Pharm 151 - 200 Flashcards
Which antiparasitic agent is highly flammable?
1 Lindane
2 Permethrin
3 Precipitated sulfur
4 Thiabendazole
5 Malathion
Malathion, an organophosphate cholinesterase inhibitor used to treat scabies and head lice, is flammable.
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What is the recommended period for contraception after cessation of acitretin therapy in the United States?
1 1 month
2 3 months
3 1 year
4 2 years
5 3 years
Etretinate has a prolonged half-life of 80-160 days. The levels may persist up to 3 years in the body. Acitretin can be converted to etretinate in the presence of ethanol.
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Painful periungual pyogenic granulomas have been associated with what medication?
1 Ketoconazole
2 Indinavir
3 Doxycycline
4 Tazarotene
5 Valacyclovir
Periungual pyogenic granulomas and painful paronychial eruptions have been reported in association with various anti-HIV medications including, indinavir, zidovudine, and lamivudine.
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Need photo #154
Which member of the tetracycline family is most likely to have caused this photomediated reaction?
1 Demeclocycline
2 Doxycycline
3 Minocycline
4 Oxytetracycline
5 Tetracycline
The tetracycline family of antibiotics are bacteriostatic and act by inhibiting protein synthesis. Each member of the family may cause photosensitivity, but demeclocycline is the most photosensitizing.
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Gray-green discoloration of the mid-portion of permanent teeth is a side effect of?
1 Doxycycline
2 Tetracycline
3 Minocycline
4 Fluoroquinolones
5 clindamycin
In contrast to tetracycline staining of the teeth, which occurs in childhood and produces a brown discoloration along the gingival third, minocycline stains the permanent teeth in adults, with a gray-green discoloration of the mid-portion of the tooth.
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A 59 year-old woman is diagnosed with acute myelogenous leukemia. Induction chemotherapy is initiated. A few days later the patient develops tender erythematous plaques on her face. What is the most likely culprit drug?
1 Methotrexate
2 Cytarabine
3 5-fluorouracil
4 Cyclophosphamide
5 Hydroxyurea
The most likely diagnosis is neutrophilic eccrine hidradenititis. Cytarabine is the usual offending agent.
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Neutrophilic eccrine hidradenitis is associated most often with which chemotherapeutic agent?
1 5-fluorouracil
2 Cytarabine
3 Dactinomycin
4 Doxorubicin
5 Vinca alkaloids
Neutrophilic eccrine hidradenitis occurs in neutropenic patients with malignancies, usually acute myelogenous leukemia. Cytarabine is the most commonly associated medication.
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Which antihistamine has suppressor T-cell inhibitory activity?
1 Doxepin
2 Promethazine
3 Fexofenadine
4 Cimetidine
5 Cromolyn sodium
Cimetidine is an H2 antihistamine that has suppressor T-cell inhibitory activity, by competitively blocking their H2 receptors. Immunomodulatory effects are useful for treating mucocutaneous candidiasis, verruca vulgaris, and condyloma acuminata.
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Which of the following medications would you not want a woman using an IUD as her only source of contraception to take?
1 Ibuprofen
2 Cefalexin
3 Etanercept
4 Infliximab
5 Lidocaine
NSAIDS (including ibuprofen) and Azathiprine have been associated with IUD failure. The other listed medications are all pregnancy category B and should be safe for use in this patient.
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Vascular leak syndrome has been associated with which chemotherapeutic agent?
1 Denileukin diftitox
2 Cytarabine
3 Methotrexate
4 Bleomycin
5 Interferon
Denileukin difitox (brand name Ontak) is approved for the treatment of cutaneous T-cell lymphoma. Denileukin difitox is a fusion protein composed from a portion of IL-2 with diphtheria toxin. The chemotherapy is taken up by cells expressing high-affinity IL-2 receptors. Capillary leak syndrome presenting with hypotension, edema, pleural effusions, and weight gain caused by fluid retention has been reported in patients receiving denileukin difitox. Q/Q(M)-477151 Report a Problem
Which of the following statements regarding podophyllin is NOT correct?
1 It is derived from the May apple plant
2 It binds tubulin
3 It arrests cells in telophase
4 It is contraindicated in pregnancy
5 None (all of these statements are true)
Podophyllin is a crude cytotoxic extract from the May apple plant. It is antimitotic, arresting cells in metaphase (not telophase) by binding to the protein tubulin. It may be teratogenic and should not be used in pregnancy.
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Which of the following statements regarding drug interactions is true?
1 Drugs that induce CYP3A enzymes may decrease levels of drugs which act as substrates for CYP3A
2 CYP3A inhibitors may increase levels and cause toxicity of drugs metabolized by cytochrome P-450
3 Terbinafine is not metabolized by cytochrome P-450
4 Tobacco induces P-450 enzymes
5 All of the above are true
The most relevant drug interactions in dermatology involve the hepatic biotransformation pathways catalyzed by the cytochrome P-450 isoenzymes from the subfamilies CYP3A3/4. Drugs that induce CYP3A enzymes may decrease levels of drugs which act as substrates for CYP3A. CYP3A inhibitors may increase levels and cause toxicity of drugs metabolized by cytochrome P-450. Terbinafine is not metabolized by cytochrome P-450, but inhibits CYP2D6-mediated metabolism. Tobacco induces P-450 enzymes.
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The most specific marker of drug-induced lupus is:
1 Anti-histone Ab
2 ANA
3 Anti-Ro Ab
4 Anti-La Ab
5 Anti-ds DNA Ab
Which of the following is true regarding the use of cyclosporine?
1 Guidelines limit the continuous use of cyclosporine in the US to 5 years
2 Cyclosporine should not be used together with methotrexate
3 Cyclosporine is not an effective treatment for psoriatic arthritis
4 Cyclosporine inhibits the activation of antigen presenting cells
5 Cyclosporine has not shown efficacy in the treatment of chronic urticaria
Cyclosporine binds to cyclophilin, an intracellular immunophilin, and inhibits the activity of calcineurin phosphatase, which is then unable to phosphorylate NFAT. Guidelines limit the use of cyclosporine in the US to one year. Cyclosporine is an effective treatment for psoriatic arthritis, alone or in combination with methotrexate. Cyclosporine inhibits the activation of T-cells, NK cells, and antigen presenting cells. And cyclosporine has shown some efficacy in histamine resistant chronic urticaria.
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Clofazamine hyperpigmentation has been described as:
1 Dark hyperpigmented streaks in the nails
2 Red-brown hyperpigmentation within skin lesions
3 Blue-gray hyperpigmentation over the anterior shins, palate, ears
4 Slate gray-purple hyperpigmentation in a photo-exposed distribution
5 Yellow discoloration of the skin, sclera
Clofazamine can induce red-brown hyperpigmentation within skin lesions of patients with Hansen’s disease.
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Which of the following side effects has not been reported in association with intravenous immune globulin?
1 Headache
2 Flushing
3 Hypotension
4 Stevens-Johnson syndrome
5 Anaphylaxis
IVIG is used to treat several diseases including graft versus host disease, connective tissue disease, and autoimmune bullous dermatoses. Adverse effects include infusion reactions (headache, flushing, chills, myalgia, wheezing, achycardia, lower back pain, nausea, or hypotension). Anaphylaxis occurs rarely. Disseminated intravascular coagulation, transient neutropenia, and aseptic meningitis syndrome has been reported. Cutaneous adverse effects include eczematous eruptions and alopecia.
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Cyclosporine forms a complex to directly interfere with activation of what calcium-dependent protein?
1 NFAT-1
2 Calcineurin
3 Calmodulin
4 Cyclophilin
5 Cytochrome P-450
Cyclosporine inhibits calcineurin, a phosphatase activated in the presence of calmodulin and calcium, by cyclophilin. Cyclosporine forms a complex with cyclophilin, blocking its ability to activate calcineurin, and thus preventing calcineurin from phosphorylating NFAT-1, a transcription factor. NFAT-1, when phosphorylated can travel to the nucleus of cells, initiate IL-2 production, and stimulate T-cell proliferation.
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Which antibiotic is the treatment of choice for pregnant patients with Rocky Mountain Spotted Fever?
1 Amoxicillin
2 Doxycycline
3 Erythromycin
4 Chloramphenicol
5 Trimethoprim
Chloramphenicol is the treatment of choice for pregnant patients with Rocky Mountain Spotted Fever. In non-pregnant patients, the treatment of choice is Doxycycline.
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Which of the following oral agents has been effective in the treatment of Norwegian scabies?
1 Thiabendazole
2 Ivermectin
3 Mebendazole
4 Griseofulvin
5 Metroniddazole
Ivermectin (Stromectol) is an anti-helminthic agent currently FDA-approved for the treatment of strongyloides and onchocerciasis. Several publications have reported efficacy of this agent in the treatment of scabies and head lice. Due to its low rate of adverse effects, its high rate of effectiveness, and its ease of administration, some authors consider this agent to be the treatment of choice for scabies and head lice. The mechanism of action of ivermectin is blockade of glutamate-gated, chloride ion channels, with adverse effects on nerve and muscle resulting in paralysis and death of the helminth or mite. The drug has a very low affinity for mammalian chloride channels resulting in its relatively low toxicity. Adverse effects are rare and have been associated with accidental intoxication. It should be avoided when there is compromise of the blood-brain-barrier. Ivermectin is pregnancy category C. There are virtually no associated drug interactions with oral ivermectin therapy.
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The SPF of a sunscreen is based on applying the sunscreen at what concentration?
1 1 mg/cm2
2 2 mg/cm2
3 3 mg/cm2
4 4 mg/cm2
5 5 mg/cm2
A sunscreen SPF is based on using it at a concentration of 2 mg/cm2 which is about 1 ounce or 30 grams for the entire average sized body. It also is about 3-5 grams for the head and neck.
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