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Y2 DERMATOLOGY > Pharmacology > Flashcards

Pharmacology Flashcards

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Dermatology Board Prep flashcards
1
Q

Immunologically-mediated skin reactions are dose-dependent. True/False?

A

False

All or nothing!

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2
Q

Non-immunologically-mediated skin reactions can be dose-dependent. True/False?

A

True

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3
Q

How do urticarial drug eruptions usually arise?

A

IgE-mediated hypersensitivity or drug-induced mast cell degranulation

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4
Q

Which drugs tend to cause pustular/bullous drug reactions?

A

Glucocorticoids
Androgens
Hypertensives

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5
Q

Fixed drug eruptions are well-demarcated and round. Which drugs are commonly associated with this?

A

Tetracycline antibiotics
Paracetamol
NSAIDs
Carbamazepine (anti-epileptic)

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6
Q

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

A

Topical
Transdermal
Subcutaenous

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7
Q

What is the single most important barrier to drug administration?

A

Stratum corneum (made up of corneocytes)

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8
Q

The stratum corneum is made up similar to a “bricks and mortar” model. What are the bricks?

A

Corneocytes embedded in filaggrin that are held together by corneodesmosomes

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9
Q

The stratum corneum is made up similar to a “bricks and mortar” model. What is the mortar?

A

Hydrophobic layer made up of intercellular lipids

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10
Q

Is the stratum corneum hydrophilic or lipophilic?

A

Lipophilic

Absorbs lipid-soluble (hydrophobic drugs)

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11
Q

The principle mechansim of drug penetration of the stratum corneum is transcellular (across the stratum corneum). True/False?

A

False

Principle mechanism is intercellular (tortuous course between corneocytes)

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12
Q

Drug vehicles are normally used in topical administration of drug (for local effect). What are vehicles?

A

Pharmacologically inactive substances that “carry” the drug

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13
Q

List some examples of drug vehicles

A 
Ointments
Creams
Gels
Lotions
Pastes and powders
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14
Q

Rate of absorption of a topically administered drug = ?

A 
J =  Kp x CvKp = permeability coefficient
Cv = concn of drug in vehicle
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15
Q

A drug must exit its vehicle if it is to penetrate the stratum corneum. True/False?

A

True

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16
Q

The bigger the Km of a drug, the better it will enter the skin. True//False?

A

True

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17
Q

Lipophilic drug in a hydrophilic vehicle absorb poorly in skin. True/False?

A

False

They absorb very well

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18
Q

Lipophilic drug in a lipophilic vehicle absorb very well in skin. True/False?

A

False
While they will absorb, the drug will want to remain in the lipophilic vehicle at the same time, so absorption is not great

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19
Q

Hydrophilic drug in a lipophilic vehicle don’t absorb very well. Why?

A

They will make it out of the vehicle but cannot penetrate the stratum corneum because they are hydrophilic

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20
Q

Hydrophilic drug in a hydrophilic vehicle absorb the best of all. True/False?

A

False

They ain’t going nowhere

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21
Q

What can enhance the absorption of a drug in skin?

A

Excipients

22
Q

What are creams?

A

Semi-solid emulsion of oil and water containing emulsifier and preservative

23
Q

Creams are cooling and greasy. True/False?

A

False

They are cooling but not greasy

24
Q

What is the danger of the preservative in creams?

A

Allergic reaction

25
Q

What are ointments?

A

Semi-solid mix of grease and oil containing soft paraffin

26
Q

What is the benefit of ointments?

A

Effective at restricting transepidermal water loss

27
Q

What is the downside of ointments?

A

Not cosmetically attractive (very greasy)

28
Q

What are lotions?

A

Suspension of medication in water/alcohol/other liquid

29
Q

What are gels?

A

Thickened aqueous solutions containing high molecular weight polymers

30
Q

What is the downside of pastes?

A

Stiff and difficult to apply

31
Q

What is the function of emollients?

A

Enhance hydration of epidermis

32
Q

For what type of conditions are emollients used?

A

Dry, scaly conditions

Mainstay for eczema

33
Q

When are wet wraps frequently used? How are they applied?

A

For very dry skin

Wrap around previously moisturised skin to lock in moisture

34
Q

What are the 3 actions of topical steroid upon skin?

A

Anti-inflammatory
Anti-proliferative
Vasoconstrictive

35
Q

Name a mild steroid for skin disease

A

Hydrocortisone

36
Q

Name a moderate steroid for skin disease

A

Modrasone

37
Q

Name a potent steroid for skin disease

A

Mometasone

38
Q

Name a very potent steroid for skin disease

A

Clobetasol

39
Q

How many grams of steroid are equvalent to 1 fingerprint unit?

A

0.5g

40
Q

1 fingertip unit = how many hand areas?

A

2

41
Q

What is meant by tachyphylaxis to steroid?

A

Steroid becomes less effective despite maintained dosage

42
Q

What conditions is potassium permanganate rinse/soak/bath useful for?

A

Antiseptic used for exudative or pompholyx eczema

43
Q

Name topical antibiotics used for acne

A

TetracyclineClindamycinErythromycin

44
Q

What is the main antibiotic used for rosacea?

A

Metronidazole

45
Q

List some antipruritics

A

Menthol
Capsaicin
Camphor/phenol
Crotamiton

46
Q

What are keratolytics used for? Name one

A 
Softening keratin (e.g. viral warts, hyperkeratotic disease)
Salicylic acid
47
Q

Emollients can be used for psoraisis along with what other options?

A

Coal tar
Vitamin D analogues
Keratolytic
Topical steroid

48
Q

Which cream has been shown to be effective for pre-cancerous and cancerous skin lesions?

A

Aldara cream (Imiquimod)

49
Q

What are the long-term side effects of gluocorticoids?

A 
Rebound psoriasis
Skin atrophy + rosacea
Infection spread
Stretch marks
Depression
50
Q

What is Steven Johnson syndrome and TEN?

A

Scarring of eyes, mouth and tongue, typically post drug

Severe burns in the elderly, typically post-drug

Y2 DERMATOLOGY (12 decks)

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