Pharm 2 - Extra Cards for Final Flashcards by Fiona Campbell

In what class of drugs is Tetrahydrozoline/Visine?

Ocular astringent, redness reliever

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What is the MOA of Tetrahydrozoline/Visine?

Vasoconstriction

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Name the Ocular Antihistamine drug.

Azelastine/Optivar

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What is the MOA of Azelastine/Optivar?

Blocks H1 receptor sites

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In what class of drugs is Ketorolac/Acular?

Ocular NSAID

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What is the MOA of Ketorolac/Acular?

COX inhibitor

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T/F. The use of ocular NSAIDS has increased risk for development of cataracts and drug induced glaucoma

False

These risks are associated with ocular steroids

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What is the MOA of Bacitracin-Polymyxin B/Polysporin Ophthalmic?

Inhibits bacterial protein synthesis

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Name the antiviral drug specifically used for HSV keratoconjunctivitis.

Vidarabine/Ara-A

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What is the MOA for Vidarabine/Ara-A?

Inhibits viral DNA synthesis

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What is the MOA of Timolol/Timoptic?

Blocks the ocular effects of epinephrine which serve to reduce the production of the aqueous humor.

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When is Timolol/Timoptic used and in what class is it found?

Glaucoma

Ocular Beta-adrenergic antagonist

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Which drug has SE (when absorbed systemically) that include worsening of asthma or emphysema, low blood pressure, fatigue, impotence?

Timolol/Timoptic

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Latanoprost/Xalantan is a selective prostaglandin receptor _________ (agonist/antagonist).

Agonist

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This drug may cause heterochromia, lengthening, thickening and darkening of the eyelashes.

Latanoprost/Xalantan

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What is the MOA of Latanoprost/Xalantan?

binds to prostaglandin receptor leading to improved aqueous humor outflow and reducing intraocular pressure.

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What immunosuppressive drug is used in the eye in low doses as a wetting agent?

Cyclosporine

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What is the MOA of Cyclosporine as a wetting agent?

T-cell inhibition reduces inflammation, allowing for an increase in tear production.

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What factors may increase topical drug penetration?

Decreased drug molecule size
Increased lipid content
Increased drug concentration within topical agent
Decreased skin integrity

In what class of drugs is Polymyxin B - Neomycin - Bacitracin/Neosporin?

Topical antimicrobial

What is the MOA of Polymyxin B-Neomycin-Bacitracin/Neosporin?

Bacteriacidal.
Polymyxin disrupts bacterial cell membrane.
Bacitracin disrupts bacterial cell wall.
(No mention of neomycin MOA)

T/F. Polymyxin B-Neomycin-Bacitracin/Neosporin is safe to use as an otic solution when there is a perforated TM.

False. Polymyxin B-Neomycin-Bacitracin/Neosporin as an otic solution should be avoided with perforated TM due to ototoxicity of Neomycin.

Which topical agent is typically used for impetigo and other skin infections caused by bacteria, especially Staph and Strep?

Mupirocin/Bactroban

What is the MOA of Mupirocin/Bactroban?

Inhibits bacterial protein synthesis

Which topical antibiotic may be used in combination with oral or IV antibiotics to treat MRSA?

Mupirocin/Bactroban

In what class of drugs is Ketoconazole/Nizarol, and what conditions might it treat?

Topical antifungal Tx for superficial fungal infxns such as tinea pedis, tines cruris, tinea corporis (ringworm), superficial yeast infxns, and seborrheic dermatitis.

What is the MOA of Ketoconazole/Nizarol?

Inhibits sterol synthesis

How many (numbered) classes of topical glucocorticoids are there? Which is the most potent?

7 different classes, numbered 1-7 Class 1 is most potent Class 7 is least potent

T/F. Halogenated corticosteroids are generally the most potent topical steroids.

True

T/F. Halogenated corticosteroids are awesome to use on the face.

False. Perioral dermatitis and rosacea may occur upon discontinuation.

What is the class and MOA of Hydrocortisone?

Class: Glucocorticoid/corticosteroid MOA: Anti-inflammatory. Affects gene transcription.

What are some indications for topical steroid use?

Atopic dermatitis Contact/allergic dermatitis Psoriasis Other autoimmune dz with skin involvement like bullous pemphigus, SLE, sarcoidosis

What are some potential side effects of topical steroids? Are they absorbed systemically through the skin?

Local: skin atrophy and striae, telengectasias, purpura, acneform lesions, overgrowth of fungus and bacteria. Yes, they are absorbed systemically. Possible systemic effects: suppression of HPA axis, increased risk for hyperglycemia, osteoporosis and osteonecrosis.

What are retinoids, and what do they modify?

Natural compounds and synthetic derivatives of retinol that exhibit vitamin A activity. Modify cellular proliferation and differentiation, immune fxn, inflammation, sebum production.

What are some diseases that are responsive to retinoids?

``` Cystic and papular acne Basal and squamous cell cancers Actinic keratosis Psoriasis Cutaneous aging ```

In what class of drugs is Tretinoin/Retin A?

Vitamin A derivative

What is the MOA of Tretinoin/Retin A?

Reduction of hyperkeratinization (which causes clogged pores - initial lesion in acne). Also increases epidermal thickness and dermal collagen synthesis.

What are some side effects of Tretinoin/Retin A?

Erythema, peeling, burning, stinging, photosensitivity.

In what class of drugs is Isoretinoin/Accutane?

Vitamin A derivative

What is the MOA of Isoretinoin/Accutane?

Reduction of hyperkeratinization, reduction of sebaceous gland number and sebum production, reduction of Propionibacterium acnes.

What pregnancy category is Isoretinoin/Accutane?

Category X | Teratogen!

What symptoms are included in the package insert warning for Isoretinoin/Accutane?

Depression, psychosis, suicidal ideation, suicide attempts, and suicide.

Phototherapy vs. photochemotherapy

Phototherapy: Use of electromagnetic non-ionizing radiation (usually UVA and UVB) as a therapeutic agent. Photochemotherapy: Phototherapy with the inclusion of a chemical agent such as Psoralen.

What does "PUVA" stand for and what is the MOA?

PUVA = "Psoralen and UltraViolet A." Patient is first given Psoralen and then exposed to UVA light. MOA not fully understood. Evidence that the therapy induces an anti-inflammatory effect through immunosuppression and inhibition of DNA synthesis.

What is PUVA therapy used for?

Treatment of psoriasis. Has also been proven effective for tx of vitiligo by stimulating melanocyte proliferation. May also be used for T-cell lymphoma, alopecia areata, and urticaria pigmentosa.

What are the side effects of PUVA?

Acute: nausea, painful erythema, blistering. Long-term: Increased risk of skin cancer. Chronic: Advanced skin aging, actinic keratosis.