20. Systemic Retinoids Flashcards

1
Q

Past q

Isotretinoin is 9-cis retinoids acid

A

F

13-cis retinoic acid

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2
Q

The primary form of dietary vitamin A in humans is retinyl ester

A

T

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3
Q

Retinal Ester is found in plants

A

F
Found in animal and meat products
Eggs and milk

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4
Q

Retinal in the 11-isomer and 11-trans isomer is important in the biochem reaction of visual function

A

T

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5
Q

Vitamin A cannot be synthesized in vivo by human body so must be acquired through diet

A

T

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6
Q

Past q

Acitretin is a poly aromatic retinoid

A

F: monoaromatic

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7
Q

Past q

High levels of retinoids are excreted in semen

A

F

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8
Q

Alcohol directly enhances re-esterification of acitretin to etretinate

A

F

Indirectly

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9
Q

What are the non aromatic retinoids ?

A

Tretinoin

Isotretinoin

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10
Q

Oral bioavailability of systemic retinoids increases with food

A

T

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11
Q

What are the mono aromatics retinoids ?

A

Etretinate

Acitretin

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12
Q

Poly aromatic retinoids are :

A

Alitretinoin
Tazarotene
Bexarotene
Adapalene

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13
Q

Isotretinoin and Acitretin are relatively water soluble

A

T

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14
Q

Acitretin is safer than etretinate for women of childbearing potential as etretinate is 50x more Lipophilic

A

T

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15
Q

Magnitude of hypertriglyceridaemia is greatest for Acitretin of all the retinoids

A

False

Bexarotene

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16
Q

Elimination of Bexarotene is primarily by the HPB route

A

True

17
Q

Fexofenadine is not metabolized by the liver

A

T

Excreted essentially unchanged

18
Q

Co admin of fexofenadine with macrolides and azoles (Cyp3a4 inhibitors) is contraindicated

A

F

No interaction or QT seen

19
Q

Cetirizine is the most sedating of second generation H1 antihistamines

A

T

20
Q

90% or more of patients treated with Bexarotene develop hypothyroidism

A

F

70%

21
Q

90% or more of patients treated with Bexarotene develop hypothyroidism

A

F

70%

22
Q

Bexarotene is a ligand that is highly specific for RXR receptors

A

T

23
Q

Isotretinoin caused hypertriglyceridaemia in 20% treated individuals

A

T

24
Q

Hypertriglyceridaemia occurs in 70-100% of Bexarotene pt with CTCL

A

T

25
Q

Retinoids reduce lymphocyte proliferation by up to 80%

A

F

20-30%

26
Q

Teratogenicity occurs in about half of cases if exposed to retinoids in first TM

A

T

27
Q

Myalgias occur in 50% pt on Isotretinoin

A

F

15%

28
Q

DISH syndrome occurs in up to 26% pt on Isotretinoin and 30% for etretinate

A

T

29
Q

Isotretinoin associated with only mild transaminase elevations in 15% patients
Worse in Acitretin

A

T

30
Q

Spontaneous abortions occur in one third of pregnancies in which mother is exposed to retinoids in the first trimester

A

T

31
Q

Liver derangement is least pronounced in Bexarotene

A

T

32
Q

Pseudo tumor cerebri is most common with Acitretin

A

F

Isotretinoin

33
Q

Blapharoconjunctivitis is seen in pt on Acitretin and Isotretinoin

A

T

34
Q

Premature epiphyseal closure may occur therefore consider risk v benefit in pre adolescents on retinoids

A

T

35
Q

Isotretinoin and acitretin are completely cleared from the body within 1 week

A

F

One month