Drugs - Sheet1

Question 1

Sertraline

Answer 1

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.

Question 2

Cyclobenzaprine

Answer 2

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.

Question 3

Ibuprofen

Answer 3

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.

Question 4

Doxycycline

Answer 4

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!

Question 5

Tetracycline

Answer 5

Bacteriostatic. Bind 30S ribosomal subunit, so no tRNA to mRNA!

Question 6

Atovaquone

Answer 6

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).

Question 7

Chloroquine

Answer 7

In the treatment of Babesiosis–provides symptomatic improvement but does not reduce parasitemia.

Question 8

Streptomycin

Answer 8

Preferred antibiotic treatment for Tularemia

Question 9

hydrocortisone

Answer 9

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.

Question 10

Retinoids (there might be two divisions of these!)

Answer 10

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

Question 11

Calcipotriene

Answer 11

(aka Dovonex)
A vitamin D analog that acts through DNA receptors to alter skin differentiation. Uses: psoriasis, eczema. Tox : irritation, increased serum calcium

Question 12

Topical Antimicrobials are used for…

Answer 12

Used for: wounds, acne, fungal infections, rosacea…

Question 13

Topical Calcineurin Inhibitors:TCIs

Answer 13

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)

Question 14

Sunscreens

Answer 14

Avobenzone / Helioplex or
Mexoryl are better against UVA.

Titanium dioxide and Zinc oxide ‘blockers’–don’t absorb

Question 15

Imiquimod: Aldara cream

Answer 15

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…..

Question 16

Topical 5-fluorouracil

Answer 16

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)

Question 17

Wound Care

Answer 17

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.

Question 18

Dapsone

Answer 18

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.

Question 19

Methotrexate

Answer 19

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.

Question 20

Biological Therapy

Answer 20

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?

Question 21

Biological Therapy: Humira

Answer 21

binds TNF.

Question 22

Oral Antimicrobials forms and uses…

Answer 22

Antibiotics: acne, folliculitis, cellulitis, rosacea, wound infection……
Anti-virals: HSV infection, cold sores, zoster……
Anti-fungals: ‘ring worm’, ‘athletes foot’, infected nails…..

Question 23

Minoxidil

Answer 23

i.e. Rogaine
Action: vasodilatation and direct stimulation of hair shaft growth.

Uses: Alopecia

Question 24

Finasteride

Answer 24

i.e. Propecia
Action: Blocks 5-alpha reductase enzyme in follicles to inhibit the conversion of testosterone to dihydrotestosterone.

Uses: Androgenetic Alopecia

Question 25

Liquid Nitrogen

Answer 25

Action: Freezes tissue (-196 C)

Uses: warts, actinic keratoses, skin cancer,
others…..

Question 26

Cosmetic Products:Soaps

Answer 26

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.

Question 27

Cosmetic Products: Alpha Hydroxy Acids

Answer 27

Exfoliate.
Thicken epidermis.
Stimulate collagen growth.
Increase skin profusion.

Result in fewer wrinkles, more pliable skin, with better hydration.