Medications

Question 1

topical steroid ladder

Answer 1

hydrocortisone, clobetasone (eumovate), betamehosone (betnovate), mometasone (elocon), clobetasol (dermovate)

Question 2

counselling for emollients

Answer 2

• advise against slipping, especially if used as a bath additive or applied after bathing
• apply along the direction of hair growth
• if prescribing a tub of ointment, use spoon to decant to minimise infection risk
• advise about risk of burn injuries if smoking after using paraffin-based emollients

Question 3

aciclovir

Answer 3

• treats herpes simplex and zoster varicella
• oral tablet 5x a day for 5 days (simplex) or 7 days (zoster varicella)
• oral, IV, eye ointment, cutaneous cream
• side effects - gastrointestinal upset, increased liver enzymes (hepatic disorders), haem reactions (anaemia, leukopenia, thrombocytopenia)

Question 4

oral antihistamines

Answer 4

• non-sedating - cetirizine, loratadine
• sedating - chlorpheniramine
• side effects - sedation, anticholinergic (dry mouth, dizziness, tinnitus)

Question 5

oral retinoids

Answer 5

• chemically related to vitamin A
• e.g. isotretinoin, acitretin
• side effects - mucocutaneous reactions, disordered liver function, myalgia, hypercholesterolaemia
• highly teratogenic - use effective contraception for 1 month after isotretinoin and 2 years after acitretin