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DERMATOLOGY PHARM Flashcards

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1
Q

MOA: Competitively inhibits viral DNA poly; competes with dGTP for incorporation into viral DNA. Does not have 3’-OH so chain elongation is ceased.

A

Acyclovir

Valacyclovir

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2
Q

MOA: Competitively inhibits viral DNA poly; competes with dGTP for incorporation into viral DNA. Has 3’—OH so synthesis of viral DNA is possible then it locks up.

A

Ganciclovir

Valganciclovir

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3
Q

MOA: Competitively inhibits viral DNA poly; competes with dCTP for incorporation into viral DNA

A

Cidofovir

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4
Q

MOA: Competitively inhibits viral DNA poly; competes with dGTP for incorporation into viral DNA

A

Famciclovir

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5
Q

MOA: Selectively inhibits the viral-specific DNA polymerases and reverse transcriptases at pyrophosphate binding site; blocks chain elongation

A

Foscarnet

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6
Q

Drug that treats:
Varciella zoster
Varciella chicken pox
HHV-8

A

Valacyclovir

Acyclovir just treats 2 varciellas

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7
Q

Drug that treats:
HHV-6
HHV-8

A

Valganciclovir

Ganciclovir just does HHV-6 and is used off-label for HHV-8

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8
Q

Drug that treats:
Pox virus family
HHV-6, -7, and -8

A

Cidofovir

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9
Q

Drug that treats:
Varicella Zoster
HHV-8

A

Famciclovir

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10
Q

Drug that treats:

HHV-6 only

A

Foscarnet

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11
Q

Antiviral Drug with few side effects.

A

Famciclovir

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12
Q

Antiviral Drug that causes:

NEUROTOXICITY (including seizures)

A

Aciclovir/Valaciclovir

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13
Q

Antiviral Drug that causes:
PANCYTOPENIA (anemia, leucopenia, neutropenia, thrombocytopenia) and is a
TERATOGEN

A

Ganciclovir/

Valganciclovir

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14
Q

Antiviral Drug that causes:

Nephrotoxicity (so monitor creatinine and urinary protein)

A

Cidofovir

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15
Q 
Antiviral Drug that causes:
Electrolyte imbalance (chelates calcium ions)
A

Foscarnet

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16
Q

What drug do you give with cidofovir to reduce renal toxicity?

A

Probenecid (inhibits renal tubular secretion)

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17
Q

MOA: Folate antagonist (bacteriostatic) that also inhibits 2nd messenger pathways involved in neutrophil chemotaxis

A

Dapsone

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18
Q

MOA: Inhibition of bacterial and mycobacterial RNA synthesis (beta-subunit of DNA-dependent RNA-polymerase

A

Rifampin

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19
Q

MOA: preferential binding (not intercalating) to mycobacterial guanine in DNA

A

Clofazimine

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20
Q

MOA: Inhibits 50S ribosomal subunit

leprosy drug

A

Clarithromycin

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21
Q

MOA: Inhibits 30S ribosomal subunit

(leprosy drug)

A

Minocycline

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22
Q

MOA: Inhibits bacterial DNA gyrase

leprosy drug

A

Ofloxacin

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23
Q

MOA: Inhibits NFKB mediated transcriptional upregulation and TNF-alpha production (blocks leukocyte migration)

A

Thalidomide

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24
Q

Drugs that treat Tuberculoid leprosy.

A

Dapsone

Rifampin

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25
Q

Drugs that treat Lepromatous leprosy.

A

Clofazimine

Clarithromycin, Minocycline, Ofloxacin (if you cannot tolerate clofazimine)

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26
Q

Drug that is used to treat side effects of leprosy.

A

Thalidomide

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27
Q

Drug that is contraindicated in G6PD deficiency.

A

Dapsone

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28
Q

Leprosy drug that causes:

  • Hepatitis
  • Jaundice
  • Staining of body/fluids to a bronzing color
  • Feces may be black or tarry
  • Depression/suicide
A

Clofazimine

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29
Q

Leprosy drug that causes:

  • Hepatic toxicity
  • Discoloration of body fluids (red)
A

Rifampin

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30
Q

Leprosy drug that requires monitoring of LFTs, CBCs, and platelet count. Why?

A

Dapsone

Causes dapsone syndrome (peripheral neuropathy, leukopenia, SJS, etc.)

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31
Q 
Lepsory drug that:
-TERATOGEN (X)
-May increase HIV viral load
-Somnolence > rash> H/A
Peripheral Neuropathy
A

Thalidomide

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32
Q

Leprosy drug that has DDIs with rifampin, cimetidine (H2 blocker), omeprazole (proton pump inhibitors), and probenecid.

A

Dapsone

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33
Q

What leprosy drug gets widely distributed throughout the body (CNS, breast milk, etc.).

A

Rifampin

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34
Q

What leprosy drug is very lipophillic (can remain for a long time in fatty tissues and reticuloendothelial system).

A

Clofaziine

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35
Q

Which drugs have the BBW: Infection, including fungal/mycobacterial/viral, neoplasms, and Tb.

A

Adalimumab
Etanercept
Infliximab

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36
Q

MOA: Human mAb (with IgG1) targeted at TNF-alpha

A

Adalimumab (SC)

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37
Q

MOA: Receptor-Ab fusion protein (with p75 TNF receptor and Fc IgG1) targeted at TNF-alpha.

A

Etanercept (SC)

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38
Q

MOA: Chimeric mAb (with variable region of mouse mAb on human IgG1) targeted at TNF-alpha.

A

Infliximab (IV)

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39
Q

MOA: mAb directed at interleukin (binds to p40 subunit integral to IL-12 and IL-23 activation to suppress formation of pro-inflammatory Th1 and Th17.

A

Ustekinumab

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40
Q

MOA: acting upon nuclear receptors (RAR) and this causes transcriptional changes in a number of factors and produces epidermal hyperplasia and a sloughing off of the surface of the skin (peels off the surface layers leaving new skin underneath with lack of infection)

A 
Acitretin (oral)
Tazorotene (oral or topical)
Tretinoin (topical)
Adapalene (topical)
Isotretinoin (topical)
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41
Q

MOA: Binds to Vit D receptor; complex associates with RXR-alpha and binds DNA vitamin D response elements to modulate epidermal differentiation and inflammation

A

Calcipotrene (topical)

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42
Q

MOA: Hormonally active form of Vitamin D3

A

Calcitrol (topical)

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43
Q

MOA: Topical pro-drug converted to benzid acid that works by free radical liberation that is lethal for P. acnes.

A

Benzoyl Peroxide

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44
Q

MOA: Inhibit protein synthesis (binds 50s ribosomal subunit)

ACNE drug

A

Clindamycin/Erythromycin

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45
Q

MOA: Topical keratolytic that causes desquamation of horny layer of the skin.

A

Salicyclic Acid

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46
Q

MILD corticosteroid.

A

Hydrocortisone

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47
Q

Moderate corticosteroid.

A

Betamethasone valerate

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48
Q

Potent corticosteroid.

A

Fluocinonide

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49
Q

Very potent corticosteroid.

A

Clobetasol Proprionate

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50
Q

Drugs that treat acne and psoriasis.

A

Salicylic acid
Acitretin
Tazorotene
Tretinoin

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51
Q

Drug that is contraindicated with immunosuppressives or concurrent vaccinations.

A

Adalimumab

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52
Q

Drug that is contraindicated with sepsis.

A

Etanercept

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53
Q

Drug that is contraindicated with heart failure and murine protein hypersensitivity.

A

Infliximab

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54
Q

Drug that is contraindicated with live virus vaccines and that you must pre-test for Tb with.

A

Ustekinumab

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55
Q 
Acne drugs that are/cause:
Teratogenic
Hyperlipidemia
Cause mucocutaneous/
musculoskeletal effects
A

Acitretin (oral)

Tazorotene (oral)

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56
Q

Drugs that increase the risk of sunburn, erythema, and burning.

A

Tazorotene (topical)
Tretinoin (topical)
Adapalene (topical)
Isotretinoin (topical)

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57
Q

Acne drug that may lead to suicidal ideation.

A

Isotretinoin (topical)

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58
Q

Drug that is a topical irritant (reduced by concurrent corticosteroids); in EXCESS causes- hypercalcemia and hypercalcuria; increased susceptibility to UV-induced skin cancer

A

Calcipotrene

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59
Q

Drug that is way more potent on calcium metabolism when given systemically! Better tolerated in sensitive skin areas.

A

Calcitrol

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60
Q

Drug that causes: Drying of skin: peeling, erythema, irritation; bleach hair or colored fabrics; AVOID contact with eyes or mucous membranes

A

Benzoyl peroxide

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61
Q

Acne drug that must be given for a minimum of 4-8 weeks.

A

Clindamycin or Erythromycin

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62
Q 
Drug that (with prolonged administration) leads to: -Tinitus and dizziness (early)
-Seizures, Renal/liver failure, and organ edema (late)
A

Salicylic acid

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63
Q

Acne drugs that are category X teratogens.

A

Isotretinoin (oral)

tazarotnene (topical)

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64
Q

Hormonal contraceptives used for acne.

A

o Ortho Tri-cyclen
o Estrostep
o YAZ

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65
Q

Drugs for tinea (widespread)

A

Terbinafine
Itraconazole
Fluconazole
Grisefulvin

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66
Q

Drugs for onchomycosis (widespread).

A 
TGIF
Terbinafine
Grisefulvin
Itraconazole
Fluconazole
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67
Q

MOA: inhibits ergosterol formation.

A

“Azoles” (oral or topical)

Amorolfine (topical)

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68
Q

MOA: Inhibits the conversion of squalene to squalene epoxide (and overall ergosterol formation)

A

terbinafine

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69
Q

MOA: Inhibits microtubule formation to stops fungal mitosis

A

Griseofulvin

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70
Q

MOA: Selectively inhibits squalene 2,3-epoxidase enzyme. Produces antibacterial effects and anti-inflammatory effects (vasoconstriction) at higher concentrations.

A

Naftifine

71
Q

MOA: Blocks fungal trans-membrane transport (depleting essential substrates and interfering with RNA and DNA synthesis)—high concentrations permit leakage of intracellular material.

A

Ciclopirox

72
Q

Drugs for localized tinea.

A 
TOPICAL:
Azoles
Terbinafine
Naftifine
Ciclopirox
73
Q

Topical drugs for onchomycosis

A

Ciclopirox

Amorolfine

74
Q

Antifungal that must be used very carefully in underlying heart problems and should NOT be used in hepatic toxicity (extensive hepatic and renal elimination) OR post-partum.

A

Itraconazole

75
Q

Antifungal that must be dose adjusted for renal elimination.

A

Fluconazole

76
Q

Antifungal that should not be used in hepatic texocity.

A

Griseofulvin

77
Q

Azole with:
Hepatotoxicity
Adrenal insufficiency
CYP inhibition**

A

Ketoconazole

78
Q 
Azole with:
Hepatotoxicity
CYP interactions
Negative inotropic action
Category C teratogenicity
A

Itraconazole

79
Q 
Azole with:
Hepatotoxicity
CYP interactions
QT prolongation
Category C teratogenicity
Optic neuritis/Photosensitivity
A

Voriconazole

80
Q 
Azole with:
Hepatotoxicity
CYP interactions
QT prolongation
Category C teratogenicity
A

Fluconazole

81
Q

Asoles that can cross CSF.

A

Voriconazole

Fluconazole

82
Q 
Azole with:
Hepatotoxicity
CYP interactions
QT prolongation
Category C teratogenicity
A

Posconazole

83
Q

Azole that must be taken with full meal to have appropriate bioavailability.

A

Posconazole

84
Q

What drug should NOT be combined with azoles (because it is useless).

A

naftifine

85
Q

Antifungal that cross-reacts with beta lactams.

A

Griseofulvin

86
Q

What drug requires routine CBCs when administering.

A

Terbinafine

causes transient lymphopenia and neutropenia with oral drug

87
Q

MOA: Combines with keratin to produce fibrillar contraction and short term occlusion of eccrine and apocine sweat gland ducts.

A

aluminum chloride

88
Q

MOA: Binds to cell membrane, internalized, cleaved into light and heavy chains→Blocks the exototic release of Ach (due to cleavage of SNAREs to inhibit the complex formation and fusion of vesicular membrane (VAMPs) with cellular membrane (SNAP25).

A

Botulinum toxin

89
Q

MOA: Quaternary ammonium compound (antimuscarinic)

used for hyperhydrosis

A

Glycopyrrolate

90
Q

MOA: Tertiary amine (antimuscarinic agent)

used for hyperhydrosis

A

Oxybutynin

91
Q

MOA: Quaternary ammonium compound that blocks nicotinic and muscarinic receptors
used for hyperhydrosis

A

Propantheline

92
Q

Drug that:

  • Capable of causing muscular paralysis
  • (respiratory arrest and death
  • Typical anticholinergic effects (dry mouth, eye problems, etc.)
  • Contains albumin (allergy)
A

Botulinum toxin

93
Q

Drug for hyperhydrosis that Crosses BBB (sedation and delirium).

A

Oxybutynin

94
Q

List the drugs for Trichogenic Agents.

A

Minoxidil

Finasteride

95
Q

Description: Topical agent used for hair re-growth.

A

Minoxidil

96
Q

Description: Oral agent used for hair loss or at higher doses for treatment of BPH.

A

Finasteride

97
Q

Description: Topical drug to reduce unwanted female facial hair. (Takes 6-8 weeks for effects to be noticeable).

A

Eflornithine

98
Q

MOA: Unknown—may activate the hair follicle directly or stimulate follicular microcirculation. May also alter local androgen metabolism.

A

Minoxidil

99
Q

MOA: Blocks 5 alpha-reductase activity to decrease scalp and serum DHT concentrations (without altering other hormones).

A

Finasteride

100
Q

MOA: Inhibition of ornithine decarboxylase (a mandatory step in polyamine production)—so you get decreased hair follicle cell division and differentiation

A

Eflornithine

101
Q

Description: Temporary relief of facial skin darkening by hormonal changes, pregnancy, OCs or HRT

A

Hydroquinolole
Flucinolone
Tretinoin

102
Q

What type of drug is Hydroquinolole?

A

melanocyte inhibitor

103
Q

What type of drug is Flucinolone?

A

steroid

104
Q

What type of drug is Tretinoin?

A

retinoic acid analog

105
Q

MOA: inhibition of melanin formation (blocking melanocyte enzymatic oxidation of tyrosine to 3,4-DOPA, and increased keratinocyte shedding from epidermis resulting in decreased epidermal melanin content).

A

Hydroquinolole

Tretinoin

106
Q

MOA: Activation by exposure to UV light (resulting in conjugation of cross-linking of DNA and cell death. Leads to delayed erthema followed over several weeks by increased epidermal melanization and thickening of the stratum corneum.

A

Methoxsalen

107
Q

What drug has:

Loss of libido, sexual dysfunction, infertility, feminization

A

Finasteride

108
Q

What drug has a DDI with saw palmetto?

A

Finasteride

109
Q

List the PEDICULICIDAL DRUGS for lice.

A

permethrin
lindane
ivermectin

110
Q

List the PEDICULICIDAL + OVICIDAL DRUG for lice.

A

malathion

111
Q

MOA: Organophosphate insecticide that is metabolized to malaoxon in the louse and inhibits acetylcholinesterase and causes neuronal hyperstimulation and paralysis.

A

malathion

112
Q

MOA: Synthetic pyrethrin that causes hyperexcitability and paralysis of louse by binding voltage-gated Na+ channels. → in RID and other OTC meds!

A

Permethrin

113
Q

MOA: Neurotoxin that interferes with GABA neurotransmitter function by interacting with the GABA receptor-chloride channel complex at the picrotoxin binding site→ leads to hyperstimulation

A

Lindane

114
Q

MOA: Oral and topical drug that causes hyperexcitability and paralysis by binding selectively and with high affinity to glutamate-gated Cl- ion channels present in invertebrate nerve and muscle cells.

A

Ivermectin

115
Q

What drug has systemic toxicity if ingested (acts like a para-sympatetic agonist)?

A

Malathion

116
Q

What drug has ashtma exacerbation (in patients allergic to ragweed or chrysanthemums).

A

Permethrin

117
Q

What drug has the potential for neurotoxicity (seizures and death) and persistence in the environment?

A

Lindane

118
Q

What drug may worsen bronchial asthma and can elevate liver transaminases?

A

Ivermectin

119
Q

What drug is NOT for younger patients where the BBB is immature?

A

Ivermectin

120
Q

What drug is rendered contraindicated in Knock-down resistance (kdr) mutations of louse sodium channels.

A

Permethrin

121
Q

What drug has a BBW for skin diseases/conditions or neonatal prematurity will increase drug systemization and is NOT FOR patients with uncontrolled seizure disorders.

A

Lindane

122
Q

Why is systemic absorption of Permethrin is NOT serious?

A

drug does not work on human sodium channels ONLY on lice sodium channels

123
Q

Drug for BCC.

A

Vismodegib

Imiquimod

124
Q

Drugs for actinic keratosis.

A

Imiquimod
Diclofenac
Trichloroacetic acid

125
Q

Drugs for melanoma.

A 
Aldesleukin
Interferon
Ipilimumab
Sorafenib
Trametinib
Vemurafenib
126
Q

MOA: Small molecule inhibitor of SMO used to block the Hedgehog pathway.

A

Vismodegib

127
Q

MOA: Topical treatment for localized disease (immunostimulant that is a direct activator of TLR7 & TLR8→ Th1 immune response, blocker of adenosine receptors, and NF-kB activator (regulates cytokines like TNF and IL).) Negatively modulate GLI activity in BCC (inhibiting Hedge-hog pathway.

A

Imiquimod

128
Q

MOA: NSAID: Inhibitor of PGE2 (inflammatory mediator)

A

Diclofenac

topical

129
Q

MOA: Chemical peel that rapidly penetrates and cauterizes skin, keratin, and other tissue.

A

Trichloroacetic acid

topical

130
Q

MOA: IL-2 agonist (stimulates cytokine cascades with various interferons, interleukins, and TNF); induces proliferation of B and T cells, monocytes, macrophages, and CTLs (indiscriminate stimulation).

A

Aldesleukin

IV or SC

131
Q

MOA: Interferon-alpha agonist (bind to the cell surface receptor tyrosine kinases→ production of several enzymes which are thought to be responsible for the pleiotropic biologic effects of alpha-IFNs:

A

Interferon

IV or SC

132
Q

MOA: Recombinant human antibody that blocks CTLA-4 and has anti-tumoral action by stimulating T cell function (CTLA-4 usually negatively effects T cell activation).

A

Ipilimumab

133
Q

Cancer drug: Alopecia, GI toxicity, intrauterine fetal death, Weight loss and fatigue

A

Vismodegib

134
Q

Cancer drug: Increases photosensitivity and can compromise birth control (condoms and diaphragm) integrity if used for HPV.

A

Imiquimod

135
Q

Cancer drug: Itchy rash, dry skin, skin peeling, redness

A

Diclofenac

topical

136
Q

Cancer drug: Burning, inflammation and localized tenderness

A

Trichloroacetic acid

topical

137
Q

Cancer drug: Capillary leak syndrome (due to stimulation of NK cells or CD25 cells), hypotension, diminished mental status, dyspnea, etc.

A

Aldesleukin

IV or SC

138
Q

Cancer drug: Flu-like symptoms, blood dyscrasias, alopecia, elevated hepatic enzymes, cough/dyspnea (do routine CBC, LFTs, CXRs and ECGs)

A

Interferon

IV or SC

139
Q

Cancer drug: Dermatitis that can be as severe as TEN. Tiredness, diarrhea, itching, rash.

A

Ipilimumab

140
Q

Cancer drug; Elevated hepatic enzymes, rash, hand and foot syndrome, anemia, bone marrow suppression (neutropenia), increased risk of hemorrhage

A

Sorafenib

141
Q

Cancer drug: Elevated liver enzymes, rapid onset of rash, diarrhea, HTN, hemorrhage, RARE: retinal pigment epithelial detachment, ILD, cardiomyopathy

A

Trametinib

142
Q

Cancer drug: Cutaneous squamous cell carcinoma; elevated creatinine, QT prolong, photosensitivity, SJS, ophthalmic issues. (need to do regular LFTs, ECGs, and electrolyte monitoring)

A

Vemurafenib

143
Q

What cancer drug is a male and female teratogen?

A

Vismodegib

144
Q

What cancer drug has a BBW: With significant CNS, cardiac, pulmonary (need regular CXRs), renal or hepatic disease and/or organ transplant.

A

Aldesleukin

IV or SC

145
Q

What cancer drug has a BBW: Use cautioned in autoimmune and cardiac disease, depression, and infection

A

Interferon

IV or SC

146
Q

What cancer drug should not be used in Adrenal insufficiency, diarrhea, Guillain-Barre syndrome, hepatitis, hyper/ hypothyroidism, hypopituitarism, myasthenia gravis, peripheral neuropathy, pregnancy, serious rash

A

Ipilimumab

147
Q

do antibiotics

A

do antibiotics

148
Q

MOA: Rapid destruction of bacterial cell membranes that leads to depolarization (potassium efflux) and is bactericidal.

A

Dapatomycin

149
Q

MOA: Binds 23S subunit of 50S to inhibit protein synthesis by ribosome.

A

Linezolid

150
Q

MOA: Binds to ribosome peptidyl transferase domain to inhibit tRNA synthetase and block AA addition to the growing peptide chain. (Inhibits protein synthesis)

A

Streptogramins:
Dalfopristin
Quinupristin

151
Q

MOA: Binds with HIGH affinity to 30s protein subunit to inhibit protein translation. NOT expelled by efflux pumps.

A

Tetracyclines like
Glycycline
Tigecycline

152
Q

MOA: binds 50S ribosomal subunit to inhibit protein synthesis.

A

Clindamycin

153
Q

MOA: binds reversibly to staph isoleucyl tRNA synthetase to inhibit protein and RNA synthesis.

A

Mupirocin

154
Q

MOA: inhibits dephosphorylation of isoprenyl pyrophosphate carrier protein (so not movement of peptidoglycan building blocks of cell wall across the cell membrane)

A

Bacitracin

155
Q

AE: Muscle pains/weakness (monitor CPK); DDI with statins

A

Daptomycin

156
Q

AE: If used over 2 weeks, optic and peripheral neuropathy; DDI with SSRIs, MAOIs, PE, etc.

A

Linezolid

157
Q

AE: Thrombophlebitis/pain at injection site, increased liver enzymes, joint/muscle pain; CYP450 inhibitor

A

Dalfopristin

Quinupristin

158
Q

AE: GI problems, hepatic/pancreatic toxicity; sun sensitivity; teeth/bone alteration.

A

Blycycline

Tigecycline

159
Q

AE: Pseudomembranous colitis from C diff, GI toxicity, hypersensitivity rash.

A

Clindamycin

160
Q

AE: not many–not systemically absorbed.

A

Mupirocin

161
Q

AE: nephrotoxic with parenteral use.

A

Bacitracin

162
Q

What antibiotic needs to be dose adjusted for renal failure?

A

daptomycin

163
Q

What drug loses action via point mutations in 23s.

A

linezolid

164
Q

What drug loses action via changes in 23S and constitutive expression of “erm” MLSb phenotype

A

Dalfopristin

Quinupristin

165
Q

What drug loses action via methylation of “erm” encoded genes that decrease affinity for ribosome?

A

Clindamycin

166
Q

What antibiotics do you need to dose adjust for liver failure?

A

Glycycline/Tigecycline

Clindamycin

167
Q

What antibiotics have absorption that is altered by food intake?

A

Linezolid

Clindamycin

168
Q

What antibiotics are used topically?

A

Mupirocin

Bacitracin

169
Q

What drugs are given in an IV 70:30 combination.

A

Dalfopristin (70): Quinupristin (30)

170
Q

What drug is given in an ointment with neomycin and polymyxin B?

A

Bacitracin

171
Q

What drug is widely absorbed but cannot penetrate the CSF?

A

clindamycin

172
Q

What antibiotics cannot be used in patients under 18?

A

Glycycline

Tigecycline

173
Q

What antibiotic cannot be used for lung infections because it is inactivated by surfactant?

A

daptomycin

174
Q

What drug is given by slow IV infusion and is widely distributed into tissues?

A

Glycycline

Tigecycline

DERM (17 decks)

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