Natural products, cancer and fungal infections

Question 1

Give examples of systemic products

Answer 1

Nicotine patches
Estradiol patches
(TRANSDERMAL DRUG DELIVERY)

Question 2

Give examples of products that provide local or regional action

Answer 2

Moisturisers or ibuprofen gel

Topical drug delivery

Question 3

Give examples of natural products used

Answer 3

Seaweed
Oils: avocado, apricot, carrot, tea tree
Sage
Chamomile

Question 4

What is the Arnica Montana

Answer 4

A flower that is used externally in gels for bruising, oedema, arthritis, inflammation

Question 5

What is the Arnica Montana made up of

Answer 5

1. Sesquiterpene Lactones and Esters

2. DH acetate, DH methacrylate, DH tiglinate

Question 6

What is the role of sesquiterpene lactones

Answer 6

1. Affects inflammatory processes by inhibition of NF-kappaB and NF-AT at micro molar concentrations
2. Influences cytokine release

Question 7

Describe how tests were done on the Arnica Montana and what did they show

Answer 7

1. Using HPLC they detected 5 compounds transversed polymer (silastic membrane)
2. Two were sesquiterpene lactones
3. They showed that they go through skin at an incredibly low rate and were not feasible to use- 3 hours shows vasodilation present

Question 8

What is glucosamine and what is it marketed for

Answer 8

1. Amino monosaccharide
2. GL-HCL or sulphate salts (GL-S)
3. Marketed to treat osteoarthritis
4. Administered at 1500mg orally per day
5. Hydrophilic compound is fully ionised in solution

Question 9

What is the rationale for glucosamine topical delivery (what are its pharmacokinetic properties, side effects)

Answer 9

Low oral bioavailability
Short half life
Side effect: induces insulin resistance at high doses in diabetic patients
Long term treatment
Not much clinical evidence for transdermal route

Question 10

What is basal cell carcinoma and how does it occur

Answer 10

Least malignant form of skin cancer

Occurs on sun exposed areas of the face, appears as nodules that have small viable blood vessels

Relatively slow growing and metastasis (spreading) before detection

Question 11

How do you treat basal cell carcinoma

Answer 11

99% full cure by surgical excision

Radiotherapy: used for large superficial forms

Cryotherapy: very superficial forms with advised follow up

Drug use: Fluorouracil cream and imiquimod cream (anticancer drugs)

Question 12

What is squamous cell carcinoma

Answer 12

1. Formed due to keratinocytes in stratified squamous epithelium
2. Symptoms: scaly red papule that ulcerate and bleed which are found on head (scalp, ears, lower lip) and hands
3. Grows rapidly and metastasises (spreads) if not removed

Question 13

What patient population normally get squamous cell carcinoma and how do you treat

Answer 13

Patient population: recent transplant or are very immunocompromised

Caught early, surgical removal or radio therapy

Question 14

What is malignant melanoma, how is it caused, risk factors and areas affected

Answer 14

1. The most dangerous of all skin cancers that is caused from exposure to UV irradiation
2. Risk factors: childhood sun exposure, intermittent sun exposure, family history
3. Highly metastatic and resistant to chemotherapy

Question 15

How do you treat malignant melanoma

Answer 15

Wide surgical excision and chemotherapy (possible immunotherapy IL2)

Depth of invasion and thickness of tumour (predict prognosis and 5 year survival rate)

Early detection allows higher survival rate (tumour less than 4mm thick)

Advice: wear hat and apply suncream at regular intervals

Question 16

What is the ABCDE approach to recognising melanoma

Answer 16

Asymmetry: one half doesn’t match the appearance of the other

Border irregularity: edges are ragged, blotched or blurred

Colour: Different shades of tan, black brown, dashes of red and white

Diameter: size of the mole is greater than 6mm, should be evaluated

Elevation

Question 17

What is the major criteria in the 7 point check list approach

Answer 17

Change in size, shape, colour

Question 18

What is the minor criteria in the 7 point check list approach

Answer 18

Diameter >6mm
Inflammation
Oozing
Bleeding
Mild irritation

Question 19

What are the three main fungi

Answer 19

Trichophyton
Microsporum
Epidermophyton

Question 20

What is the fungi called for a candidiasis infection

Answer 20

Candida albicans (yeast)

Question 21

What is Tinea Capitis, Corporis, Cruris, Pedis

Answer 21

Infection of: 
Capitis: scalp
Corporis: body
Cruris: groin
Pedis: foot