Pharmacology

Question 1

What are some factors that can affect topical absorption?

Answer 1

Concentration, vehicle, chemical properties of the drug, thickness and hydration of stratum corneum, temperature, skin site and occlusion

Question 2

Types of vehicles for topical medications?

Answer 2

Solution, cream, lotion, gel, foam, tape, paste, spray powder, shampoo, ointment, paint

Question 3

How do topical steroids affect the body

Answer 3

Regulate pro-inflammatory cytokines, suppress fibroblast, endothelial and leukocyte function, cause vasoconstriction and inhibit vascular permeability

Question 4

How much topical steroid should be used on an area double the size of one hand?

Answer 4

A finger tip unit- about 0.5g

Question 5

What are some side effects of topical steroids?

Answer 5

Thinning/ atrophy, striae, bruising, hirsutism, telangiectasia, acne/ rosacea/ perineal dermatitis, glaucoma, systemic absorption, cataracts

Question 6

What are retinoids?

Answer 6

Vitamin A analogues that normalise keratinocytes function and have anti inflammatory and antic cancer effects

Question 7

What type of medication is isotretinoin and what it effective against?

Answer 7

It is a retinoids and it is effective against acne

Question 8

What type of medication is acitretin and what it effective against?

Answer 8

A retinoid and it is efffective against psoriasis

Question 9

What type of medication is bexarotene and what it effective against?

Answer 9

It is a retinoid and is effective against cutaneous T cell lymphoma

Question 10

What type of medication is alitretinoin and what it effective against?

Answer 10

A retinoid and is effective against hand eczema

Question 11

What are some side effects of retinoids?

Answer 11

They are teratogenic, and can cause: cheilitis (dry lips), xerosis, increase transaminases and triglycerides and can rarely cause psychiatric, eye and bone side effects

Question 12

What is cheilitis?

Answer 12

Dry lips

Question 13

What is xerosis?

Answer 13

Dry skin

Question 14

What immunosuppressants are used to treat inflammatory skin conditions?

Answer 14

Oral steroids, azathioprine, ciclosporin, methotrexate, mycophenolate mofetil

Question 15

What is the risk of immunosuppressants?

Answer 15

Risk of malignancy and serious infection

Question 16

What regular blood tests need to be completed if takin immunosuppressants?

Answer 16

FBC, renal and live function

Question 17

What are biologics?

Answer 17

Genetically engineered proteins derived from human genes, designed to inhibit specific components of the immune system and are used in inflammatory conditions

Question 18

What does the suffix “-cept” mean in a biologic drug name?

Answer 18

Indicates it is a receptor fusion

Question 19

What does the suffix “-mab” mean in a biologic drug name?

Answer 19

Monoclonal antibodies

Question 20

What are the risks with taking biologics?

Answer 20

Risk of infection- TB reactivation, immunosufficient, avoid live vaccines
Risk of malignancy
TNF inhibitors can cause risk of demyelination

Question 21

What is omalizumab used for?

Answer 21

Monoclonal antibody to IgE reactions with mechanism unknown

Question 22

Treatment for Acne?

Answer 22

Topical retinoids, benzoyl peroxide, topical antibiotics (clindamycin/ erythromycin), azelaic acid, antibiotic tablets (Lymecycline, tetracycline), combine oral contraceptive pill, isotretinoin tablets

Question 23

Treatment for Rosacea?

Answer 23

Avoid vasodilators and irritants, metronidazole cream or gel, azelaic acid cream or gel, ivermectin cream, tetracyclines, surgery for rhinophymas