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Dermatology > Pharmacology and Prescribing > Flashcards

Pharmacology and Prescribing Flashcards

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Dermatology Board Prep flashcards
1
Q

When is medicine used without license?

A
  • Unlicensed - not approved for UK use but no alternative
  • Off label - licensed meds for unlicensed indication
  • Specials - clinically effective but no evidence in clinical trials
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2
Q

What are causes of prescription error?

A
  • Lack of knowledge
  • Mistake writing/genrating the prescription
  • Poor communication
  • No local or national guidelines
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3
Q

What are the two actions of pharmacology?

A
  • Pharmacokinetics - the effect of the body on the drug

* Pharmacodynamics - the effect of the drug on the body

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4
Q

What needs to be considered with pharmacokinetics?

A

• Route of administration - topic where possible, but it oral, optimal absorption important

  • Distribution - where the drug goes
  • Metabolism - esp. in liver disease
  • Excretion - esp. in renal disease
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5
Q

Why is topical administration advantageous?

A

Prevents systemic side effects

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6
Q

What needs to be considered with the pharmacodynamics of drugs?

A

• Individual variation in response

  • Age of patient
  • Pregnancy risk
  • Drug interactions
  • Pharmacogenetics
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7
Q

Name factors associated with poor adherence =

A
  • Psychiatric co-morbidities
  • Slower acting agents
  • Multiple applications per day
  • Lack of patient education
  • Cosmetic acceptability of treatments
  • Unintentional non-adherence
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8
Q

Describe topical administration

A
  • Medication applied to the skin

* Vehicle + active drug

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9
Q

Describe vehicles used in topical therapy

A

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

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10
Q

Name seven factors that affect absorption

A
  • Concentration
  • Base/vehicle
  • Chemical properties of the drug
  • Thickness and hydration of stratum corneum
  • Temperature
  • Skin site
  • Occlusion
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11
Q

Name different types of vehicles

A
  • Solution
  • Cream
  • Lotion
  • Gel
  • Shampoo
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12
Q

Give example of different drugs used topically

A
  • Corticosteroid
  • Antibiotic
  • Chemo
  • Coal tar
  • Antiviral
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13
Q

What are the properties of topical steroids?

A

Anti-inflammatory and immunosuppressive properties

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14
Q

What are the actions of topical steroids?

A
  • Regulate pro-inflammatory cytokines
  • Suppress fibroblast, endothelial, and leukocyte function
  • Vasoconstriction
  • Inhibit vascular permeability
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15
Q

What measurement is used for topical steroids?

A

Finger tip unit

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16
Q

What are the features of the finger tip unit?

A
  • About 0.5g
  • Should treat area double the size of one hand
  • Useful in young children
17
Q

What are possible side effects of topical steroids

A
  • Thinning /atrophy
  • Striae
  • Bruising
  • Hirsutism
  • Telangiectasia
  • Acne/rosacea/perioral dermatitis
  • Glaucoma
  • Systemic absorption
  • Cataracts
18
Q

Name three systemic treatment in dermatology

A
  • Retinoids
  • Traditional immunosuppressants
  • Biologics (also immunosuppressive)
19
Q

What are retinoids?

A

Vitamin A analogues
• Normalise keratinocyte function
• Anti-inflammatory and anti-cancer effects

20
Q

What are retinoids used to treat?

A
  • Acne
  • Psoriasis
  • Cutaneous T cell lymphoma
  • Hand eczema
21
Q

What are the side effects of retinoids?

A

• Teratogenic

  • Cheilitis (dry lips) and xerosis (dry skin)
  • ↑transaminases, ↑triglycerides
22
Q

What are immunosuppressants used to treat?

A

Inflammatory skin disorders

23
Q

Give examples of immunosuppressants

A
  • Oral steroids
  • Azathioprine
  • Ciclosporin
  • Methotrexate
  • Mycophenolate mofetil
24
Q

What are possible side effects of immunosuppressants?

A

• Risk of malignancy and serious infection

Need regular blood test monitoring
• FBC
• Renal function
• Liver function

25
Q

What are biologics used to treat?

A

Inflammatory conditions

• Inhibit specific components of immune system

26
Q

What is indicated when drug name ends in ‘-cept’?

A

Indicates that it is a it is a receptor fusion

27
Q

What is indicated when drug name ends in ‘-mab’?

A

Monoclonal antibodies

28
Q

What is indicated when drug name includes series of infixes which immediately precede ‘mab’?

A
  • Zu - humanised
  • Ix - chimeric
  • U - fully human
  • Li-/-l- immunomodulator
29
Q

What is a licensed biologic used for psoriasis?

A

Infliximab

30
Q

What biologic is used for chronic spontaneous urticaria?

A

Omalizumab

31
Q

What biologic is used for eczema?

A

Dupilumab

32
Q

What are possible side effects of biologic?

A

Risk of infection:
• TB reactivation
• Serious infection
• Avoid live vaccines

  • Risk of malignancy
  • TNF inhibitors – risk of demyelination

Dermatology (8 decks)

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