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MSK 2-Pharmacology > Derm Pharm (kruse) > Flashcards

Derm Pharm (kruse) Flashcards

1
Q

acute inflammation with oozing, vesiculation, and crusting is best tx with __

A

drying preparations

tinctures, wet dressings, lotions

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2
Q

chronic inflame with xerosis, scaling, and lichenification is best tx with __

A

lubrication preparations

creams and ointments

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3
Q

__ preparations are best to apply to the scalp and hairy areas while __ agents are useful in intertriginous areas

A

drying

lubricating

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4
Q

name the 2 most commonly used topical abx for mild to moderate cases of acne

A

clindamycin and erythromycin

should not be used as mono therapy b/c combo tx (w/retinoids, benzoyl peroxide) decreases resistance

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5
Q

___ is a topical antibacterial that inhibits cell wall synthesis and __ is also a topical antibacterial that increases permeability of the cell wall.

A

Bacitracin

gramicidin

both active against gram + orgs

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6
Q

this topical antibacterial inhibits protein synthesis (binds to bacterial isoleucyl-tRNA synthetase. Effective tx for impetigo caused by S aureus and group A beta-hemolytic strep

A

mupirocin

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7
Q

this topical antibacterial binds to ribosomal 50s subunit and inhibits normal bacterial protein biosynthesis. Effective against group A beta-hemolytic strep and MRSA

A

retapamulin

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8
Q

this topical antibacterial increases permeability of cell wall membrane and effective against gram negs such as P aeruginosa, E coli, enterobacter, and klebsiella

A

Polymyxin B sulfate

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9
Q

these topical antibacterials irreversibly bind 30s subunit and inhibit protein synthesis

A

Neomycin and Gentamycin

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10
Q

these topical abx for acne inhibits protein synthesis by reversibly binding to 50s ribosomal subunit

A

clindamycin and erythromycin

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11
Q

this topical abx inhibits nucleic acid synthesis; anti-inflamm effects. Effective against acne rosacea

A

metronidazole

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12
Q

this topical abx for acne inhibits P. acnes by competitive inhibition of p-aminobenzoic acid utilization and inhibits bacterial folic acid synthesis

A

Sodium sulfacetamide

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13
Q

__ are prototypical azoles used for almost all candidiasis infx that can be tx topically

A

clotrimazole and miconazole

inhibit synthesis of ergosterol by inhibiting fungal CYP450

used for tinea corporis (ringworm), tinea pedis (athletes foot), tinea cruris (jock itch), tinea versicolor and cutaneous candidiasis

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14
Q

this topical antifungal prep is broad spectrum, inhibits uptake of precursors of macromolecular synthesis. Used to tx topical dermatomycosis, candidiasis, tinea versicolor, and moderate onychomycosis of fingernails and toenails

A

ciclopirox olamine

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15
Q

these topical anti fungal preps inhibit squalene epoxidase and effective for topical tx of tinea corporis, tinea cruris, and tinea pedis

A

allylamines: terbinafine (Lamisil) and naftifine

Butenafine has similar MOA

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16
Q

this topical anti fungal prep is effective in tx of most cutaneous mycoses but is ineffective against candida. Used for tinea pedis, tinea cruris, and tinea corporis. Unknown MOA

A

Tolnaftate (Tinactin)

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17
Q

This topical anti fungal prep has broad anti fungal activity but rarely used topically. Cumulative organ toxicity

A

Amphotericin B (ampho-terrible)

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18
Q

This class of oral anti fungal agents are P450 inhibitors, used for systemic yeast infx that are seen in immunocompromised pts such as T1DM, leukemia, AIDS

A

Azoles

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19
Q

this oral anti fungal agent inhibits fungal cell mitosis at metaphase and binds to human keratin, making it resistant to fungal invasion. Tx dermatophyte infx (hair, skin, nails) but not candida infx

A

griseofulvin

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20
Q

this oral anti fungal agent has high 1st pass metabolism, accumulates in skin, nails, fat. Oral prep effective for tinea corporis, tinea capitis, and onychomycosis

A

terbinafine

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21
Q

These topical antiviral agents convert pharmacologically active triphosphate metabolites and inhibit viral DNA synthesis and viral replication. Modest benefit for herpes labialis

A

Acyclovir, valacyclovir, penciclovir, famciclovir

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22
Q

this immunomodulators is for tx of external genital and perianal warts in adults, actinic keratoses on face and scalp, biopsy-proven BCC of the trunk, neck, extremities. Unknown MOA

A

imiquimod

23
Q

these immunomodulators inhibit T-cell activation and prevent release of inflamm cytokines and mediators from mast cells. Useful in tx of atopic dermatitis and psoriasis

A

tacrolimus and pimecrolimus

don’t use in immunocompromised pts or kids <2

24
Q

common adverse events of retinoid acid and derivatives (topical retinoid preps)?

A

eythema, mild peeling, and dryness

avoid or minimize sun exposure

not recommended in pregnant women

25
Q

this oral retinoid prep reduces sebaceous gland size and reduces sebum production

A

isoretinoin (accutane)

26
Q

use for isoretinoin? common adverse events? severe side effects?

A

unmanageable severe cystic acne

common: resemble hypervitaminosis A: dryness and itching
severe: suicide risk, teratogen

27
Q

this acne preparation releases free-radical oxygen which oxidizes bacterial proteins in the sebaceous follicles decreasing the # of anaerobic bacteria and decreasing irritating-type free FAs. Antimicrobial against P. acnes

A

benzoyl peroxide

28
Q

this acne prep has antimicrobial activity against P. acnes as well as in vitro inhibitory effects on conversion of T –> DHT

A

azelaic acid

also used to tx hyperpigmentation

29
Q

UV light can be used for __

A

psoriasis

PUVA-Psoralen followed by UVA radiation

30
Q

__ is a topical therapy for psoriasis that keeps skin moist and minimizes itching and tenderness
__ are for topical tx of psoriasis that are Vitamin D3 analogs that have hypo proliferative effects on keratinocytes
__ is a topical tx for psoriasis that is a retinoid acid derivative

A

Emollients

Calcipotriene, calcitriol

Tazarotene

31
Q

this drug for psoriasis inhibits calcineurin and thereby inhibits transcription of IL-1 and IL-2 receptors

A

cyclosporine

32
Q

sytemic tx for psoriasis reserved for __?

A

pts w/more than 10% body surface area involvement or less extensive, but debilitating disease

33
Q

this systemic tx for psoriasis inhibits DHF reductase, used in combo with phototherapy or bio agents

A

MTX

34
Q

this is the systemic retinoid of choice in psoriasis used in combo with UVB or PUVA tx

A

aciretin

35
Q

this biologic response modifier for psoriasis interferes with lymphocyte activation, is a dimeric fusion protein and should be discontinued when CD4 counts remain <250

A

alefacept

36
Q

these TNF inhibitors are biologic response modifiers for tx psoriasis.

A

etanercept, infliximab, adalimumab

37
Q

this biologic response modifier for tx psoriasis targets and interferes with IL-12 and IL-23. Possible link with major CV events

A

ustekinumab

38
Q

lowest efficacy topical corticosteroid? Highest efficacy?

A

lowet=0.25-2.5% Hydrocortisone

highest=0.05% Clobetasol propionate

39
Q

this keratolytic agent is approved for tx of acne, seborrheic dermatitis, psoriasis, hyperkeratosis

A

salicylic acid

careful…salicylate toxicity, avoid use with other salicylates

40
Q

this keratolytic agent inhibits thymidylate synthetase and blocks synthesis of DNA and RNA

A

fluorouracil

41
Q

first generation H1-receptor antagonists for tx pruritus? side effects?

A

Diphenhydramine and promethazine

some anticholinergic activity and are sedating

42
Q

2nd gen H1-receptor antagonists for pruritis? Metabolism? anticholinergic effects?

A

cetirizine, loratadine, desloratadine, fexofenadine HCl

Metabolized by CYP3A4 and CYP2D6 –> don’t coadminister w/imidazole, antifungals, macrolides

lack anticholinergic effects and non sedating (don’t cross BBB)

43
Q

this trichogen is used for androgenic alopecia, more responsive to vertex balding, tx must be continued or any drug-induced hair growth will be lost

A

Minoxidil (rogaine)

44
Q

this trichogen is for androgenic alopecia and BPH, competitive and selective inhibitor of type 2 isoenzyme of steroid 5a-reductase; blocks T — DHT in prostate gland, epididymis, seminal vesicles, liver, and inner root sheath of hair follicles

A

finasteride (propecia)

45
Q

these BRAF inhibitors for melanoma are kinase inhibitors of BRAF V600E mutation –> increase the risk for new primary cutaneous malignancies (SCC, keratoacanthoma, new primary melanomas)

A

Vemurafenib and dabrafenib

46
Q

this BRAF inhibitor for melanoma is a kinase inhibitor of BRAF V600E or V600K mutations –> increased risk of cardiomyopathy

A

Trametinib

47
Q

serious adverse events with BRAF inhibitors?

A

All are associated with serious HS runs, including severe dermatologic runs as well as ophthalmologic complications

48
Q

this agent for melanoma is a CTLA-4 blocker Ab approved for tx of unresectable or metastatic melanoma

A

Ipilimumab

49
Q

__ is approved for adjuvant tx of stage III node-positive melanoma pts

A

pegylated IFN-alpha 2b

50
Q

this antineoplastic is approved for tx of cutaneous lesions in pts w/AIDS-related Kaposis sarcoma

A

aliretinoin

51
Q

this antineoplastic agent is available in both oral formula and a topical gel for tx of cutaneous T cell lymphoma

A

bexarotene

52
Q

__ is the 1st hedgehog pathway inhibitor available for oral tx of metastatic BCC or locally advanced BCC in adults who are not candidates for surgery or radiation

A

Vismodegib

53
Q

these antineoplastic agents are histone deacetylase inhibitors approved for tx of cutaneous T cell lymphoma in pts with progressive, persistent, or recurrent disease. Adverse events: PE, DVT, thrombocytopenia, anemia, GI disturbances

A

vorinostat and romidepsin

MSK 2-Pharmacology (7 decks)

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