Miscellaneous Systemic Drugs

Question 1

T/F

Co administration of anticholinergic with SSRI’s may lead to increased anticholinergic adverse effects

Answer 1

False

Co admin with TCAs

Question 2

T/F
The pharmacological effects of atenolol and digoxin may be increased by simultaneous use of anticholinergic agents
Eg glypyrrolate + propantheline

Answer 2

True

Question 3

T/F

Anticholinergic agents may control symptoms of hyperhidrosis at low doses without appreciable side effects

Answer 3

True

Question 4

Which synthetic derivatives of testosterone are used to treat hereditary angioedema?

Answer 4

Danazol
Stanozolol

Both have potent fibrinolytic activity

Question 5

What are dermatological use of attenuated androgens ?

Answer 5

Lipodermatosclerosis
Livedoid vasculopathy
Cryofibrinogenaemia

Question 6

T/F

Danozol and stanozolol are attenuated androgens alkylated at 17-a

Answer 6

True

Question 7

Adverse effects of danozol and stanozolol

Answer 7

In female patients :Mild hirsutism
Deepening of voice
Alopecia
Acne
Menstrual irregularities 
Weight gain

Other : neuromuscular dysfunction eg. Muscle cramps , myalgias and elevations in serum creatine phosphokinase

Question 8

T/F

Biotin is vitamin B7

Answer 8

True

Question 9

Foods rich in biotin

Answer 9

Organ Meat
Egg yolk 
Fish
Nuts
Milk

Question 10

Signs of biotin deficiency

Answer 10

Thinning of hair
Poliosis
Seb derm like eruption (like zinc deficiency)

Question 11

Clinical uses of biotin

Answer 11

Keratodermas 50mg daily

Dermatitic eruptions 5mg daily

Question 12

What is clofazamine

Answer 12

The most active antimycobacterial riminophenazine dye known

Question 13

T/F

Colchicine is an alkaloid which must be shielded from UV light

Answer 13

True

Question 14

T/F
Colchicine Is metabolized by the liver ,the majority is eliminated through bile in faeces, and 10-20% of the dose is eliminated unchanged in the urine

Answer 14

True

Question 15

What is colchicine MoA?

Answer 15

Binds to dimers of tubulin
Preventing their assembly into micro tubules
–> this results in mitotic arrest at metaphase and interference with cell motility and chemotaxis

Therefore both antimitotic and antiinflammatory.

Question 16

What happens in colchicine overdose ?

Answer 16

Cholera like syndrome with dehydration , hypokalaemia,

Hyponat, metabolic acidosis , renal failure & shock

Question 17

Use of gold in derm

Answer 17

DLE
SLE
pemphigoid
EBA
Psoriatic arthritis

Question 18

T/F

Nicotinamide deficiency leads to pellagra

Answer 18

True

Question 19

How Is nicotinamide anti inflammatory ?

Answer 19

Inhibits PARP-1,
A nuclear enzyme that enhances nuclear factor KB tx

Reduces lysosomal enzyme release & stabilises leukocytes by inh cAMP PDE

Inhibit mast cell degranulation

Question 20

Potassium iodide MoA

Answer 20

Iodides in infected granulomas and necrotic tissue have been shown to inhibit granuloma formation

Suppress generation if inflammatory O2 intermediates

? Immunosuppressive effect mediated through release of heparin

Question 21

Dermatological conditions with evidence of VitE deficiency

Answer 21

EBA
CLE
GA
Yellow nail syndrome

Question 22

Cutaneous findings of zinc deficiency

Answer 22

Circumorificial and acral dermatitis + accompanying diarrhoea

Question 23

Derm uses of Zinc

Answer 23

Inconsistent success in
Acneiform conditions
Alopecia
Verrucae 
Acute cutaneous leishmaniasis
Leg ulcers in persons with low zinc

Question 24

Which are the two most frequently used anticholinergics on hyperhidrosis?

Answer 24

GLYCOPYRROLATE AND PROPANTHELINE

Question 25

Potassium iodide may cause hypothyroidism

Answer 25

T

Question 26

Clofazamine half life is 70 days

Answer 26

T

Question 27

Colchicine binds directly to tubulin

Answer 27

F | To dimers of tubulin

Question 28

Glycopyrrolate works by blocking effect of Ach on sweat glands

Answer 28

T

Question 29

Glypyrrolate and propantheline side effects

Answer 29

Common- dry mouth blurred vision | Rare seizures hyperthermia, glaucoma

Question 30

Stanozolol has been shown to increase collagen synthesis of cultured dermal fibroblasts

Answer 30

T | Beneficial effect in wound healing

Question 31

Dan and Stan have sodium retaining effects

Answer 31

T | Thus can worsen hypertension. And CCF

Question 32

Which conditions is biotin treatment for ?

Answer 32

``` Unna thost (uncombable hair) syndrome Brittle nails ```

Question 33

Clofazimine inh mycobacterium tuberculosis

Answer 33

T

Question 34

Clofazamine most common side effect is orange brown discoloration of the skin

Answer 34

T | 2-4 weeks after commencement

Question 35

Colchicine concentrates poorly in leukocytes

Answer 35

F | Extremely well

Question 36

What can colchicine be used to treat ?

Answer 36

``` Behcets DH Sweets LABD IgA pemphigus EBA LCV Dermatomyositis Scleroderma Relapsing poky chondrites Pachydermoperiostosis ```

Question 37

Colchicine can cause acute and chronic azoospermia

Answer 37

T

Question 38

How does gold work as anti inflammatory ?

Answer 38

Inh phagocytic and chemotactic response or macrophages and PMN

Question 39

Gold can cause keratitis with corneal ulceration | Deposits in cornea and lens-- chrysiasis

Answer 39

T

Question 40

Nicotinamide is assoc with flushing and pruritus

Answer 40

F | This is nicotinic acid (converted to nicotinamide in the body), a potent vasodilator

Question 41

Nicotinamide has Few side effects

Answer 41

T Rare headaches and GI No flushing or pruritus

Question 42

Mild iodism from KI simulates a head cold

Answer 42

T

Question 43

Thalidomide half life

Answer 43

9 hours

Question 44

Thalidomide is effective in erythema nodosum leprosum

Answer 44

T

Question 45

Thalidomide may cause hypothyroidism

Answer 45

T