Pharmacology Flashcards
What is pharmacokinetics?
The effect of the body on the drug
What is pharmacodynamics?
The effect of the drug on the body
Distribution =
where the drug goes
Metabolism =
how drug is processed (esp in liver disease)
What factors can affect pharmacodynamics?
Age
Pregnancy
Drug interactions
Pharmacogenetics
Try n name some factors associated with poor adherence
Psychiatric co-morbidities Slower acting agents Multiple applications per day Lack of patient education Cosmetic acceptability of treatments Unintentional non-adherence
What is topical therapy?
Medication applied to the skin
Vehicle + active drug
What is the vehicle of a drug?
Pharmacologically inert, physically and chemically stable substance that carries the active drug
What are some vehicles for drugs?
Solution Cream Lotion Gel Foam Tape Paste Spray powder Shampoo Ointment Paint
What properties do topical steroids have? What does this involve?
Anti-inflammatory and immunosuppressive
- regulate pro-inflammatory cytokines
- suppress fibroblast, endothelial and leukocyte function
- vasoconstriction
- inhibit vascular permeability
What is a finger tip unit?
About 0.5g
What area should a finger tip unit treat?
Area double the size of one hand
Try n list off some possible side effects of topical steroids
Thinning/atrophy Striae Bruising Hirsutism Telangectasia Acne/rosacea/perioral dermatitis Glaucoma Systemic absorption Cataracts
Name 3 types of systemic treatment in dermatology
- Retinoids
- Traditional immunosuppressants
- Biologics (also immunosuppressive)
What type of analogues are retinoids?
Vitamin A (normalise keratinocyte function/anti-inflammatory and anti-cancer effects)
Give the 4 different retinoids used orally in dermatology and what conditions they treat
Isotretinoin = acne Acitretin = psoriasis Bexarotene = cutaneous T cell lymphoma Alitretinoin = hand eczema
Why do retinoids require careful patient selection?
Teratogenic effects
What are some side effects of retinoids?
Chellitis (dry lips) and xerosis (dry skin)
Increased transaminases, increased triglycerides
Rarely - psychiatric, eye, bone side effects
What are immunosuppressants used to treat?
Inflammatory skin disorders
What are the types of immunosuppressants?
Oral steroids Azathioprine Ciclosporin Methotrexate Mycophenolate mofetil
What are 2 risks associated with immunosuppressants?
Malignancy
Serious infection
What monitoring is required when taking immunosuppressants?
Reg blood test monitoring (FBC (esp metho + aza), renal (esp ciclo), liver function (esp metho))
What are derm biologics termed as?
‘the next generation in treatment of inflammatory conditions’
What actually are biologics?
Genetically engineered proteins derived from human genes designed to inhibit specific components of the immune system
What is the major pro and con of biologics?
V effective but v expensive
What are 2 possible risks of biologics?
Infection
Malignancy
(also TNF inhibitors - risk of demyelination)
What have biologics been revolutionary in the treatment of?
Advanced melanoma
