Pharm Flashcards
1
Q
Used for severe dermatoses over nonfacial areas like scalp, plan, or sole of feet?
A
Clobestalol (class 1)
2
Q
Side affects of topical steroids
A
Acne Striae skin atrophy steroid rosacea Hyperpigmentation Telangiectasias
3
Q
Systemic SE of steroids?
A
Hyperglycemia
Cushings
Hypertension
4
Q
Topical med w/ antimicrobial and comedolytic properties
SE: bleaching hair + skin irritation
A
Benzyl peroxide
5
Q
Retinoids?
A
Vitamin A derivatives
6
Q
Used for acne+ photodamaged skin + hyperpigmenation?
A
Retinoids
7
Q
SE of retinoids?
A
Photosensitivity dryness Pruritus erythema scaling
8
Q
Retinoids CI w/?
A
Benzoyl peroxide–> oxidizes retinoin
9
Q
SE of isotrentinoin?
A
Teratogenic
Elevated LFTs
Elevated TGs
10
Q
Inhibits keratinocyte proliferation?
SE?
A
Calcipotriene
SE: skin irritation
11
Q
Inhibits keratinocyte proliferation but stimulates differentiation+ inhibits T cell proliferation?
A
Calitriol
12
Q
Topical retinoid used for Psoriasis & acne
SE: Teratogenic + photosensitivity
A
Tazorotene
13
Q
Only drug used to treat Squamous cell carcinoma?
A
Cisplatin
14
Q
Drugs used in treatment of Actinic keratosis?
A
Fluorouracil
Diclofenac
Imiquimod
Trichloroacetic acid
15
Q
3 sites of Skin cancer metastasis?
A
Lung + intestines+ Brain
16
Q
MOA: direct activator of TLR7/ TLR8–> initiates Th1 cell immune response
Blocks adenosine receptors
A
Imiquimod
17
Q
Activation of NF-kappa B
A
Leads to upregulation of cytokines like TNFalpa and Interleukins
18
Q
SE: allergy to its components
Skin rxn
Increased Photosensitivity
CAN compromise CONDOMS
A
Imiquimod
19
Q
Hedgehog driven tumor?
A
Basal cell carcinoma
20
Q
MOA for Imiquimod used to Tx basal cell carcinoma?
A
INHIBITS GLI-A–> Suppresses Hedgehog Receptor signaling independent of TLR
21
Q
Abberant Hedgehog signaling leads to?
A
increased Bcl2(anti-apoptotic protein) + VEGF
22
Q
SMO vs. PTCH1 inhibition in Hedgehog pathway?
A
SMO is downstream of PTCH1 so inhibiting PTCH1 without SMO is ineffective
23
Q
Protein target in Hedgehog signaling inhibition?
A
SMO
24
Q
SMO inhibitor?
A
Vismodegib
25
SE of Vismodegib?
Intrauterine is FATAL
Male mediated Teratogenicity
Pregnancy should be avoided: Teratogenic
Alopecia: most common
26
MOA: IL 2 receptor agonist-> induces proliferation and differentiation of B & T cells, monos, macs, and CTLs (NK cells)?
Aldesleukin
27
CI for Aldesleukin?
CNS, cardiac, pulmonary, hepatic, or renal Disease or Organ transplant= increases rejection
28
SE: capillary leakage syndrome and baseline and daily CXR recommended?
Aldesleukin
29
Immunomodulator administered IV or SC?
Inferferon alpha
30
SE of Interferon alpha?
```
Autoimmune disease worsening
Cardiac Disease
Depression/ Suicidal
elevated LFTs
Pulmonary infiltrates: pneumonitis
most common: flu like symptoms+ neutropenia
```
31
Tests routinely taken for pt on Interferon alpha?
CBC
EKG
LFTs
CXR
32
Ipilimumab MOA?
CTLA-4 recombinant antibody
| Blocks Cytotoxic Tcells from interacting w/ CD80+ CD86
33
BBW SE for Ipilimumab?
```
Adrenal insufficiency
Guillain Barre
Hepatitis
SERIOUS RASH
Peripheral neuropathy
Teratogenic
```
34
MOA: Inhibiting the negative regulator of CTLs (CTLA4) which increases T cell # and action
Ipilimumab
35
Sorafenib MOA?
Multi Kinase inhibitor (VEGF, PDGFR, KIT, RAF )
36
SE of Sorafenib?
```
Hepatitis (elevated LFTs)
Hand and Foot syndrome
Rash+ anemia
Teratogenic
FATAL GI or Brain or Respiratory Bleeding
Teratogenic
```
37
SE: Fatal bleeding?
Sorafenib (VEGF + PDGFR actions)
38
Oral Reversible MEK inhibitor?
Trametinib
39
Trametinib is a MEK inhibitor for pt w. what mutations?
BRAF V600E and V600K
40
SE of Trametinib?
```
Skin toxic
Decreased LVEF
RENTINAL pigment epithelial detachment
Cardiomyopathy
Interstitial lung dz
Hemorrhage
Teratogenic
```
41
Whats more downstream of RTK: BRAF or MEK?
RTK-> NRAS-> BRAF (vemurafinib)-> MEK (trametinib)-> ERK-> proliferation/ survival
42
Common SE of Sorafenib+ Trametinib + Vemurafenib?
RASH
43
SE: EYE and Secondary malignancies?
BRAF (vem) and MEK(tram) inhibitors
44
Oral inhibitor of mutated BRAF?
Vemurafenib
45
Genotype of Vemurafenib requirement?
BRAF mutation (V600E)
46
Resistance to BRAF / MED inhibitors?
Alternative pathway activation s
47
SE of Vemurafenib?
```
QT prolongation
Photosensitivity
Cutaneous 2nd Squamous cell carcinoma
SEVERE skin rxn
SEVERE eye issues: uveitis + iritis + retinal v occlusion
Teratogenic
```
48
MOA of Carmustine?
alkylation + carbamoylation of amino acids
49
MOA of Decarbazine?
Pro-drug of active akylating moiety
50
Dactinomycin MOA?
DNA intercalator
51
Flourouracil MOA?
Thyidylate synthase inhibitor: interferes w/ RNA & RNA synthesis
52
Lomustine MOA?
Alkylator
53
Non-invasive lesion due to sun exposure-> epithelial transformation extremely unlikely to progress to SCC?
Actinic Keratosis
54
Topical Tx for Actinic Keratosis?
Fluorouracil + Imiquimod
55
Non topical Tx of actinic Keratosis>
NSAID diclofenac and Trichloroacetic acid
56
DIclofenac MOA?
Inhibitor of inflammatory mediators: PGs
57
SE of Diclofenac?
RASH and skin peeling
58
Trichloroacetic acid MOA?
chemical peel: rapidly penetrates and cauterizes (to burn) skin + keratin
59
SE of Trichloroacetic acid?
Burning
Inflammation
Tenderness
60
Tx of tuberculoid leprosy?
Dapsone + Rifampin for 12mo
61
Tx of Lepromatous leprosy?
Dapsone+ Rifampin + Clofazimine for 24 mo
62
What is Dapsone's harmful metabolite via CYP 3A & 2C9?
Hydroxylamine
63
Potent oxidant--> causes Methemoglobinemia and Hemolysis?
Dapsone metabolite Hydroxylamine
64
Dapsone in CI in pts with... due to...?
G6PD deficiency causes Hemolysis
65
Drug interactions for Dapsone (hydroxyl amine)?
Rifampin-> increased toxicity
Trimethoprim-> increase Serum levels of Drugs
Cimetidine + omeprazole-> decrease toxicity
66
Elimination of Dapsone?
Renal Excretion
67
Dapsone MOA?
Folic acid derivative-> inhibits Thymidine and purine synthesis
*site of action btwn Sulfa and Trimethoprim
68
Inhibitors of second messenger pathway involved in PMNs chemotaxis?
Dapsone (folate antagonists)
69
SE of Dapsone?
```
RASH (SJ syndrome)
Hemolysis
Methemoglobinemia
Hepatitis
Cholestatic jaundice
Peripheral MOTOR neuropathy
SEVERE hypoalbuminemia
Leukopenia/ agranulocytosis
```
70
Labeled uses of Dapsone?
Acne vulgaris
Dermatitis Herpetiformis
LEPROSY (hansen's disease)
71
Rifampin SE?
```
Crosses inflamed Meninges + placenta + breast milk
Hepatic Toxic/ metabolism
CYP inducer
hematuria
RED colored fluids
```
72
Common SE of Dapsone and Rifampin?
Hemolysis
73
Clofazimine MOA?
Binds to Mycobacterial Guanine (cystine) in DNA
74
SE of Clofazimine?
```
Highly lipophilic-> Long T1/2 (months)
Hepatic Toxicity/ elimination
Staining of Body+ bodily fluids + infants
Skin discoloration
Black Tarry feces
```
75
SE Clofazimine and Rifampin have in common?
Discolor Bodily fluids
76
SE include Black tarry feces + hepatitis+ skin discoloration?
Clofazimine
77
Test routinely ordered to monitor Leprosy pt drug toxicity?
CBC + platelet count
AST
ALT
78
Drugs used for patients who cannot tolerate Clofazimine>
Clarithromycin
Minocycline
Ofloxacin
79
Leprosy pt w/ sudden eruption of numerous, painful, nodules, neuritis?
Erythema nodosum leprosum
80
Tx of Erythema nodosum leprosum?
Corticosteroids
Clofazimine
Thalidomide
81
Inhibits Nf kappaB meidated transcription upregulation of TNF alpha production?
Thalidomide--> blocks leukocyte migration
82
Main SE of thalidomide?
Teratogenic
Increase in Plasma HIV viral load
Peripheral neuropathy
83
Thalidomide is used to Tx?
Side effects of Leprosy
| Myeloma (anti-angiogenic activity)
84
Leprosy with:
Cell mediated response
Granuloma formation
Few organisms?
Tuberculoid Leprosy
85
Cytokines involved in Tuberculoid leprosy?
```
IFN gamma
TNF
IL-2
IL-16
IL-12
```
86
Humeral repsonse
Foamy macrophages
Many organisms?
Lepromatous leprosy
87
Cytokines involved in Lepromatous leprosy?
Il-4
| IL-10
88
Dx used to treat Tinea and Onchymycosis by Blocking transmembrane transport depleting essential substrates and interfering with RNA & DNA synthesis?
Ciclopirox
| Does NOT inhibit synthesis or lyse fungal cell wall
89
MOA: Inhibit fungal ergosterol synthesis by inhibiting P-450 enzyme that converts lanosterol to Ergosterol?
Azoles
90
What is the enzyme blocked by Azoles?
14-alpha demethylase
91
SE: inhibits testosterone synthesis/ adrenal dysfunction?
Ketoconazole
92
Major inhibitor of CYP 2C19?
Voriconazole
93
Significant inter-patient variability of CYP 2C19 affects the serum levels of?
Voriconazole
94
Itraconazole is an inhibitor and substrate for?
CYP 3A4
95
Posaconazole inhibits CYP?
CYP 3A4 + P-gp
96
Fluconazole inhibits CYP?
CYP 2C9 + 3A4
97
Azoles acting on CYP 2B6 + 2C19?
Voriconazole
98
Azoles acting on CYP 2C9?
Fluconazole + Voriconazole
99
Azole with RENAL elimination?
Fluconazole
100
Azoles able to enter CSF?
Fluconazole [HIGH]
| Voriconazole [low]
101
Azoles that does NOT cause QT prolongation?
Itraconazole
102
SE: photosensitivity + Optic Neuritis + SCC and Melanoma cases?
Voriconazole
103
Which azole must be taken with food for Proper Bioavailability?
Posaconazole
104
MOA for Griseofulvin?
interferes w/ microtubule function: disrupts mitosis + Deposits in Keratin tissue (Nails)
105
Metabolism and elimination of Griseofulvin?
hepatic metabolism
| eliminated via Liver/ kidney/ Perspiration
106
SE of Griseofulvin?
```
CYP 3A4 INDUCER
Teratogenic
Hepatotoxic
Interferes w/ Porphyrin metabolism= confusion + headaches
Penicillium hypersensitivity
Photosensitivity
```
107
SE: CYP 3A4 inducer + causes porphyria?
Griseofulvin
108
Inhibits Fungal squalene epoxide?
Terbinafine
109
Terbinafine metabolism and Elimination?
Hepatic metabolism
| RENAL elimination
110
SE: transient Lymphopenia & neutrooenia + Abnormal LFTs + visual disturbances + teratogenic?
Terbinafine
111
MOA: Squalene epoxide inhibitor + anti-inflammatory by inhibiting PGs + LTs + Histamins causing vasoconstriction?
Naftifine
112
Naftifine SE + CI?
Hypersensativity
Teratogenic
CI: Do NOT use w/ AZOLES
113
why are Naftifnine and Azoles CI in concurrent use?
Both inhibit Ergosterol synthesis but Naftifine @ earlier stage thus diminishes Azoles actions
114
Cilopriox MOA?
Topical ONLY
| Blocks Fungal transmembrane transport (DNA + RNA synthesis?
115
SE for Ciclopirox?
Hypersensitivity
| Skin irritation
116
Amorolfine MOA?
TOPICAL only: Inhibits ergosterol synthesis
117
SE of Amorolfine?
Hypersensitivity
118
Acyclovir is used to Treat?
VZV and HSV
119
Anti-virals used to treat Varicella Zoster?
Acyclovir + Famciclovir + Valacyclovir
120
What two antivirals are PRO_ DRUGS?
Valacyclovir + Valganciclovir
121
Metabolized to its active product Penciclovir?
Famciclovir--> used to Treat Recurrent Herpes Labialis
122
MOA: competitively inhibit viral DNA pol. Compete w/ Deoxyguanosine triphosphate for incorporation into Viral DNA?
```
Acyclovir
Famciclovir
Ganciclovir
Valacyclovir
Valganciclovir
```
123
Mode of resistance is mutated Viral Thymidine kinsae?
Acyclovir
124
Anti-virals that require inracellular kinase-dependent phosphorylation for activity?
```
Acyclovir
Famciclovir
Ganciclovir
Valacyclovir
Valganciclovir
```
125
Anti-virals that DO NOT require intracellular phosphorylation?
Cidofovir
| Forscarnet
126
SE of acyclovir + Valacylovir?
neurotoxic/ Seizures
127
Anti-viral with no Significant SE?
Famciclovir
128
SE for Cidofovir?
Nephrotoxic
| Hypersensitivity
129
Management of Cidofovir Nephrotoxicity?
Co-adminstration w/ Probenecid and IV saline
130
SE: electrolyte imbalance - chelates Ca2+ & Nephrotoxicity?
Forscarnet
131
MOA: Viral DNA pol inhibitor by binding to Pyrophosphate-binding site--> Blocks chain elongation?
Forscarnet
132
MOA: inhibits DNA pol by competing w/ deoxycytosine triphosphate for incorporation into Viral DNA?
Cidofovir
133
SE: Pancytopenia, thrombocytopenia + Teratogenic+ Renal toxic?
Ganciclovir + Valganciclovir
134
Which of the anti-virals DO NOT have Cross hypersensitivity?
Cidofovir
| Forscarnet
135
MOA of Minoxidil?
Potent vasodilator (artery>vein)--> HTN
* *Activates hair follicle directly or stimulates follicular microcirculation
* *Alter local androgen metabolism
136
SE of minoxidil?
Poor skin absorption-> little systemic SE
| Skin irritations
137
MOA: Testosterone analog-> blocks 5-alpha-reductase activity to decrease scalp and serum DHT concentration?
Finasteride
138
SE of Finasteride?
Loss of libido
**Sexual dysfunction
Feminization
139
Finasteride is CI w/ concurrent use of?
Saw palmetto--> similar MOA
140
Main SE Male sexual dysfunction?
Finasteride
141
MOA; decrease Ornithine decarboxylase-> decrease cell division & differentiation
USED to reduce Unwanted female facial hair
Eflornithine
142
MOA: produces trypanostatic action--> USED against Sleeping Sickness?
Eflornithine
143
SE of Eflornithine?
Not for eyes of mucus membranes
| Rare skin adverse rxns
144
Tri-Luma USE and makeup?
TRI= Fluocinolone + Hydroquinone + Tretinoin
| USE: Decrease Skin Darkening
145
Fluocinoolone MOA?
Anti-inflammatory corticosteroid
146
Hydrquinone MOA?
Inhibits melanin formation by blocking Melanocyte enzymatic oxidation of tyrosine to 3,4-DOPA.
147
MOA of Tretinoin?
Modulates skin growth and pigmentation
| **Increased Keratinocyte shedding from Retinoid treatment
148
SE TRI-LUMA?
Increased sensitivity to UV
149
Oral topical pigment agent activated by UVA 9320-400nm Exposure?
Methoxsalen
150
SE of Methoxsalen?
Delayed erythema
| increased epidermal melanization> thicken Conrneum
151
Uses of Methoxsalen?
Vitiligo
Psoriasis
cutaneous T-cell Lymphoma (mycosis fungoides)
Alopecia
152
Apoptosis involves what proteins?
Decreased Bcl-2
| Increased Bax & p53
153
source of stem cell for hair regrowth>
Bulge
154
MOA of Melathion?
Topical Organophosphate-> metabolized in louse to malaoxon--> inhibits acetyl-cholinesterase
155
Outcome of Melathion in Human body?
Rapidly converted to inactive metabolites and Excreted by the KIDNEY
156
SE of oral/pulmonary ingested Malathion?
```
Increased GI peristalsis
decreased Ocular accommodation
Bradycardia
Confusion
Hypotension
```
157
Tx for Malathion toxicity?
Atropine or pralidoxime
158
What is the ONLY ovicidal therapy available for treating lice?
Malathion
159
MOA of Permethrin?
Bind to voltage gated Na channels--> cause hyperexcitability and paralysis
160
SE of Permethrin?
Asthma exacerbation--> ragweed allergy
| But drug reaching systemic circulation is rapidly inactivated by ester hydrolysis
161
Resistance to Permethrin?
Knock-down resistance mutation (kdr) of louse Na channels
162
Lindane MOA?
GABA blockade
Only used in pts who CANNOT tolerate or have failed 1st line treatment
163
SE of Lindane?
BBW: Skin dz + Neonatal prem + CNS stimulant causes SEIZURES
164
Lindane CI w/ ?
Py w. seizures due to its GABA blockade-> promotes seizures
165
Disfavored due to Neurotoxicity and persistence in the environment?
Lindane
166
Ivermectin MOA?
Selectively binds to Glutamate-gated Cl- channel present in Invertebrate nerves and muscle cells.
167
Disfavored in younger pts do its tendency to CROSS the BBB + elevates LFTs + worsens Bronchial Asthma?
Ivermectin
168
Physical methods of controlling Lice?
Benzyl alcohol
Cetaphil
Petroleum Jelly--> Shown to have OVICIDAL efficacy
169
Before prescribing Isotrention to a young women what tests should be done?
Pregnancy test (Serum beta HCG levels)
170
Pathogenesis: 5 alpha reductase + androgenic effects of dihydrotestosterone actions?
Male pattern baldness
171
Calcipoteiene MOA?
activates Nuclear transcription factor (vitamin D receptor) inhibits keratinocyte proliferation and induces differentiation
172
Before prescribing Isotrention to a young women what tests should be done?
Pregnancy test (Serum beta HCG levels)
173
Pathogenesis: 5 alpha reductase + androgenic effects of dihydrotestosterone actions?
Male pattern baldness
174
Calcipoteiene MOA?
activates Nuclear transcription factor (vitamin D receptor) inhibits keratinocyte proliferation and induces differentiation
175
Pg: Antigen presents and T cells release cytokines (TNF and IFN) inducing keratinocyte and endothelial cell proliferation?
Psoriasis
176
Numerous lesions on the trunk caused by FGF receptor 3 mutation causing monotonous proliferation of basal cells?
Seborrheic Keratosis
177
Thickened stratum corneum with retained nuclei?
parakeratosis
178
<1cm lesion showing cytologic atypia precursor to SCC caused by TP53 mutations?
Actinic keratosis
179
Round, coin like lesion with a "stuck on" appearance?
Soborrheic keratosis
180
Impairs antigen presentation by Langerhan cells causing immunosuppression?
UVB
181
Most common UV induced mutation in SCC?
TP53
182
Likelihood of SCC to metastasize is related to?
Thickness and degree of invasion into Subcutis
183
SCC located in _____ are generally much more aggressive?
Mucosal SSC
184
Which skin cancer is associated with dysregulation of Hedgehog signaling pathway?
Basal cell carcinoma
185
Mutation in what gene in most associated w/ familial basal cell carcinoma?
PTCH gene
186
"Pearly" papules with prominent subepidermal blood vessel dilations (telangiectasia)?
BCC
187
Palisading alignment of tumor cells in the outermost layer separating from stroma?
BCC
188
Can arise from chemical exposure, thermal burn sites, or HPV infection in immunosuppression?
SCC
189
Superficial lesions in which cells produce melanin and grow in nests along dermoepidermal junction is associated w/ what mutation?
Activating BRAF mutations (melanocytic nevi)
190
The most important signs of early manifestation of Melanoma?
Evolution (Change in color or size)
191
Progenitor cells for BCC?
Hair follicles/ Germinative keratinocytes (basal layer)
192
Progenitor cells for SCC?
Epidermal keratinocytes (spinous layer)
193
Whats the most common invasive neoplasm in US?
Basal Cell Carcinoma
194
What gene mutation is associated w/ sporadic BCC?
| What is the role of that gene?
PTCH mutation
| Hedgehog signaling pathway--> regulator of basal epidermal cell proliferation
195
Risk factors for BCC?
UV exposure
Sunburns (esp blistering)
FHx of BCC
Immunosuppression
196
Most common mutation in SCC?
TP53
197
"pearly" nodule w/ telangactasias?
BCC
198
Which type of neoplasm requires the Stroma for metastasis?
BCC
199
AD mutation in PTCH causing increased risk of neoplasms, MSK defects, and Jaw cysts?
Grolin syndrome (Basal cell nevus syndrome)
200
What is the action of PTCH?
It suppresses the SMO protein which activates teh Hedgehog signaling pathway
201
what drug inhibits SMO?
Vismodegib
202
Progression of SCC?
Minimal atypia (Actinic keratosis)
Full thickness epidermal atypia confined abouve basement membrane (SCC in situ)
Invasive SCC
203
Erythroplasia of Queyrat?
SCC of glans penis
204
Risk factors for developing SCC?
```
UV
HPV
Immunosuppression
Chronic inflammation
Scars (burns)
Chemical exposure (arsenic)
```
205
Risk of metastasis of cutaneous SCC is related to?
SIze >2cm
Depth into dermis >4mm
Anatomic site (mucosal membranes)
Host immune status
206
Keratinocyte neoplasm rapidly growing 2-6 wks, Painful and may involute spontaneously?
Keratoacanthoma
207
An ulcerated invasive SCC arising on background of chronic inflammation, scarring, radiation, and trauma?
Marjolin's Ulcer
208
Whats the most common type of cancer in 25-29 yo?
Melanoma
209
Mature melanocytes with descent into dermis and no melanocytes above basal layer?
Nevi
210
Melanocytes do not mature w/ descent and located above basal layer?
Melanoma
211
What mutation is common to both Nevi and Melanoma?
BRAF
212
>50 moles increases risk for?
melanoma
213
Melanoma risk factors?
>50 nevi
H/o blistering sunburns
immune dysfunction
214
Acral Lentiginous melanoma?
Melanoma on palms and soles of feet
215
Melanocytes are derived from what embryonic cells?
Neural crest cells
216
#1 organ site for metastasis of Melanoma?
SKIN
217
Most common cause of death for pt w. melanoma?
CNS involvement
218
Single most important prognostic factor for melanoma?
Lymph node involvement
219
Most important histological prognostic factors for Melanoma?
Breslow thickness + ulcerations
220
breslow's thickness?
Distance involved from the stratum granulosum to the deepest tumor cell
221
MOA for Vemurafenib?
Inhibits BRAF (approved for metastatic melanoma)
222
Combination therapy of Vemurafenib and ipilimumab shows great improvement.
MOA of Ipilimumab?
Ab against CTLA4= inhibiting this receptor leads to increase in Tcell actions= increased immune response to tumor
223
UVB form what in DNA?
Thymine dimers
224
MOA of Etanercept?
TNF alpha receptor Antagonist (Antibody fusion protein)
225
MOA of Adalimumab?
Human Ab against TNF alpha (Components: igG1)
226
Components of Etanercept>
p75 + TNF receptor and Fc igG1
227
MOA of Infliximab?
Chimeric mouse Ab against TNF alpha
228
CI w/ heart failure and causes Hypersensitivity?
Infliximab
229
Etanercept is CI w/ what condition?>
Sepsis
230
What are the BBW for Adalimumab + etanercept + infliximan?
Infections: Fungal/ myco / viral
Neoplasia
TB
231
CI use concurrently with Immunosuppressives or vaccinations?
Infliximab
Adalimumab
Etanercept
232
MOA of Ustekinumab?
Binds p40= disrupts IL-12 + IL-23 signaling
| suppresses Formation of inflammatory cytokines by Th1 and Th17 cells
233
SE of Ustekinumab?
Increase risk of infection and Neoplasia
| Anaphylaxis
234
Ustekinumab is CI w/ what and what tests should be done prior to treatment?
CI w/ LIVE virus vaccines
| Test for TB
235
Functions of Vitamin A (retinoids)?
Embryonic growth
Reproduction
Vision
236
Effects of Retinoids?
Modulates prolif + diff of keratinocytes
Inhibits keratinization
induces apoptosis
Immunologic/ anti-inflammatory
237
Targeting RAR predominately affects?
Cellular differentiation and proliferation
238
Targeting RXR induces?
Apoptosis
239
SE of Retinoids?
```
acutely: conjunctivitis + reduced night vision
Teratogenic
Suicidal ideas
TGs and ALT level checks
Increase risk for SUNBURNS
```
240
RARs vs. RXR selective retinoids SE?
RAR:Mucocutaneous + musculoskeletal
RXR: Phsiochemical
241
MOA for Topical retinoids against acne?
Correct abnormal keratinization
reduce P acnes
reduce inflammation
242
MOA of retinoids against Photoaging?
inhibits MMPs in response to UV
243
MOA of calcipotriene?
Binds to vitamin D receptor;
| RXR and binds DNA vit D elements to reduce inflammation
244
SE of Calcipotriene?
Hypercalcemia + hypercalciuria
| Increased UV skin cancer risk
245
MOA of Calcitriol?
Hormonally active form of vit D3
246
MOA of benzoyl peroxide?
PRO-drug converted in skin to benzoic acid
| **Liberates free radical to kill P acnes
247
MOA for Clindamycin?
```
Inhibits 50s (static)
*P acnes have resistance
```
248
Name mild Corticosteroid?
Hydrocortisone
| Methylprednisolone
249
Name moderate CS?
Betamethasone valerate
250
Name Potent CS?
Fluocinonide
251
Name very Potent CS?
Clobetasol propionate
| Bethamethasone dipropionate
252
Fluorinated Topical steroids should not BE?
applied to the FACE-> causes perioral dermatitis
253
SE of topical CS?
Iatrogenic cushings
dermal atrophy
Rosacea (persistent erythema)
Steroid acne
254
Salicylic acid is CI in?
Renal or hepatic impairment
| Pregnancy-> neonatal toxicity when applied to chest
255
SE of salicylic acid intoxication?
Dizziness
Tinnitus
seizures
Renal and Liver failure
