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Dermatology > Pharmacology > Flashcards

Pharmacology Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the 3 major routes of drug administration through the skin?

A

Topical, transdermal, subcutaneous

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2
Q

Which route of drug administration is mainly used for local effect? Which are used for prolonged systemic effects?

A

Local = topical, Systemic = transdermal and subcutaneous

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3
Q

What is the most important barrier to drug penetration?

A

Keratin layer

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4
Q

What are adjacent corneocytes held together by?

A

Corneodesmosomes

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5
Q

Both local and systemic drugs must cross the keratin layer. True or false?

A

True

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6
Q

Penetration of the keratin layer normally only allow diffusion of which drugs?

A

Small, hydrophobic drugs

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7
Q

The topical route is mainly used for treatment of what?

A

Superficial skin disorders

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8
Q

What do keratolytic drugs do? When are they used?

A

Break down the keratin layer- used in warts

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9
Q

What are 2 important factors which influence the rate and extent of absorption of a topically applied drug?

A

Solubility of the drug in the vehicle, movement of the drug from the vehicle to the keratin layer

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10
Q

Transdermal drug delivery is driven by what?

A

Diffusion

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11
Q

What type of drug dissolved in what type of vehicle will be the most effective at getting through the keratin layer?

A

Lipophilic drug in a lipophilic or hydrophobic vehicle

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12
Q

Only the drug which is dissolved in the vehicle is able to be absorbed. True or false?

A

True

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13
Q

Increased partitioning of a drug results from what?

A

Reduction in barrier function in the keratin layer

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14
Q

What are the relative potencies of drugs in thick and thin skin?

A

Thick skin = high potency, thin skin = low potency

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15
Q

What does it mean for a drug to have high potency?

A

Evokes a response at a low concentration

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16
Q

Which is more potent, hydrocortisone butyrate or hydrocortisone acetate?

A

Hydrocortisone butyrate

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17
Q

Corticosteroids have what effect on blood vessels?

A

Vasoconstriction

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18
Q

Systemic side effects do not occur with topical administration of steroids. True or false?

A

False, it is less likely but systemic side effects can still occur

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19
Q

Which is more potent, and ointment or a cream?

A

Ointment

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20
Q

Describe subcutaneous administration?

A

A needle into adipose tissue below the skin surface

21
Q

A drug which is delivered via subcutaneous administration will reach the systemic circulation how?

A

By diffusion into capillaries or lymphatic vessels

22
Q

What are 3 advantages of using the skin as a site of administration?

A

Steady state concentration can be achieved, avoids first pass metabolism and absorption can be terminated rapidly

23
Q

Many drugs are suitable for transdermal administration. True or false?

A

False- not many drugs are suitable

24
Q

Glucocorticoids signal via what type of receptor? Specifically which one?

A

Intracellular receptors - specifically GRalpha

25
Q

Are glucocorticoids lipophilic or lipophobic? How do they enter cells?

A

Lipophilic- enter cells by diffusion through the plasma membrane

26
Q

What happens to glucocorticoids in the cytoplasm?

A

They combine with GRalpha and are translocated to the nucleus aided by importins

27
Q

What do glucocorticoids bind to in the nucleus?

A

Glucocorticoid response elements

28
Q

What happens once glucocorticoids have bound to GREs?

A

Transcription of specific genes is either switched on or off, mRNA levels are altered and mediator proteins are produced

29
Q

Name the bases which topical drugs can be used in?

A

Gels, creams, ointments, pastes, lotions

30
Q

What are creams? What do they contain?

A

Semisolid emulsion of oil in water. Contain emulsifier and preservatives.

31
Q

Do ointments contain preservatives?

A

No

32
Q

When should ointments be used?

A

If the skin is really dry or cracked

33
Q

What is a lotion?

A

A suspension of medication in water, alcohol or other liquid

34
Q

Where are lotions particularly useful?

A

To treat the scalp and hair bearing areas

35
Q

Where are gels used to treat?

A

Scalp, hair bearing areas and face

36
Q

What vehicle is often used in cooling and drying bandages?

A

Pastes

37
Q

What is the function of emollients and when are they used

A

Enhance rehydration of the skin, used in dry/scaly conditions especially eczema

38
Q

How much emollient should be prescribed weekly?

A

300-500g

39
Q

When and how should emollients be applied?

A

Directly after bathing, in the direction of hair growth

40
Q

What are some dermatological effects of topical steroids?

A

Steroid rosacea, fixed telangiectasia, perioral dermatitis

41
Q

What type of steroid should be started first?

A

Potent, and then reduced

42
Q

How much topical steroid is used for two hands? How much is used for the whole body?

A

Two hands = one fingertip length, whole body = 20-30g ointment

43
Q

What are tacrolimus and pimecrolimus examples of?

A

Calicneurin inhibitors

44
Q

What do calicneurin inhibitors do? When are they used?

A

Suppress lymphocyte activation, used in atopic eczema

45
Q

What can be added to calamine lotion for a cooling sensation?

A

Anti-pruritic e.g. menthol

46
Q

When are keratolytics used?

A

Viral warts, hyperkeratotic eczema, psoriasis, corns and calluses

47
Q

Use of vitamin D analogue in psoriasis is limited to what?

A

100g/week

48
Q

Psoriasis can be aggravated by what drug?

A

Beta blockers (propranolol)

Dermatology (15 decks)

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