Exam 2: Dermatologic Agents

Question 1

• MOA:penetrate cell membrane and bind to a cytoplasmic receptor-heat shock protein complex. The heat shock protein is released and the hormone receptor complex is transported to the nucleus. Interacts with glucocorticoid response elements on various genes and other regulatory proteins to (+) [or sometimes (-)] their expression.
• Anti-inflammatory and Immunosuppressive Effects
o Decrease adhesion, migration and function of macrophages, PMS, and other lymphocytes;
o Block production and release of various cytokines, and acute phase reactants;
o Suppress growth-factor induced DNA synthesis and fibroblast proliferation
o Antimitotic; anti-inflammatory; reduce capillary permeability; local vasoconstriction; secondary anti-pruritic effects

Answer 1

Glucocorticoids

Question 2

Inhibits bacterial cell wall synthesis; Gram (+)

OTC topical

Answer 2

• Bacitracin

Question 3

Inhibits bacterial protein synthesis; Gram (-), some Gram (+)
OTC topical

Answer 3

• Neomycin

Question 4

Binds to phospholipids in cell membrane and alters permeability; Gram (-)
OTC topical

Answer 4

• Polymixin

Question 5

o Inhibits bacterial enzymes necessary for protein and RNA synthesis
o Effects Gram (+) and some Gram (-) bacteria
o Broader spectrum of activity than OTC products

prescription abx

Answer 5

• Mupirocin

Question 6

Functional Roles 
•	Vision
•	Cell proliferation and differentiation
•	Bone growth
•	Immunity; tumor suppression
Effects gene expression via two families of receptors (RARs; RXRs)
•	RARs: affect cellular differentiation and proliferation
•	RXRs: induce apoptosis

Answer 6

Retinoids

Question 7

• MOA: decr cohesiveness of follicular epithelial and comedone (blackhead) formation and incr turnover of follicular epithelial cells

Answer 7

Tretinoin (acne; photodamaged skin); Adapalene (acne); Tazarotene (acne; psoriasis; photoaging)

Question 8

• MOA: Normalized epithelial cell proliferation; inhibits sebum production; decr P. acnes colonization; some direct anti-inflammatory activity
• AE: HIGHLY TERATOGENIC–>must be prescribed under the iPLEDGE program

Answer 8

Isotretinoin

Question 9

• MOA: Inhibits bacterial protein synthesis (50S)

SURFACE ACNE (INFLAMMATORY PAPULES)

Answer 9

Erythromycin

Question 10

• MOA: Inhibits bacterial protein synthesis (30S)

SURFACE ACNE (INFLAMMATORY PAPULES)

Answer 10

Clindamycin

Question 11

•	MOA: Solubilizes surface protein layers; mild antibacterial
SURFACE ACNE (INFLAMMATORY PAPULES)

Answer 11

Benzoyl peroxide; Salicylic acid

Question 12

o MOA: binds to PCN-binding proteins; Gram (+) and some Gram (-)

CYCSTIC ACNE (ELEVATED ENCAPSULATED LESIONS=ORAL TX TO PREVENT SCARRING)

Answer 12

• Amoxicillin

Question 13

o MOA: Inhibits bacterial protein synthesis (30S); Gram (-) and some Gram (+)

CYCSTIC ACNE (ELEVATED ENCAPSULATED LESIONS=ORAL TX TO PREVENT SCARRING)

Answer 13

• Tetracycline; Doxycycline; Minocycline

Question 14

o Uses: for short-term and intermittent long-term therapy for eczema (mild-to-moderate atopic dermatitis).
o MOA: inhibits production of interleukins, interferons, other antigen-stimulated products in T cells; inhibit the release of pre-formed mediators from skin mast cells and basophils, breastfeeding

Answer 14

• Tacrolimus; Pimecrolimus