have irritant or allergic reaction if preservative/ perfume in cream

26
Q

What are SE of oral acyclovir

A

GI upset
Raised liver enzyme
Haemaotlogical disorder
Reversible neurological

27
Q

What are SE of anti-histamine

A

Sedation

Anti-cholinergic - blurred vision / dry mouth / retention and constipation

28
Q

Types of anti-histamine

A 
Sedating
- CHlorphenamine
Non-sedating
- Cetrizine
- Loritidine
29
Q

When are they used

A

Type1 hypersensitvity
Eczema
Pruritus as block histamine receptors

30
Q

What are topical Ax

A

Fusidic acid
Neomycin
Dapsone

31
Q

What are oral Ax

A 
Penicillins
Cephalosporin 
Gentamicin
Macrolides
Nitrofurantoin
32
Q

When are they indicated

A

Bacterial skin infection

Acne

33
Q

What are SE

A 
Local skin irritation
GI upset
Rashes
Anaphylaxis
Vaginal candidiasis
C.diff
34
Q

What are topical anti-septic

A

CHlorhexidine

35
Q

When is it indicated

A

Prevent skin infection

36
Q

SE

A

Irritant / allergy

37
Q

Indication for oral retinoid

A

Severe acne

Psoriasis

38
Q

SE

A 
Dry skin, lips and eyes 
Disordered liver function
Hypercholesterol 
Myalgia
Arthralgia 
Depression 
Teratogenic - one month before and after contraception needed

Dermatology (12 decks)

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