Pharmacology

Question 1

major routes of skin drug administration

Answer 1

topical
subcutaneous
transdermal

Question 2

describe the bricks of the brick and mortar model

Answer 2

corneocytes containing keratin and filaggrin in protein cell envelope attached by dermasomes

Question 3

describe the mortar of the brick and mortar model

Answer 3

lipid based with cholesterol

Question 4

describe intercellular drug movement through the skin

Answer 4

moves around cells in the intercellular space

Question 5

describe transcellular drug movement through the skin

Answer 5

moves through cells and through intercellular space

Question 6

what is a vehicle

Answer 6

pharmalogically inactive substance varying in water content

Question 7

what law does rate of absorption of drug in skin follow

Answer 7

ficks law

Question 8

if vehicle is hydrophilic and drug is lipophilic what happens

Answer 8

partitions pretty easily into skin

Question 9

if vehicle is hydrophilic and drug is hydrophilic what happens

Answer 9

drug stays in vehicle and doesnt get absorbed

Question 10

if vehicle is lipophilic and drug is lipophilic what happens

Answer 10

partitions between both

Question 11

if vehicle is lipophilic and drug is hydrophilic what happens

Answer 11

drug slowly partitions into skin but not very well

Question 12

excess undissolved drug in a vehicle is bad as it doesnt facilitate good absorption. there is one exception, when

Answer 12

transdermal patches

Question 13

what is an excipient

Answer 13

chemical added to topical treatments to facilitate better skin absorption

Question 14

how can you increase partitioning into the skin physically and chemically for topical treatments

Answer 14

dress with cling film
use an excipient
use the right type of vehicle

Question 15

true/fase - clobetasone is more potent than blobetasol

Answer 15

false

Question 16

true/false - hydrocortisone butyrate has better absorption than hydrocortisone acetate

Answer 16

true

Question 17

safety of steroid creams/ointments in low dose for short term

Answer 17

pretty safe

Question 18

adverse effects of potent steroids for long term

Answer 18

skin atrophy
telangiectasia 
striae atrophica 
steroid rebound 
steroid rosacea 
adrena suppression/cushings
purpura 
masked infection 
glaucoma and cataract

Question 19

mechanism of action of steroids

Answer 19

nuclear receptors
bind to GREs in promoter region of specific genes to control protein expression by altering mRNA production hence protein synthesis

Question 20

advantages of s/c delivery `

Answer 20

slow absorption
administration of oil or protein based drugs
can deposit drugs under skin

Question 21

true/false - skin bypasses first pass metabolism

Answer 21

true

Question 22

what is TDD

Answer 22

transdermal drug delivery

patch applied to epidermis

Question 23

what drugs can be used for TDD

Answer 23

nicotine
scopolamine
fentanyl

Question 24

how may permeability of skin be enhanced for TDD

Answer 24

chemical enhancement

Question 25

describe the different bases/vehicles

Answer 25

``` gels creams ointment pastes lotions foams ```

Question 26

components of ointments

Answer 26

grease/oil (soft paraffin)

Question 27

what may a lotion treat

Answer 27

scalp and hair bearing areas

Question 28

uses of emollients?

Answer 28

all dry/scaly conditions

Question 29

what is especially important in prescribing an emollient

Answer 29

cosmetically acceptable so the patient actually uses it

Question 30

direction of use of an emollient?

Answer 30

apply after bathing apply in hair growth direction makes skin slippy use spatula to remove from tub

Question 31

true/false - you can smoke using an emollient

Answer 31

false - certainly not if it is paraffin based

Question 32

your patient comes to you using a moisturiser and they have contact dermatitis. is it okay for them to use it

Answer 32

yes, as long as it doesnt contain SLS

Question 33

uses of topical steroids

Answer 33

eczema psoriasis non-infectious inflammatory disorders like lichen planus keloid scars

Question 34

how much steroid ointment is on a fingertip unit

Answer 34

1/2 gram | 2 handspans

Question 35

how much ointment is required to coat entire body

Answer 35

20-30g

Question 36

when would you use potassium permanganate

Answer 36

acute exudative eczema

Question 37

when would you use antibiotics

Answer 37

acne/rosacea impetigo infected eczema

Question 38

what would you give for cold sore

Answer 38

topical antiviral

Question 39

what would you give for herpes zoster

Answer 39

oral antiviral

Question 40

what would you give for candida

Answer 40

clotrimazole, nystatin

Question 41

what would you give for dermatophytes

Answer 41

clotrimazole, terbinafine

Question 42

therapies for psoriasis?

Answer 42

``` coal tar viramin D analogue keratolytic topical steroid dithranol ```

Question 43

what could you give for psoriasis of scalp

Answer 43

greasy ointment tar shampoo steroids in alcohol base lotion or shampoo vitamin D analogues

Question 44

when are keratolytics used

Answer 44

viral warts | corns/calluses

Question 45

example of keratolytic

Answer 45

salicylic acid

Question 46

examples of antipruritics

Answer 46

menthol capsaicin camphor/phenol crotamiton

Question 47

when may you use 5-flurouracil

Answer 47

superficial BCC or bowens

Question 48

where is a wet wrap used most

Answer 48

paediatrics for very dry skin

Question 49

what is a calicneurin inhibitor and name one and side effect

Answer 49

tacrolimus alternative to topical steroid suppresses lymphocyte action burning on application, often on increased alcohol consumption

Question 50

tacrolimus can cause what

Answer 50

increased risk of skin cancer and cutaneous infection