Drugs - Sheet1 Flashcards
Sertraline
Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat anxiety disorders and major depression. Oral dosage:
Adults: Initial dose of 25 mg/day. After one week, increase dose to 50 mg. If necessary, increase by 50 mg/day at intervals of not less than one week up to 200 mg/day.
Cyclobenzaprine
Flexeril. skeletal muscle relaxant used for relief of musculskeletal spasm (not CNS disease). Cyclobenzaprine relieves muscle spasms through a central action, possibly at the brain stem level, with no direct action on the neuromuscular junction or the muscle involved.
Ibuprofen
NSAID. Ibuprofen competitively inhibits both cyclooxygenase (COX) isoenzymes, COX-1 and COX-2, by blocking arachidonate binding resulting in analgesic, antipyretic, and anti-inflammatory pharmacologic effects. The enzymes COX-1 and COX-2 catalyze the conversion of arachidonic acid to prostaglandin G2 (PGG2), the first step of the synthesis prostaglandins and thromboxanes that are involved in rapid physiological responses.
Doxycycline
Doxycycline is generally bacteriostatic against a wide variety of organisms, both gram-positive and gram-negative. Binds bacterial 30S ribosomal subunit, so no tRNA to mRNA!
Tetracycline
Bacteriostatic. Bind 30S ribosomal subunit, so no tRNA to mRNA!
Atovaquone
oral antiprotozoal agent. selectively inhibit mitochondrial electron transport, leading to inhibition of pyrimidine synthesis. The site of action appears to be the cytochrome bc1 complex (complex III).
Chloroquine
In the treatment of Babesiosis–provides symptomatic improvement but does not reduce parasitemia.
Streptomycin
Preferred antibiotic treatment for Tularemia
hydrocortisone
Actions: Anti-inflammatory
Immunosuppressive
Anti-proliferative
Vasoconstrictive
Uses: eczema, contact dermatitis,
psoriasis, itch, lichen planus….. Adverse effects: SKIN ATROPHY, striae, acne, suppression of the HPA axis.
Retinoids (there might be two divisions of these!)
Vitamin A analogs which work through nuclear receptors on DNA causing alteration of gene transcription. Opens up comadons (?)
Actions: Regulate cell growth, inhibit carcinogenesis, alter enzymes involved with cellular differentiation.
Uses: acne, psoriasis, cosmetic skin improvement. (repair disordered keratinization)
Tox: dryness, irritation, sun sensitivity, Teratogenicity
Calcipotriene
(aka Dovonex)
A vitamin D analog that acts through DNA receptors to alter skin differentiation. Uses: psoriasis, eczema. Tox : irritation, increased serum calcium
Topical Antimicrobials are used for…
Used for: wounds, acne, fungal infections, rosacea…
Topical Calcineurin Inhibitors:TCIs
Work through calcineurin to alter T-cell activation.
A.E. : limited. Local irritation or burning
Contact dermatitis, eczema around the eye (don’t want steroid b/c of atrophy)
Sunscreens
Avobenzone / Helioplex or
Mexoryl are better against UVA.
Titanium dioxide and Zinc oxide ‘blockers’–don’t absorb
Imiquimod: Aldara cream
An “immune response modifier”.
Increases local immune activity through Toll receptors (i.e. INF, TNF, NK cells, T cells).
Initially approved for Condyloma….., now Actinic Keratosis, BCC.
Other uses include common warts, molluscum, in situ Ca…..
Topical 5-fluorouracil
i.e. Carac, Efudex
5-FU inhibits thymidylate synthase resulting in reduced DNA synthesis.
Acts selectively in actinic damaged skin cells (cancerous cells–used with imiquimod for ACTINIC KERATOSIS)
Wound Care
keep covered with a nonstick dressing to allow natural cytokines to facilitate healing.
Monitor for infection.
“Airing out” wounds slows healing and increases likelihood of scarring.
Dapsone
A Sulfone.
Mainstay of leprosy therapy.
Action: Inhibits myeloperoxidase in PMNs.
Affect on CD11a/CD18.
Uses: dermatitis herpetiformis, linear IgA disease, bullous lupus, Sweet’s syndrome, spider bite….(**neutrophilic skin dz).
A.E. : Hemolysis (esp. G6PD deficiency),
Methemaglobinemia, Motor neuropathy.
Lab: G6PD, CBC.
Methotrexate
Long history of use.
Action: Dihydrofolate reductase inhibitor that disrupts DNA synthesis to block cell division. Immunosuppressive.
Uses: psoriasis, CTCL, lupus, others….
A.E. :hepatotoxicity, myelosuppression, pneumonitis.
Lab: CBC, LFT (lymphoma), Liver biopsy.
Biological Therapy
Newest generation of systemic therapy
for psoriasis, psoriatic arthritis, (RA).
Biogenetically engineered proteins which disrupt/inhibit focused portions of the immune system involved in psoriasis.
Appear to be safe for long-term control without organ toxicity.
A.E.: Injection site irritation.
Risk of Infection?
Exacerbate CHF?
Reactivate TB?
Risk for cancer?
Others?
Biological Therapy: Humira
binds TNF.
Oral Antimicrobials forms and uses…
Antibiotics: acne, folliculitis, cellulitis, rosacea, wound infection……
Anti-virals: HSV infection, cold sores, zoster……
Anti-fungals: ‘ring worm’, ‘athletes foot’, infected nails…..
Minoxidil
i.e. Rogaine
Action: vasodilatation and direct stimulation of hair shaft growth.
Uses: Alopecia
Finasteride
i.e. Propecia
Action: Blocks 5-alpha reductase enzyme in follicles to inhibit the conversion of testosterone to dihydrotestosterone.
Uses: Androgenetic Alopecia
Liquid Nitrogen
Action: Freezes tissue (-196 C)
Uses: warts, actinic keratoses, skin cancer,
others…..
Cosmetic Products:Soaps
Generally made from animal fats. Have a negative charge. Tend to strip off natural skin barrier lipids resulting in water loss.
Suggest: Minimizing their use. Try non-soap cleansers like Cetaphil, Purpose, Basis.
Cosmetic Products: Alpha Hydroxy Acids
Exfoliate.
Thicken epidermis.
Stimulate collagen growth.
Increase skin profusion.
Result in fewer wrinkles, more pliable skin, with better hydration.
