Miscelaneous dermal drugs

Question 1

What are the trichogenic agents?

Answer 1

minoxidil; finasteride

Question 2

What are the antitrichogenic agents?

Answer 2

eflornithine

Question 3

what are the pigmentation therapies?

Answer 3

hydroquinone/fluocinolone/tretinoin; methoxsalen

Question 4

What are proposed MOAs for minoxidil?

Answer 4

1) may activate hair follicle directly or stimulate microcirculation; 2) alter local androgen metabolism

Question 5

What are the common ADEs of minoxidil?

Answer 5

skin irritations (excoriations, psoriasis, sunburn) can increase systemic absorption

Question 6

T/F Minoxidil Tx must continue for maintenance of effects

Answer 6

true

Question 7

What are the 2 uses for finasteride?

Answer 7

low dose for hair loss; high dose for BPH Tx

Question 8

What is the MOA of finasteride?

Answer 8

Testosterone analog that blocks 5-a reductase activity

Question 9

What does finasteride cause?

Answer 9

decrease in scalp and serum DHT concentrations

Question 10

What are ADEs associated with finasteride?

Answer 10

loss of libido; sexual dysfxn; feminization

Question 11

Why should finasteride and palmetto not be used together?

Answer 11

similar MOAs

Question 12

Who would consider taking eflornithine?

Answer 12

women wanting to get rid of facial hair

Question 13

What is the MOA of eflornithine?

Answer 13

decreases ornithine decarboxylase to decrease cell division and differentiation

Question 14

How can eflornithine be used against sleeping sickness?

Answer 14

produces a trypanostatic action

Question 15

Where should eflornithine be applied only?

Answer 15

facial and chin areas only

Question 16

What are ADEs associated with eflornithine?

Answer 16

rare and if occur then mild

Question 17

What does the combination of fluocinolone; hydroquinone and tretinoin treat?

Answer 17

temp relief of facial skin darkening by hormonal changes, pregnancy, OCs or HRT

Question 18

What is the MOA of fluocinolone?

Answer 18

anti-inflam corticosteroid

Question 19

What is the MOA of hydroquinone?

Answer 19

inhibits melanin formation by blocking melanocyte enzymatic oxidation of tyr to 3,4 DOPA

Question 20

What is the MOA of tretinoin?

Answer 20

modulates skin growth and pigmentation

Question 21

How does tretinoin use result in decreased epidermal melanin content?

Answer 21

increased keratinocyte shedding

Question 22

What is the ADE associated with the combination of fluocinolone; hydroquinone and tretinoin?

Answer 22

Increased UV sensitivity

Question 23

What is significant about the activation of methoxsalen?

Answer 23

activated by UVA exposure and is a topical pigmenting agent

Question 24

What is the MOA of methosalen?

Answer 24

conjugation and cross linking of DNA resulting in cell death

Question 25

Once activated, how does the MOA of methosalen continue to work?

Answer 25

delayed erythema followed over several weeks by increased epidermal melanization and stratum corneum thickening

Question 26

What diseases are indicated for methoxsalen tx?

Answer 26

vitiligo; psoriasis relief; cutaneous T cell lymphoma; alopecia areata; dermatoses; eczema; lichen planus

Question 27

What is the source of stem cell for hair regrowth? affected by CTX?

Answer 27

bulge => no affect from CTX

Question 28

What does apoptotic death involve?

Answer 28

decreased Bcl-2 and increased Bax and p53

Question 29

Alopecia severity is dependent on what?

Answer 29

drug, dose, intensity and route dependent

Question 30

What are the concerns for scalp cooling?

Answer 30

viability of scalp micro-metastases experiencing sub-lethal drug exposure

Question 31

What patients have persistent high drug levels after cooling process is terminated?

Answer 31

patients w/ renal or hepatic disease

Question 32

What are frequent severe causes of alopecia from CTX agents?

Answer 32

Doxorubin; daunorubicin; paclitaxel; docetaxel; cyclophosphamide; ifosfamide; etoposide