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Integ > Drugs > Flashcards

Drugs Flashcards

1
Q

Erythromycin and Clindamycin:

MOA, Clinical, Adverse Effects,

A

MOA: It is a 50S subunit inhibitor, and is a bacteriostatic and inhibits protein synthesis.

Bacteriostatic.

Clindamycin causes pseudomembranous colitis

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2
Q

Benzoyl Peroxide

A

MOA: absorbed by skin –> benzoic acid –> metabolized by purine–> oxidize of bacterial proteins. Is

Clinical: acne rosacea.

Used in combo with antibiotics. Greater efficacy and decreased resistance.

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3
Q

Dapsone

MOA
Adverse Effects:

A

MOA: antibacterial and antibacterial

Adverse Effects: Methemoglobinemia and orange staining of skin benzoyl peroxide.

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4
Q

Azelaic Acid

MOA, Clinical Uses

A

MOA: anti comedome, anti-hyperproliferation, competitive inhibitor of mitochondrial oxidoreducatases and 5 alpha reductase, which lowers hyperpigmentation.

Clinical: Lightens post inflammatory hyperpigmentation, mild inflammatory acne, and comedonal acne.

Adverse Effects: Hypo-pigmentaton of the skin

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5
Q

Doxyxlycline, Minocycline, Tetracycline

MOA, Clinical Uses

A

MOA: 16rRNA of the 30s subunit, preventing binding of aminoacyl tRNA to the acceptor site

Clinical Uses: for inflammatory acne vulgaris

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6
Q

Clotrimazole and Miconazole.
MOA:
Adverse Effects:

A

MOA: Inhibit CYP450 14 alpha- demethylase (essential enzyme in ergosterol synthesis)

Clinical: Tinea Corporis, Tinea Cruris, tinea pedis, tine versicolor, Tina nigra.

Miconazole: is used for diaper dermatitis complicated by Candida albicans infection.

Adverse Effects: irritation, burning/ stinging,

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7
Q

Ketaconazole:

MOA:

Clinical Uses: (Topical)

Adverse Effects (oral)

Contraindications:

Do not use:

A

MOA: same as all azoles

Shampoo/ foam: seborrheic dermatitis, white and black piedra.

Clinical Uses:

Shampoo: Seborrheic Dermatitis

Topical: Tinea pedis, Tinea Cruris, Tinea Corporis

Clinical oral: chromomycosis, paracoccidioidimycosis, mucocutaneous candidiadis.

Do not use: if patient has achrohydria, is on bicarb, antacids, H2-blockers or PPIs

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8
Q

Itraconazole and Fluconazole
MOA
Clinical Aspects

A

MOA: CYP-450 14 alpha Demethylase needed for ergosterol synthesis.

Clinical Aspects: Used for onychomycosis.

Itraconzole: white pierdra, lobo mycosis, chromoblastomycosis

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9
Q

Terbinafine:

MOA
Clinical Use:
Oral Use:
Topical:

Side Effects:

A

MOA: It affects squalene epoxidase–> stops ergosterol synthesis

Clinical: first line for the dermatophytosis

Topical: tinea corporis, curries, versicolor and nigra

Oral: First choice for onychomycosis

Side Effects: Are change or loss of taste and smell. Not recommended in patients with renal or hepatic failure or in pregnant women.

Not recommended for renal or hepatic failure in women.

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10
Q

Naftinine:
MOA:
Clinical:
Adverse Effects:

A

MOA: same as any oral allylamine.
Clinical: tinea, corporis, pedis, curries.
Anti-inflammatory activity.
Adverse Effects:

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11
Q

Butenafine:

MOA:
Clinical
Adverse Effects

A

works as general allylamine

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12
Q

Griseolfulvin:
MOA:
Clinical:
Contraindications:

A

MOA: inhibition of mitotic spindle and inhibition of fungal mitosis

Clinical: Tinea Capitis , fungistatic and requires long time to be useful

Contraindications: pregnancy, patients with poryphria and hepatic failure

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13
Q

Ciclopirox Olamine

A

MOA: chelation of polyvalent cations resulting in stopping of metal dependent enzymes that are responsible for degradation of peroxides within fungal cell.

Clinical: Mild to moderate onychomycosis of fingernails and toenails. Seborrheic dermatitis, white piedra.

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14
Q

Imiquimod:
MOA:
Clinical:
Adverse Effects:

A

MOA: TLR7 agonist for immune cells and induces production of interferons alpha and gamma

Clinical: genital and perianal warts, common warts and cutaneous warts

Molluscum contagium

HSV off label.

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15
Q

Cimetidine:

MOA
Clinical
Adverse Effects:

A

MOA: immunoomdulatory effects by histamine induced T suppressor cell activity.

Clinical: warts in children, and molluscum contagious in small children

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16
Q

Lindane:
MOA:
Clinical Use
Contraindications:

A

MOA: It is directly absorbed by the parasites and ova through exoskeleton.

It activates the nervous system–> causes seizures and death of parasitic arthropods.

Clinical: scabies and lice.

Contra: potential for neurotoxicity and hematoxivity.

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17
Q

Crotamiton:
MOA:

A

MOA: scabicidal activity, and antipruritic effects.

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18
Q

Permethrin:

MOA:
Clinical:

A

MOA: inhibits sodium ion channel through sodium ion cell membranes channels. Paralysis and death of the parasite.

Clinical: head lice and nits (lotion and cream), and scabies

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19
Q

Ivermectin:

MOA:
Clinical:

A
  1. Glutamate gated chloride channel binding–> increases cl ions, and hyperpolarization of nerve of muscle cell and death of parasite

Clinical: topical heals lice and rosacea in adults, and immature onchocerciasis.

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20
Q

Praziquantel

MOA:
Clinical:

A

MOA: increases cell permeability to schistosomes, and causes there to be strong contractions and paralysis of worm musculature.

Clinical: Schistosoma adult forms

`

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21
Q

Glucocorticoids

MOA:
Clinical Uses:

A

MOA: anti-inflammatory and immunosuppressive effects. Used for inflammatory and pruritic conditions.

MOA: bind to glucocorticoid response elements in DNA.

Adverse Effects: Tachyphylaxis

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22
Q

Hydrocortisone

Clinical:

A

Clinical: corticoid responsive dermatoses

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23
Q

Betamethasone

A

Clinical: corticoid responsive dermatoses, plaque psoriasis

24
Q

Halobetasol

A

Clinical: corticosteroid responsive dermatoses, plaque psoriasis

25
Q

Clobetasol

A

Clinical: Corticosteroid responsive dermatoses, psoriasis.

Adverse: growth retardations

26
Q

Adapalene
MOA:
Clinical:
Adverse Effects:

A

MOA: binds to RAR. Comedolytic, normalize desquamation.

Clinical: bactericidal with activity abasing P. Acnes

27
Q

Tretinoin:

A

MOA: comedlytic, normalize desquamation

28
Q

Tazarotene:

A

MOA: prodrug hydrolyzed to tazoretinic acid. Binds to RAR. Anti-inflammatory, anti proliferative and immunological activity.

Clinical: acne vulgaris, psoriasis, facial mottled hyper and hypopigmentation, and benign facial lentigenes.

Pregnancy Category X

29
Q

Isotretinoin

A

MOA: Decreased sebum, C.acnes concentration and inflammation. Strong comedolytic effects,

Teratogen, patients f childbearing age must be on 2 forms of contraception and monthly pregnancy checks should be done.

30
Q

How do antihistamines work?

A

Sedating and used for nighttime itch.

Non-sedating H1 receptor and H2 receptor have almost limited effect in treatment of chronic itch.

Elderly population: may be confusion and urinary retention.

31
Q

Diphenhydramine
MOA:
Clinical/ Adverse:

A

MOA: blocks the H1 receptor
Clinical: for chronic urticaria, nocturnal itch, and drug related itch

Contra: not for neonates, premature infants, and nursing mothers.

Note: topical products are not OTC for children under 2 yeas.

32
Q 
Doxepin 
MOA: 
Clinical: 
Adverse Effects: 
Contraindications:
A

MOA: blocks H1 and H2 receptors
Clinical: nocturnal urticaria
Contraindication: QT prolonging.

33
Q

Hydroxyzine

A

MOA: it is basically a H1 receptor blocker.

Clinical: Histamine mediated pruritis, and pruritis due to allergic conditions

34
Q

Hydroquinone:
MOA:
Adverse Effects:

A

MOA: inhibits tyrosine kinase
Clinical: temporarily reduces hypo pigmentation

There is possible carcinogenicity

35
Q

Monobenzone

A

MOA: irreversible depigmentation
Clinical: for vitiligo patiens, some percutaneous absorption takes place.

36
Q

Mequinol

Contraindications:

A

MOA: Substrate for the enzyme tyrosinase, competitive inhibitor of formation of melanin precursor.

Clinical: solar lentigenes

Contraindications: mequinol and tretinoin can cause fetal harm

37
Q

Minoxidil

A

MOA: Stimulates hair growth secondary to vasodilation.

Androgenic Alopecia: reverses progressive miniaturization of terminal scalp hairs.

38
Q

Finasteride

A

MOA: 5 alpha reductase inhibitors –> blocks testosterone to DHT conversion.

Clinical: promotes hair growth and prevents further hair loss

39
Q

Bimatoprost

A

MOA: synthetic analog of prostaglandin

Clinical: hypertrophichosis of eyelashes.

40
Q

Acitretin

A

check the slide

41
Q

Calcipotriene

A

Synthetic Vitamin D3, binds to D3 receptors and inhibits keratinocyte proliferation

Clinical: Plaque type psoriasis vulgaris.

42
Q

Calcitriol

A

Better tolerated and used treat plaque psoriasis

43
Q

Etanercept

A

TNF receptor dimer that binds to both TNF alpha and TNF beta.

Decoy receptor not a monoclonal antibody.

44
Q

Infliximab

A

Partially humanized mouse antibody against TNF alpha

45
Q

Adalimumab

A

Fully human IgG1 antibody. that binds to TNF

Clinical: moderate to severe plaque psoriasis, psoriatic arthritis

46
Q

Certolizumab

A

binds selectively and neutralizes TNF alpha activity.

Does not induce complement activation, ab dependent cell mediated cytotoxicity or apoptosis.

Moderate to severe plaque psoriasis, psoriatic arthritis

47
Q

Ustekinumab

A

MOA: human Ig1K monoclonal antibody. Binds with high affinity and specificity to p40 subunit of IL-12 and IL-23

–> inhibits chemokine and cytokine release

used for moderate to severe plaque psoriasis

48
Q

Guselkumba, Tildrazkizumbab, Rizankizumab

A

IgI1 monoclonal antibody.

Binds to p-19 subunit of IL-23
same as ustekinumba.

49
Q

Secukinumab, Ixekizumab

A

binds to IL-17A, inhibits release of pro inflammatory cytokines and chemokine.

S–> IgG1
I–> IgG 4

50
Q

Brodalumab

A

Humanized Ig2 monoclonal antibody that binds selectively to IL-17A receptor

suicidal ideation and behavior.

51
Q

Ipilimumab

A

Ig1- Anti-CTLA-4 antibody that binds to CTLA 4 that down regulates the T cell activation.

Treats melanoma + metastatic to the brain

52
Q

Nivolumab and Pembrolizumab

A

Ig4-Anti-PD antibody to L1/L2

Melanoma and lymph nodes cancer

53
Q

Aldesleukin

A

IL-2–> increases WBC, lymphocyte toxicity, killer cell activity, IFN-gamma production.

Adverse: capillary leak syndrome

CI: only for patients with normal cardiac and pulmonary function

54
Q

Encororafenib

Cobimetinib

A

BRAF inhibitor and combined with +Binemetinib

+ Vermurafinib and reversible MAPK inhibitor

55
Q

Dabrafenib

A

+Trametinib
V600E +K
inhibits mutated BRAF including 600E

56
Q

Actinic Keratosis

A

Topical treatment for precancerous Actinic keratosis–> Diclofenac/ Doclifenyak

Integ (3 decks)

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