08 Drugs for eye and skin conditions Flashcards
8.01 GLAUCOMA EYEDROPS
Muscarinic agonists - pilocarpine
from the opposing end, antimuscarinic eye drops can worsen glaucoma
8.01 GLAUCOMA EYEDROPS
Prostaglandin F2 analogues - latanoprost, bimatoprost
increases outflow of aqueous humour to reduce intraocular pressure
8.01 GLAUCOMA EYEDROPS
Adrenergic agonists and antagonists - brimonidine, timolol
reduction in intraocular pressure can be achieved with α2-adrenergic agonists (brimonidine) or β-adrenergic antagonists (timolol)
8.01 GLAUCOMA EYEDROPS
Carbonic anhydrase inhibitors - dorzolamide
decreases aqueous humour production
acetazolamide oral formulation is used as a diuretic and for mountain sickness
8.02 VEGF INHIBITORS
Ranibizumab, aflibercept, bevacizumab - actions
reduces vasculogenesis and angiogenesis
decreases new vessel formation
8.02 VEGF INHIBITORS
Ranibizumab, aflibercept, bevacizumab - MOA
inhibits vascular endothelial growth factor (VEGF), which is responsible for maintenance of vasculature and new vessel formation
8.02 VEGF INHIBITORS
Ranibizumab, aflibercept, bevacizumab - abs/distrib/elim
given as intravitreal injections for neovascular pathology in the retina
8.02 VEGF INHIBITORS
Ranibizumab, aflibercept, bevacizumab - clinical use
wet age-related macular degeneration
thrombosis of retinal vasculature
diabetic retinopathy
8.02 VEGF INHIBITORS
Ranibizumab, aflibercept, bevacizumab - adverse effects
local ophthalmic complications from intravitreal injection
8.03 RETINOIDS
Vitamin A derivatives: isotretinoin, adapalene, acitretin, tretinoin - actions
attenuate proliferative and inflammatory response
reduce sebaceous gland production
8.03 RETINOIDS
Vitamin A derivatives: isotretinoin, adapalene, acitretin, tretinoin - MOA
bind to RXR (retinoid X receptor) and RAR (retinoic acid receptor) nuclear receptors to modulate epidermal cell growth and sebaceous gland activity
8.03 RETINOIDS
Vitamin A derivatives: isotretinoin, adapalene, acitretin, tretinoin - abs/distrib/elim
given orally, variable bioavailability
topical tretinoin and adapalene for acne
large proportion bound to plasma proteins
8.03 RETINOIDS
Vitamin A derivatives: isotretinoin, adapalene, acitretin, tretinoin - clinical use
acne (isotretinoin, adapalene)
psoriasis (acitretin)
8.03 RETINOIDS
Vitamin A derivatives: isotretinoin, adapalene, acitretin, tretinoin - adverse effects
major risk of teratogenicity - restricted use and close monitoring is required
hypervitaminosis A - dry or inflamed mucosa
8.04 TREATMENT OF PSORIASIS
Retinoids e.g. acitretin, alitretinoin
normalises epidermal cell differentiation and keratinisation
8.04 TREATMENT OF PSORIASIS
Vitamin D analogues e.g. calcipotriol
applied topically to promote differentiation and suppress proliferation of keratinocytes
8.04 TREATMENT OF PSORIASIS
Dithranol
mode of action unclear, but typically used in short-contact therapy where topical application is washed off after 1h
8.04 TREATMENT OF PSORIASIS
Apremilast
anti-inflammatory effect through inhibition of phosphodiesterase 4
8.04 TREATMENT OF PSORIASIS
Dimethyl fumarate
immunomodulatory effect
used in moderate to severe plaque psoriasis
8.04 TREATMENT OF PSORIASIS
Monoclonal antibodies
diverse range of biopharmaceuticals used in psoriasis
e.g. adalimumab, ustekinumab, secukinumab
8.05 SKIN PARASITES
Permethrin
single application
to be washed off 8-12h later
for treatment of scabies
8.05 SKIN PARASITES
Crotamiton
applied once daily for 3-5 days
for treatment of scabies
can also be used for pruritus due to chickenpox, dermatitis, etc.
8.05 SKIN PARASITES
Dimeticone
used for head lice
topical application to hair
washed off after 8h
