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Y2 - Dermatology > Pharmacology > Flashcards

Pharmacology Flashcards

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Dermatology Board Prep flashcards
1
Q

When is topical administration usually used?

A 
Superficial skin disorders
Skin infections
Itching
Dry skin
Warts
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2
Q

What are the vehicles for topical administration?

A 
Lotions
Creams
Ointments
Gels
Pastes
Powders
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3
Q

What is Fick’s law of diffusion?

A

Rate = permeability x concentration of drug in the vehicle

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4
Q

What does permeability of a drug take into account?

A

Partition co-efficient
Diffusion co-efficient
Length of the diffusion pathway

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5
Q

What is the partition co-efficient?

A

The movement of the drug from vehicle into the stratum corneum

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6
Q

What type of drug and vehicle are needed to reach systemic capillaries?

A

Lipophillic (easily moves through the skin)

Lipophilic or hydrophilic vehicle

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7
Q

What type of drug and vehicle are needed for superficial skin conditions and why?

A 
Hydrophilic drug in lipophilic base
Only partitions (moves through skin) weakly
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8
Q

What type of drug and vehicle would not penetrate the skin?

A

Hydrophilic drug and base

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9
Q

What are excipients and why are they used in vehicles?

A

Substances that can enhance hydrophobic drug solubility to enhance absorption

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10
Q

What is the advantage to transdermal patches?

A

Excess non-dissolved drug can be included to increase duration of effectiveness and provide a constant rate of delivery

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11
Q

What can the partition co-efficient be improved by?

A

Hydration of the skin by occlusion by ointment or cling film

Inclusion of excipients

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12
Q

What aspects of the nature of skin influence the absorption of topical drugs?

A

Thickness of the site of application
Hydration of the skin
Integrity of the epidermis

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13
Q

What skin conditions are topical steroids used treat?

A

Atopic eczema
Psoriasis
Pruritis

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14
Q

How do topical steroids work?

A

Anti-inflammatory
Immunosupressant
Vasoconstricting
Anti-proliferating for keratinocytes and fibroblasts

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15
Q

What are the categories of topical steroid?

A

Mild
Moderate
Potent
Very potent

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16
Q

In what vehicles are topical steroids available?

A

Lotion
Cream
Ointment

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17
Q

What are the side effects of high potency steroids?

A

Steroid rebound
Skin atrophy
Systemic effects
Spread of infection due to immune suppression
Steroid rosacea
Stretch marks and small superficial dilated blood vessels (telangectasia)

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18
Q

What is the mechanism of action of topical steroids?

A

Signal via nuclear receptors

Lipophilic molecules, enter by diffusion

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19
Q

How does subcutaneous administration work?

A

Drug inserted into the fatty (adipose) tissue just beneath the surface of the skin
Drug reaches the systemic circulation by diffusion into either capillaries or lymphatic vessels

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20
Q

What are the advantages of subcutaneous administration?

A

Absorption is slow
Preferred for many protein drugs and oil-based drugs
Can be used to introduce depot of drug that is slowly released into circulation
Simple and relatively painless

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21
Q

What is the disadvantage of subcutaneous administration?

A

Injection volume limited

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22
Q

What is transdermal drug delivery?

A

Drug is incorporated into an adhesive patch applied to the epidermis
Drug absorption partially controlled by a drug release membrane
Absorption occurs by diffusion across cutaneous barrier

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23
Q

What are the drugs that are most suitable for transdermal drug delivery?

A

Low molecular weight
Moderately lipophilic
Potent
Short half-life

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24
Q

What are the advantages of transdermal delivery?

A 
Steady rate of drug delivery
Decreased dosing frequency
Avoidance of first-pass metabolism
Rapid termination if half-life too short
User-friendly, convenient and painless
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25
Q

What are the disadvantages of transdermal delivery?

A

Relatively few suitable drugs
Allergies
Cost

26
Q

What are examples of drugs that can be given by transdermal delivery?

A

Scopolamine
Nicotine
GTN

27
Q

What are the advantages and disadvantages of topical skin treatments?

A

Advantages: direct application, reduced systemic effects
Disadvantages: time consuming, correct dosage can be difficult, messy to use

28
Q

What are the vehicles that can be used to apply drugs?

A 
Gels
Creams
Ointments
Pastes
Lotions
Foams
29
Q

What is a cream?

A

Semisolid emulsification of oil in water

30
Q

What are the benefits of cream?

A

High water content so cools and moisturises
Not greasy
Easy to apply
Cosmetically acceptable

31
Q

What is an ointment?

A

Semisolid grease/oil

32
Q

What are the advantages and disadvantages of ointments?

A

Possibility of contamination so can’t share
Restrict water loss
But greasy so less cosmetically attractive

33
Q

What is a lotion?

A

Liquid suspension or solution of medication water, alcohol or other liquid

34
Q

What are lotions used to treat?

A

Scalp conditions and other hair bearing areas

35
Q

What are gels?

A

Thickened aqueous liquids containing high molecular wight polymers

36
Q

What are gels used to treat?

A

Scalp, hair bearing areas, face

37
Q

What are pastes?

A

Semisolids that contain finely powdered material

38
Q

What are the disadvantages of pastes?

A

Stiff, greasy, difficult to apply

39
Q

What are the benefits of pastes?

A

Protective, occlusive, hydrating
Can protect surrounding skin
Often used in cooling, drying soothing bandages

40
Q

What are foams?

A

Colloid with two or three phases, usually a hydrophilic liquid in continuous phase with a foaming agent

41
Q

What are the advantages of foams?

A

Increased penetration of active agents

Spreads easily over large areas of skin with no greasy/oily film

42
Q

What is the action of emollients?

A

Enhance rehydration of the epidermis

43
Q

What are emollients used for?

A

All dry or scaly conditions

44
Q

When is wet wrap therapy used?

A

For very dry skin, mostly for children

45
Q

When are calcineurin inhibitors used?

A

As alternative to steroids in eczema

46
Q

What are the types of anti-invectives?

A

Antiseptics
Abtibiotics
Antivirals
Antifungals

47
Q

What is the action of antiseptics?

A

Bacteriostatic or bactericidal

48
Q

What are the uses of antiseptics?

A

Recurrent infections
Skin cleansing
Wound irrigation

49
Q

What are the skin uses of antibiotics?

A

Acne and rosacea
Skin infections
Infected eczema

50
Q

What are the disadvantages of using antibiotics in skin conditions?

A

Resistance
Sensitisation
Only use if you have to

51
Q

When are antivirals used in skin conditions?

A

Herpes simplex virus cold sores
Eczema herpeticum
Herpes Zoster (shingles)

52
Q

When are antifungals used in skin conditions?

A

Candida

Dermatophytes (ring worm)

53
Q

When are keratolytic agents used?

A

Viral warts
Hyperkeratotic eczema and psoriasis
Corns and callouses
To remove keratin plaques in scalp

54
Q

What is an example of a keratolytic agent?

A

Salicylic acid ointment

55
Q

How are warts treated?

A 
Mechanical paring plus:
Salicylic acid (keratolytic)
Formaldehyde
Silver nitrate
Cryotherapy
56
Q

How is psoriasis treated?

A 
Emollients and a choice of:
Coal tar
Vitamin D analogue
Keratolytic
Topical steroid
Dithranol
57
Q

Which treatments are used in stable chronic plaque psoriasis?

A

Coal tar
Vit D analogues
Dithranol

58
Q

What treatments are used in scalp psoriasis?

A

Greasy ointments to soften scale
Tar shampoo
Steroids in alcohol base or shampoo
Vit D analogues

59
Q

What treatments are used in psoriasis in axilla?

A

Topical steroids for face, flexures, groin/genitals
Consider combination antibacterial and anti fungal
Calcineurin inhibitors

60
Q

What are topical treatments for superficial basal carcinomas?

A

5-fluorouracil

Imiquimod

61
Q

What are possible side effects of topical therapies?

A

Burning or irritation
Contact allergic dermatitis
Local toxicity
Systemic toxicity

Y2 - Dermatology (12 decks)

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