Derm Pharm 2 Flashcards
drugs for psoriasis
- acitretin
- tazarotene
- calcipotriene, calcitriol
- cyclosporine
- PUVA therapy
- methotrexate
- biologic response modifiers
Acitretin
- tx severe psoriasis
- teratogenic
Tazarotene
- psoriasis, acne, photoaging
- active metabolite binds to retinoic acid R’s
Calcipotriene, calcitriol
- synthetic vit D3- regulates skin cell prod and prolif
- tx plaque-type psorasis
Cyclosporine
- inhibits calcineurin- inhibits transcription of IL-1 and 2 R’s- blocks T-cell act
- psoriasis, RA, crohn’s dz, liver/heart/kidney/BM transplants
Methotrexate
- inhibits DHFR, and suppresses immunocompetent skills in skin
- psoriasis, mult cancers, RA
Biologic response modifiers used to treat psoriasis
- Alefacept
- TNF inhibitors
- Ustekinumab
Alefacept
- immunosuppressive dimeric fusion protein- consists of CD2-binding portion of human leukocyte fxn ag-3 linked to FC portion of human IgG1
- interferes w lymphocyte act
TNF inhibitors
- Etanercept- binds to 2 molecules of TNF
- Infliximab- binds to TNF
- Adalimumab- binds to TNF
- evaluate for TB prior!!!
Ustekinumab
- IgG1k monoclonal ab- binds to IL-12 and 23- inhibits TH1 and 17 cell-mediated responses
- serious allergic rxns- angioedema, anaphylaxis
Anti-infl agents
-topical corticosteroids
Topical corticosteroids
- immunosuppressive and anti-infl
- systemic tx is reserved for severe dermatological illnesses
- hydrocortisone (lowest efficacy), prednisolone, dexamethasone, betamethasone, mometasone, triamcinolone, clobetasol propionate (highest efficacy)
Keratolytic and destructive agents
- peeling agent- causes softening and dissolution or peeling of stratum corneum and epidermis
- salicylic acid
- fluorouracil
Salicylic acid
- acne, seborrheic dermatitis, psoriasis, hyperkeratosis
- toxicity can occur
fluorouracil
-inhibits thymidylate synthetase and blocks syn of DNA and RNA
Antipruritic agents
-antihistamines
Antihistamines
- H1-R antagonists
- first generation- diphenhydramine, promethazine- some anticholinergic activity (sedating)
- second gen- no anticholinergic SEs, nonsedating- cetirizine,loratadine, desloratadine, fexofenadine hydrocloride
Trichogenic and Antitrichogenic agents
- Minoxidil
- Finasteride
- Bimatoprost
- Eflornithine
Minoxidil
(Rogaine)
-used for androgenic alopecia and hair transplantation
Finasteride
(propecia)
- tx androgenic alopecia and BPH
- inhibitor of type 2 steroid 5alpha-reductase- blocks T to DHT in prostate gland, seminal vesicles, epididymis, liver, and hair follicles
- SEs- dec libido, ED
Agents for Melanoma
- BRAF inhibitors- vemurafenib, dabrafenib, trametinib
- Ipilimumab
- Pegylated interferon
BRAF inhibitors
- tx metastatic melanoma w BRAF mutations
- Vemurafenib, dabrafenib- kinase inhibitors of BRAF V600E mutation- inc risk of new primary cutaneous malignancies
- Trametinib- kinase inhibitor of BRAF B600E and K- inc risk of cardiomyopathy
- all assoc w serious hypersensitivity rxns
Ipilimumab
- CTLA-4 blocker ab
- tx unresectable or metastatic melanoma
- can cause severe immune-mediated adverse reactions due to T-cell act and prolif
Pegylated interferon
-adjuvant tx of stage III node-positive melanoma
Other antineoplastic agents
- alitretinoin
- bexarotene
- vismodegib
- vorinostat and romidepsin
alitretinoin
-tx cutaneous lesions in pts w AIDS-related Kaposi sarcoma
Bexarotene
- binds and activates retinoid X R subtypes
- tx cutaneous T cell lymphoma
- teratogenic
- can inc triglycerides and chol
Vismodegib
- hedgehog pathway inhibitor
- tx metastatic BCC or locally advanced BCC
Vorinostat and romidepsin
- histone deacetylase inhibitor
- tx cutaneous T cell lymphoma
Antiseborrhea agents
-tx dandruff (seborrheic dermatitis)
