ABSTRACT
Match the most appropriate drug from the list above with the indication below:
1 Topical treatment for acne 2 Topical treatment for psoriasis 3 Systemic treatment for refractory psoriasis 4 Tinea pedis 5 Fungal nail infection
393 DRUGS AND THE EYE
Match the indication/effect from the list below with the most appropriate drug:
1 Causes miosis 2 CMV retinitis 3 Acute glaucoma 4 Short-duration mydriatic 5 Discolours soft contact lenses
ANSWERS: see page 173
381 a) True Acne vulgaris occurs in at least 90 per cent of adolescents. b) True The topical use of peeling agents such as benzoyl peroxide c) True or azelaic acid or topical retinoids on a regular basis is d) False usually all that is necessary. In more severe cases oral e) False antibacterial drugs are beneficial and if this is ineffective
oral isotretinoin may be considered by specialists
382 a) False Isotretinoin is a vitamin A analogue. It is prescribed under b) False hospital supervision usually for at least four months. There is c) True a persistent risk of teratogenicity for at least one month after d) False stopping oral therapy. Co-pyrindiol (cyproterone acetate, an e) True anti-androgen with ethinylestradiol) is useful in women
whose acne is refactory to antibiotics/topical treatments and who also wish to receive oral contraception. There is an increased risk of thromboembolism
383 a) True In mild wet eczema, the topical use of drying agents such b) False as lotions of aluminium acetate or calamine are useful. c) False When the lesions are dry and scaly the use of emollients d) False (e.g. E45) combined with a keratolytic is beneficial. e) True Topical corticosteroids are often required both in ‘wet’ and
‘dry’ eczema. Nocturnal pruritus may be relieved by sedative antihistamines
384 a) False – Adapalene is a topical retinoid-like drug used in mild to moderate acne
b) True – Enhances rate of loss of surface scale c) False – PUVA (photochemotherapy using an oral psoralen with
long-wave ultraviolet radiation) is an effective treatment for psoriasis
d) True – Irritates normal skin e) True – Does not irritate normal skin
385 a) True – Folic acid reduces the possibility of toxicity b) False – Sometimes useful in acne c) True – Inhibits T-cell activation d) False – Used in type 2 diabetes in combination with metformin e) True – An oral retinoid
386 a) True All sulfonamides and beta-lactam antibacterials can cause b) True this syndrome c) False
e)
387 a) True – With unusual/recurrent skin infections consider diabetes mellitus or immunosuppression. Antibiotic therapy, diabetes mellitus and immunosuppression are risk factors
b) True c) True d) True e) True
388 a) True – Intraocular administered doses avoid hepatic first-pass metabolism and can lead to bradycardia
b) False c) False – Not enough absorbed to cause systemic toxicity d) False e) True – With high doses enough can be absorbed to produce
systemic anticholinergic effects
389 a) True – Muscarinic (M3 in the eye) receptor antagonist blocks action of sphincter muscle of the iris
b) False – Topical carbonic anhydrase inhibitor c) True – Muscarinic (M3 in the eye) receptor antagonist blocks
action of sphincter muscle of the iris d) True – Stimulates α1 adrenoreceptors constricting the radial
muscle of the iris e) False – Non-steroidal anti-inflammatory drug (NSAID) used in eye
drops for prophylaxis and reduction of inflammation following ocular surgery
390 a) True – Carbonic anhydrase inhibitor given systemically reduces production of the aqueous humour
b) False – First-generation antihistamine which will dilate the pupil (due to its anticholinergic properties), worsening glaucoma
c) False – Steroids can exacerbate glaucoma in certain genetically predisposed patients
d) True – Prostaglandin F2α analogue lowers intraocular pressure by increasing uveoscleral flow
e) True – Beta-adrenergic antagonist reduces secretion/formation of aqueous humour
391 a) False – Aciclovir is indicated for herpes simplex infection b) True – Blocks vascular endothelial growth factor (VEGF) c) True d) False – Useful for staphylococcal infections e) True – Prostaglandin analogue which increases uveoscleral flow
392 DRUGS AND THE SKIN
1 H The topical use of keratolytic agents such as benzoyl peroxide or retinoic acid on a regular basis in conjunction with systemic antibiotic therapy is successful in most patients with acne.
