Derm Pharm Flashcards
Hydrocortisone
Class: Steroid
Uses: Dermatitis, psoriasis
SE: Atrophy/thinning of skin (collagen), stretch marks, talangiectasias, acne, cataract or glaucoma if applied near eye; Systemically, affects hypothalamic-pituitary-adrenal axis –> growth retardation
Misc: Seven classes, w/class I being the strongest and class VII being the weakest; side effects may be permanent
Cyclosporine
Class: Immunosuppressant
Uses: Inflammatory conditions (psoriasis)
SE: Raise blood pressure, damage kidneys if used long-term
Methotrexate
Class: Folate analog
MOA: Inhibits DHFR
Uses: Inflammatory conditions (psoriasis), conditions needing immunosuppression
SE: Hepatotoxicity (develops slowly, can give up to 4.5 g over life); pulmonary toxicity (develops quickly); leukopenia; rarely, renal toxicity; N/V
Misc: PO, IM (1/week); any drug increasing unbound protein may cause methotrexate toxicity (sulfa, salicylates, TCN, phenytoin)
Biologics
MOA: Block TNF-a
Uses: Inflammatory conditions, arthritis
SE: Few (may unmask neurologic disease, latent infections (must do PPDs), malignancies)
Misc: Costly
UV light therapy
Class: UVA, UVB, UVC
MOA: Immunosuppression of T-cells via type I or type II reactions –> mono- or bifunctional adducts in DNA
Uses: Inflammatory conditions: atopic dermatitis, CTCL, lichen planus, psoriasis (not useful for non-inflammatory conditions)
SE: Skin cancer, thinning/leathering of skin
Misc: Usually used with psoralens (photosensitizing agents that increase efficacy); phenothiazines, thiazides, sulfonamides, NSAIDs, tetracycline, benzodiazapenes also sensitize skin to light therapy
Isotretinoin (Accutane)
Class: Retinoid
MOA: Stimulate epithelial cell turnover; also anti-inflammatory
Uses: Acne
SE: Teratogenic effects (washes out in three weeks)
Misc: Good as adjunct to other therapies
Acitretin (Soriatane)
Class: Retinoid
MOA: Stimulate epithelial cell turnover; also anti-inflammatory
Uses: Psoriasis
SE: Teratogenic effects (stays in fat stores for three years)
Misc: Good as adjunct to other therapies