Pharmacology

Question 1

What is pharmacokinetics?

Answer 1

The effect of the body on the drug

Question 2

What is pharmacodynamics?

Answer 2

The effect of the drug on the body

Question 3

Distribution =

Answer 3

where the drug goes

Question 4

Metabolism =

Answer 4

how drug is processed (esp in liver disease)

Question 5

What factors can affect pharmacodynamics?

Answer 5

Age
Pregnancy
Drug interactions
Pharmacogenetics

Question 6

Try n name some factors associated with poor adherence

Answer 6

Psychiatric co-morbidities
Slower acting agents
Multiple applications per day
Lack of patient education 
Cosmetic acceptability of treatments
Unintentional non-adherence

Question 7

What is topical therapy?

Answer 7

Medication applied to the skin

Vehicle + active drug

Question 8

What is the vehicle of a drug?

Answer 8

Pharmacologically inert, physically and chemically stable substance that carries the active drug

Question 9

What are some vehicles for drugs?

Answer 9

Solution
Cream
Lotion
Gel
Foam
Tape
Paste
Spray powder
Shampoo
Ointment
Paint

Question 10

What properties do topical steroids have? What does this involve?

Answer 10

Anti-inflammatory and immunosuppressive

• regulate pro-inflammatory cytokines
• suppress fibroblast, endothelial and leukocyte function
• vasoconstriction
• inhibit vascular permeability

Question 11

What is a finger tip unit?

Answer 11

About 0.5g

Question 12

What area should a finger tip unit treat?

Answer 12

Area double the size of one hand

Question 13

Try n list off some possible side effects of topical steroids

Answer 13

Thinning/atrophy
Striae
Bruising
Hirsutism
Telangectasia
Acne/rosacea/perioral dermatitis
Glaucoma
Systemic absorption 
Cataracts

Question 14

Name 3 types of systemic treatment in dermatology

Answer 14

• Retinoids
• Traditional immunosuppressants
• Biologics (also immunosuppressive)

Question 15

What type of analogues are retinoids?

Answer 15

Vitamin A (normalise keratinocyte function/anti-inflammatory and anti-cancer effects)

Question 16

Give the 4 different retinoids used orally in dermatology and what conditions they treat

Answer 16

Isotretinoin = acne
Acitretin = psoriasis 
Bexarotene = cutaneous T cell lymphoma 
Alitretinoin = hand eczema

Question 17

Why do retinoids require careful patient selection?

Answer 17

Teratogenic effects

Question 18

What are some side effects of retinoids?

Answer 18

Chellitis (dry lips) and xerosis (dry skin)
Increased transaminases, increased triglycerides
Rarely - psychiatric, eye, bone side effects

Question 19

What are immunosuppressants used to treat?

Answer 19

Inflammatory skin disorders

Question 20

What are the types of immunosuppressants?

Answer 20

Oral steroids
Azathioprine
Ciclosporin
Methotrexate 
Mycophenolate mofetil

Question 21

What are 2 risks associated with immunosuppressants?

Answer 21

Malignancy

Serious infection

Question 22

What monitoring is required when taking immunosuppressants?

Answer 22

Reg blood test monitoring (FBC (esp metho + aza), renal (esp ciclo), liver function (esp metho))

Question 23

What are derm biologics termed as?

Answer 23

‘the next generation in treatment of inflammatory conditions’

Question 24

What actually are biologics?

Answer 24

Genetically engineered proteins derived from human genes designed to inhibit specific components of the immune system

Question 25

What is the major pro and con of biologics?

Answer 25

V effective but v expensive

Question 26

What are 2 possible risks of biologics?

Answer 26

Infection
Malignancy
(also TNF inhibitors - risk of demyelination)

Question 27

What have biologics been revolutionary in the treatment of?

Answer 27

Advanced melanoma