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Pharmacology > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

What are the contraindications to doxepin?

A

Hypersensitivity
Pregnancy
Seizure disorder
Arrhythmias
<18 years
Glaucoma, urinary retention

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2
Q

What are the adverse effects of doxepin?

A

CNS: sedation, lowered seizure threshold
Cardiac: prolonged QT, arrhythmias, hypotension
Anticholinergic: dry mouth, blurred vision, urinary retention, constipation
Weight gain

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3
Q

What are the drug interactions of doxepin?

A

CYP2D6 - MAOi, SSRI/SNRIs

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4
Q

What is the MOA of thalidomide?

A
  1. Antiinflammatory
  2. Immunomodulatory
  3. Neural effects
  4. Vascular effects
  5. Sedative
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5
Q

What are the indications for thalidomide in dermatology?

A

Erythema nodosum leprosum
Lupus
GvHD
Neutrophilic dermatoses
Prurigo nodularis
Kaposi sarcoma

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6
Q

What are the contraindications to thalidomide?

A

Hypersensitivity
Female of childbearing age
Sexually active males
Peripheral neuropathy
Children <12 years

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7
Q

What are the adverse effects of thalidomide?

A

Teratogenicity
GI effects
CNS: peripheral neuropathy, drowsiness, mood changes, dizziness
Skin: pruritus, xerosis/xerostomia, brittle fingernails, red palms
Endo: hypothyroidism, hypoglycaemia
Haem: leukopenia, VTE

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8
Q

What baseline and ongoing monitoring is required for thalidomide?

A

Baseline
FBC, UEC, LFT, BhCG
Neuro exam +- NCS

Ongoing
BhCG weekly for 4/52, then monthly

FBC and neuro exam monthly for 3 months and then every 3 months

*No semen donation for 1 month after cessation

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9
Q

What are the dermatologic indications for hydroxychloroquine?

A

Cutaneous lupus, DM, Jessners
PMLE, PCT, solar urticaria
Granuloma annulare, sarcoidosis
Urticarial vasculitis
Lichen Planopilaris, oral LP
Follicular mucinosis

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10
Q

What drugs interact with hydroxychloroquine?

A

CYP3A4 & 2C8 drugs
PPI, antacids
Macrolides (QT prolongation)
Cimetidine
Smoking

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11
Q

What are the adverse effects of hydroxychloroquine?

A

Ocular
- bulls eye maculopathy
- reversible eg blurred vision, halos, photophobia, corneal deposits
GI effects
Skin
- blue grey hyperpigmentation
- hypersensitivity rashes
- psoriasis
Haem: cytopaenias
CNS: headache, vertigo, tinnitus, irritability, mood swings, psychosis, muscle weakness

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12
Q

What baseline and ongoing monitoring is required for hydroxychloroquine?

A

Baseline
FBC, UEC, LFT, BhCG, G6PD
Ophthal consult, porphyrin screen

Ongoing
FBC, UEC, LFT monthly for 3 months and then every 3-4 months
Ophthalmological assessment annually

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13
Q

What are the dermatologic indications for IVIg?

A

Kawasaki disease
Scleromyxedema
Immunobullous disease eg PV, BP
SJS/TEN
DM, SLE, SSc

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14
Q

What is the MOA of IVIg?

A

Blocks Fas-Fas ligand interactions
Downregulates antibody production
Neutralises pathogenic antibodies
Inhibits autoreactive T cells

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15
Q

What are the contraindications to IVIg?

A

Anaphylaxis
IgA deficiency
CCF, CRF (fluid overload)
Rheumatoid arthritis, cryoglobulins

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16
Q

How is IVIg dosed?

A

Kawasaki: 2g/kg single dose over 12 hours
TEN: 2g/kg divided over 3 days

Immunobullous: 2g/kg/month
SLE: 2g/kg/month
DM: 2g/kg/month

Scleromyxedema:
- induction: 2g/kg over 5 days
- maintenance: 0.5-2g/kg/month

*monitor BP/HR & fluid status during infusion

17
Q

What are the adverse effects of IVIg?

A

Anaphylaxis, hypersensitivity reactions (eg EM, dermatitis, purpura)
Infusion reactions
Fluid overload
Haem: cytopenias, VTE
Increased infection risk

18
Q

What baseline assessment is needed before giving IVIg?

A

Cardiac, pulmonary & renal status, weight
FBC, UEC, LFT, Ig levels, hepatitis B/C/HIV, rheumatoid factor, cryoglobulins

Ongoing
FBC, UEC (if at risk of acute renal failure)

19
Q

What is the advice about vaccinations in the setting of IVIg?

A

Give 3 months after last IVIg dose

20
Q

What is the MOA of interferon?

A
  1. Antiproliferative
  2. Antiviral
  3. Immunoregulatory
21
Q

What are the indications for interferon?

A

CTCL
Vascular tumours eg KS
Viruses eg HPV, leishmaniasis, leprosy, MAC
Melanoma
AICTD eg lupus, behcet, SSC
Chronic granulomatous disease

22
Q

What are the contraindications to interferon?

A

Hypersensitivity
Pregnancy/lactation

Cardiopulmonary disease
Cytopaenias
Coagulopathies

Diabetes mellitus
Depression
E. Coli hypersensitivity
Filler

Organ transplant

23
Q

What are the adverse effects of interferon?

A

Flu-like symptoms
GI effects
Xerosis, alopecia
CNS: dizziness, confusion, memory loss, paresthesia, weakness
CVS: hypotension, dysrhythmias
Haem: cytopaenias
Rhabdomyolysis

24
Q

What baseline and ongoing monitoring is required for interferon?

A

Baseline: FBC, UEC, LFT, BhCG, CPK, TFT

Monitoring: FBC, UEC, LFT, CPK monthly, ECG every 3 months

Pharmacology (13 decks)

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