20. Systemic Retinoids Flashcards
Past q
Isotretinoin is 9-cis retinoids acid
F
13-cis retinoic acid
The primary form of dietary vitamin A in humans is retinyl ester
T
Retinal Ester is found in plants
F
Found in animal and meat products
Eggs and milk
Retinal in the 11-isomer and 11-trans isomer is important in the biochem reaction of visual function
T
Vitamin A cannot be synthesized in vivo by human body so must be acquired through diet
T
Past q
Acitretin is a poly aromatic retinoid
F: monoaromatic
Past q
High levels of retinoids are excreted in semen
F
Alcohol directly enhances re-esterification of acitretin to etretinate
F
Indirectly
What are the non aromatic retinoids ?
Tretinoin
Isotretinoin
Oral bioavailability of systemic retinoids increases with food
T
What are the mono aromatics retinoids ?
Etretinate
Acitretin
Poly aromatic retinoids are :
Alitretinoin
Tazarotene
Bexarotene
Adapalene
Isotretinoin and Acitretin are relatively water soluble
T
Acitretin is safer than etretinate for women of childbearing potential as etretinate is 50x more Lipophilic
T
Magnitude of hypertriglyceridaemia is greatest for Acitretin of all the retinoids
False
Bexarotene
Elimination of Bexarotene is primarily by the HPB route
True
Fexofenadine is not metabolized by the liver
T
Excreted essentially unchanged
Co admin of fexofenadine with macrolides and azoles (Cyp3a4 inhibitors) is contraindicated
F
No interaction or QT seen
Cetirizine is the most sedating of second generation H1 antihistamines
T
90% or more of patients treated with Bexarotene develop hypothyroidism
F
70%
90% or more of patients treated with Bexarotene develop hypothyroidism
F
70%
Bexarotene is a ligand that is highly specific for RXR receptors
T
Isotretinoin caused hypertriglyceridaemia in 20% treated individuals
T
Hypertriglyceridaemia occurs in 70-100% of Bexarotene pt with CTCL
T
Retinoids reduce lymphocyte proliferation by up to 80%
F
20-30%
Teratogenicity occurs in about half of cases if exposed to retinoids in first TM
T
Myalgias occur in 50% pt on Isotretinoin
F
15%
DISH syndrome occurs in up to 26% pt on Isotretinoin and 30% for etretinate
T
Isotretinoin associated with only mild transaminase elevations in 15% patients
Worse in Acitretin
T
Spontaneous abortions occur in one third of pregnancies in which mother is exposed to retinoids in the first trimester
T
Liver derangement is least pronounced in Bexarotene
T
Pseudo tumor cerebri is most common with Acitretin
F
Isotretinoin
Blapharoconjunctivitis is seen in pt on Acitretin and Isotretinoin
T
Premature epiphyseal closure may occur therefore consider risk v benefit in pre adolescents on retinoids
T
Isotretinoin and acitretin are completely cleared from the body within 1 week
F
One month
