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Dermatological Block > Drugs for Cancer, Sunscreen, Lice > Flashcards

Drugs for Cancer, Sunscreen, Lice Flashcards

1
Q

Ovicidal lice drug

A

Malathion

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2
Q

Malathion MOA

A

applied topically; organophosphate that is metabolized by the louse to malaoxon, inhibiting acetylcholinesterase causing neuronal hyperstimulation and paralysis

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3
Q

Malathion Human Metabolism

A

rapidly converted to inactive metabolites and excreted by kidneys

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4
Q

Malathion Adverse Effects

A

Not associated with many, but if accidentally ingested can cause cholinergic excess that can be treated with atropine and pralidoxime

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5
Q

Permethrin MOA

A

cause hyperstimulation and paralysis by binding voltage-gated sodium channels within the louse

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6
Q

Permethrin Adverse Effects

A

asthma exacerbation in patients allergic to ragweed; minimal percutaneous absoprtion with no interactions

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7
Q

Permethrin Resistance

A

Knock down resistance (kdr) mutations of louse sodium channels

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8
Q

Lindane Uses

A

louse treatment for people who cannot tolerate or have failed first line therapy; administered topically as shampoo or lotion

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9
Q

Lindane Adverse Effects

A

Neurotoxicity - CNS stimulant promoting seizures, blockade of GABA action); black box - skin diseases, neonatal prematurity, people with uncontrolled seizure disorders

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10
Q

Ivermectin MOA

A

causes louse hyperexcitability and paralysis by binding selectively and with high affinity to glutamate-gated chloride ion channels present in invertebrate nerve and muscle cells

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11
Q

Ivermectin Adverse Effects

A

Elevated liver enzymes, cross BBB of children, worsen bronchial asthma

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12
Q

Physical methods of removing lice

A

lice comb, benzyl alcohol, petroleum jelly

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13
Q

Cinoxate

A

organic UV filter sunscreen that absorbs UV-B radiation

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14
Q

Para-aminobenzoic acid (PABA)

A

organic UV filter sunscreen that absorbs UV-B radiation

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15
Q

Trolamine

A

organic UV filter sunscreen that absorbs UV-B radiation

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16
Q

Dioxybenzone, Oxybenzone

A

organic UV filter sunscreen that absorbs UV-B and UV-A2 radiation

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17
Q

Avobenzone

A

Only FDA approved organic sunscreen that protects against UV-A1 radiation

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18
Q

Titanium Dioxide and Zinc Oxide

A

sunscreens of inorganic compounds that function by reflecting and scattering UV radiation; provide UV-A and UV-B protection

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19
Q

Microionized Titanium Dioxide Exception

A

Does not provide UV-A1 protection; nonionized form does

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20
Q

SPF

A

the amount of UV radiation required to produce a sunburn on protected skin relative to that of unprotected skin; primarily a measure of UV-B exposure

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21
Q

Targeted Drugs for Basal Cell Carcinoma

A

Imiquimod and Vismodegib

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22
Q

Targeted Drugs for Melanoma

A

Aldesleukin, Interferon, Ipilimumab, Sorafenib, Trametinib, Vemurafenib

23
Q

Targeted Drugs for Actinic Keratosis

A

Diclofenac and Trichloroacetic Acid

24
Q

Targeted Drugs for Squamous Cell Carcinoma

A

None available

25
Q

Standard chemotherapuetics for BCC

A

5-Fluorouracil

26
Q

Imiquimod MOA

A

Topical immune response initiator through direct activation of TLR7/8, involves adenosine receptor blockage and activation of NFkB causing upregulation of cytokines like TNFa and interfleukins; also acts on GLI to repress HH signaling

27
Q

Imiquimod Uses

A

BCC, Actinic Keratosis, HPV

28
Q

Imiquimod Adverse Effects

A

Skin reactions, allergy, increased photosensitivity, compromise of condom/diaphragm

29
Q

Vismodegib MOA

A

oral SMO inhibitor; lipophilic agent with extensive metabolism

30
Q

Vismodegib Adverse Effects

A

Black Box: intrauterine fetal death, M/F Teratogenicity,

Others: alopecia, GI issues, weight loss, fatigue

31
Q

Treatment of SCC

A

No standard regimens, but usually Cisplatin based therapy

32
Q

Aldesleukin MOA

A

binds to cell surface IL-2 receptor, inducing proliferation and differentiation of B and T cells, monocytes, macrophages, and CTLs; given IV or SC

33
Q

Aldesleukin Contraindications

A

Significant CNS, Cardiac, Pulmonary, renal, or hepatic disease; organ transplant recipient

34
Q

Aldesleukin Adverse Effects

A

Capillary leak syndrome; CNS, Cardiac, Pulm issues; all organ systems affected

35
Q

Interferon alpha 2b

A

IV or SC administered immunomodulator

36
Q

Interferon Adverse Effects

A

AI disease, Cardiac disease, depression, flu like symtoms, neutropenia, leukopenia, anemia, alopecia, elevated hepatic enzymes, cough, dyspnrea, pulmonary infiltrates, pneumonitis, pneumonia

37
Q

Routine tests run while on Interferon

A

CBC, pulmonary X-ray, ECG, LFTs

38
Q

Ipilimumab MOA

A

CTLA4 recombinant antibody that bolsters antitumor response of immune system by blocking the interaction of CTLA4 with CD80/86 on T cells thus increasing activation and proliferation

39
Q

Ipilimumab Adverse Effects

A

severe and fatal immune reactions; dematitis, toxic epidermal necrolysis; adrenal insufficiency, diarrhea, Gullain-Barre, hepatitis, hyper/hypothyroidism, myasthenia gravis, peripheral neuropathy, pregnancy, rash

40
Q

Sorafenib MOA

A

oral multi-kinase inhibitor - VEGF, PDGFR, KIT, Raf kinase; hepatic metabolism

41
Q

Sorafenib Adverse Effects

A

Hand and foot syndrome, rash/desquamation, anemia, bone marrow suppression, neutropenia, increased bleeding in GI, Resp, and brain, Hepatitis, teratogen

42
Q

Trametinib MOA

A

oral reversible MEK inhibitor for patients with BRAF V600E/K mutations

43
Q

Trametinib Adverse Effects

A

rapid onset of skin toxicity, GI toxicity, decreased LVEF, HTN, hemorrhage, cardiomyopathy, interstitial lung disease, retinal pigment epithelial detachment, teratogen

44
Q

Vemurafenib MOA

A

oral inhibitor of mutated BRAF, including V600E; resistance is via alternative pathway activation;

45
Q

Vemurafenib Pharm

A

Hepatic metabolism with potential PGP and CYP interactions

46
Q

Vemurafenib Adverse Effects

A

Elevated serum creatinine, QT prolongation and TP, increased photosensitivity, cutaneous SCC, SJS, opthalmologic issues (uveitis, iritis, retinal vein occlusion), teratogen

47
Q

Tests to run on Pt receiving Vemurafenib

A

LFTs, ECG, electrolyte monitoring, derm exams

48
Q

BRAF/MEK inhibitors common toxicities

A

Liver, Heart, Eye, possible secondary malignancies, skin issues (SJS)

49
Q

Diclofenac MOA

A

used for Actinic Keratosis; inhibitor of inflammatory mediators including PGE2

50
Q

Diclofenac Adverse Effects

A

itchy rash, dry skin, skin peeling, and redness

51
Q

Trichloroacetic Acid MOA

A

used for actinic keratosis; chemical peel - rapidly penetrates and cauterizes skin, keratin, and other tissues

52
Q

Trichloroacetic Acid Adverse Effects

A

Burning, inflammation, localized tenderness

53
Q

Standard Chemo for Melanoma

A

Dacarbazine, Lomustine, Carmustine

Platinums, Vincas, Taxanes

Dermatological Block (6 decks)

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