wk 8- inflammatory

Question 1

anti histamines

Answer 1

reduces the effects mediated by the chemical histamine as it competes with histamine for binding sites at the H1 receptor

histamine is released during allergic responses

antihistamines are competitive h1 receptor antagonists

Question 2

what does histamine do

Answer 2

histamin can bind to H1, H2 H3, h4

h1- stimulates smooth muscle contraction in lungs/gastro tract, stimulates sensory nerve (pruritus and sneezing), increase vascular permeability (swelling)

all reactions of an allergy

Question 3

what is urticaria

Answer 3

redness and swelling of the dermis causing it to to alway be itchy

caused by histamine causing small blood vessels to leak

Question 4

when are anti histamines useful

Answer 4

acute situations

allergic skin reactions (tape, dressings)
pruritic conditions (itchiness)
for sedation before procedures

Question 5

classification of anti histamines

Answer 5

first generation
-sedating

second generation
-less sedating

Question 6

sedating anti histamines can help what

Answer 6

anti pruritic
anti nausea
motion sickness
sedation

Question 7

adverse effects of sedating anti histamines

Answer 7

1. dry mouth
2. blurred vision
3. constipation
4. urinary retention
5. bronchial mucous thickening
6. drowsiness

Question 8

sedating anti histamines are contraindicated in

Answer 8

glaucoma
prostatic hypertrophy

Question 9

phernogen also called

Answer 9

promethazine

Question 10

less sedating anti histamines are what

Answer 10

h1 antagonists that do not cross the blood brain barrier

less lipophilic and lesser anticholinergic side effects

Question 11

types of 2nd gen anti histamines

Answer 11

desloratadine
fexofenadine
loratadine

Question 12

adverse effects of less sedating anti histamines

Answer 12

droswiness
fatigue
headache
nausea
dry mouth

Question 13

desloratadine

Answer 13

indicated in
allergic rhinitis
chronic urticaria

Question 14

loratadine

Answer 14

lower potency anti histamines

indicated in
sesaonal rhinitis
urticaria

Question 15

precautions in populations for anti histamines

Answer 15

breast feeding
pregnancy
elderly

hepatic/renal impairment (depends on drug)

Question 16

fexofenadine

Answer 16

indicated in
allergic rhinitis
chronic urticaria

Question 17

when giving an antihistamine to a child what age should they be over

Answer 17

2 years

Question 18

topical corticosteroids effects

Answer 18

anti inflammatory
immunisuppressant
anti proliferative
vasoconstrictive

Question 19

when to use a topical corticosteroid for inflammatory skin conditions (indications)

Answer 19

contact dermatitis
atopic dermatitis/ eczema
venous stasis dermatitis
psoriasis
hypergranulated ulcer

Question 20

how can topical ingredients pass through the skin

Answer 20

1. trans epidermal
2. trans appendageal - through sweat glands and follicules)

Question 21

factors affecting absorption of topicals

Answer 21

diffusion gradient
number of appendages
level of skin hydration
how often medicament applied
thickness of stratum corneum

Question 22

how long and what strength of corticosteroids can podiatrists prescribe

Answer 22

10 day course

up to 1% potency

Question 23

what conditions of the skin increases absorption

Answer 23

inflammed
diseased
hydrated
temperature

Question 24

how do topical corticosteroids work

Answer 24

bind to and activate glucocorticoid receptor

Question 25

what are the anti proliferative effects of corticosteorids

Answer 25

thinning of stratum corneum

long term use collagen and elastic fibres diminished

Question 26

when to use ointment

Answer 26

if dry, lichenified skin- better penetration and less of an irritant

Question 27

when to use cream

Answer 27

weepy skin- less of an irritant and less occulsive

Question 28

when to use lotion

Answer 28

hairy areas- more appendengeals and lotions can absorb rapidly through these

Question 29

how much topical corticosteroids should you apply

Answer 29

fingertip unit (0.5g)

Question 30

when do you see the most adverse effects with corticosteroids

Answer 30

with long term use

Question 31

ADRs of corticosteroids

Answer 31

-adrenal suppression
-infection (immunosuppressant)
-sodium/water retention
-swelling
-hypertension
-hyperkalemia
-delayed healing
-skin atrophy
-allergic dermatitis
-vehicle related AEs (itching, burning, irritation)
-bruising
-muscle wasting
-psychiatric effects (euphoria, depression, mood swings)

Question 32

what to consider with corticosteroids

Answer 32

age- child or infant
potency
use of occlusion
duration- prolonged increases risk
location- thick/thin skin, appendages which all affect penetration

Question 33

what is tachyplylaxis

Answer 33

tolerance to the action of a drug after repeated doses

reduce risk by 2 weeks on, 1 week off

Question 34

what is usually the reason for drugs not workin

Answer 34

non compliance
misusing

Question 35

what is steroid rebound phenomenon

Answer 35

sudden, dramatic rebound of the disease is observed after stopping therapy often more severe than previously

Question 36

what potency to use

Answer 36

mod, potent and very potent, no need to use mild

Question 37

where to use topical corticosteroids

Answer 37

thick lesions/plantar surface (thick skin)

Question 38

how long can you use topical corticosteroids

Answer 38

2-3 weeks only (10 days for pods, need to involve GP if longer required)

Question 39

how many times do you apply corticosteroids

Answer 39

once daily

Question 40

when to use cortico

Answer 40

early evening

Question 41

once in maintenance what to do?

Answer 41

step down to weaker steroid

Question 42

what can you use corticosteroids with?

Answer 42

emollient

Question 43

how could a first generation antihistamine interact with respiratory disorders, cardiovascular disease or concurrent CNS depressant

Answer 43

CVD- tachycardia as a side effect

talking about this being in exams
study

Question 44

what do corticosteroids do to diabetics/ blood glucose control?

Answer 44

causes hyperglycameia by blocking the action of insulin