Pharm Flashcards

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1
Q

Physical Sunscreens

A

Inorganics- titanium dioxide, zinc oxide

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2
Q

Chemical Sunscreens

A

cinoxate, para-aminobenzoic acid, trolamine, dioxybenzone, oxybenzone

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3
Q

Ustekinumab MOA

A

binds p40 subunit integral to IL12 and 23 activation. Tx psoriasis

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4
Q

AE of Ustekinumab

A

increased risk of infection and neoplasia, live virus vaccine contraindicated, test for TB before tx, anaphylaxis possible

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5
Q

BBW of infliximab

A

infection, neoplasia

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6
Q

Infliximab contraindications

A

heart failure, murine protein hypersensitivity

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7
Q

Etanercept contraindications

A

sepsis. BBW infections, neoplasia

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8
Q

Adalimumab BBW

A

infection, neoplasia

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9
Q

Target RAR

A

tretinoin, adapalene, tazarotene

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10
Q

Target RXR

A

bexarotene, alitretinoin

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11
Q

All oral retinoids are

A

potent teratogens

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12
Q

Calcipotriene MoA

A

topical, binds to Vit D receptor, RXRalpha - modulates epidermal differentiation and inflammation, improves psoriatic plaques

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13
Q

AE Calcipotriene

A

topical irritant, hypercalcemia, hypercalciuria, abdominal pain, constipation, depression, fatigue, HTN, anorexia, weight loss, muscle weakness, N/V, thirst, increased susceptibility to UV induced skin cancer

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14
Q

Benzoyl Peroxide

A

topical pro drug converted to benzoic acid in skin, free radicals kill nearby P. Acnes

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15
Q

AE Benzoyl Peroxide

A

dry skin, peeling, erythema, irritation, avoid mucous membrane contact, may bleach hair and clothing

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16
Q

Clindamycin MoA

A

Acne med. inhibits protein synthesis (50s). Lots of resistance within P. Acnes.

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17
Q

Basal Cell Tx

A

cisplatin, cyclophosphamide, doxorubicin, fluorouracil, MTX, vinblastine. Imiquimod, Vismodegib

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18
Q

SCC Tx

A

cisplatin

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19
Q

Melanom Tx

A

carmustine, dacarbazine, dactinomycin, docetaxel, lomustine, vinblastine. Aldesleukin, interferon, ipilimumab, sorafenib, trametinib, vemurafenib

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20
Q

Actinic keratosis Tx

A

fluorouracil, diclofenac, imiquimod, trichloroacetic acid

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21
Q

Imiquimod MoA

A

small molecule tumor directed immune response initiator, activates TLR7/8 and NFKB -> upreg of TNFalpha and interleukins. Prevents transcriptional upregulation of GL1

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22
Q

Imiquimod uses

A

BCC, Actinic keratosis, HPV

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23
Q

AE Imiquimod

A

allergies to benzyl alcohol and paraben components, skin rxns common (mild to mod), increased photosens, can compromise condoms and diaphragms

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24
Q

Aberrant SHH signaling implicated in

A

Basal Cell Carcinoma. Leads to upreg of anti apop Bcl2, VEGF, angiopoietins. Pathway seems to be ligand independent, so must block at SMO or lower

25
Q

Vismodegib MoA

A

oral SMO inhibitor, lipophilic with extensive metabolism

26
Q

BBW of Vismodegib

A

fetal death, male teratogenecity, verify pt is not pregnant!

27
Q

AE of Vismodegib

A

Alopecia, GI toxicity (N/V/D) common, weight loss, fatigue + BBW

28
Q

Imiquimod is Category

A

C

29
Q

Methotrexate is Category

A

X

30
Q

Aldesleukin MoA

A

binds to cell surface IL2 receptor induces prolif and differentiation of B and T cells, monos, macros, CTLS and NK cells

31
Q

Aldesleukin administered

A

IV or SC

32
Q

BBW of Aldesleukin

A

contraindicated in pts with CNS, cardiac, pulmonary disease. Capillary leak syndrome

33
Q

Aldesleukin contraindicated in

A

pts with CNS, cardiac, pulm, renal, hepatic disease or organ transplant

34
Q

AE Aldesleukin

A

hypotension, s-tach, peripheral vasodilation, SVT, diminished mental status, speech diff, cortical blindness, limb or gait ataxia, hallucinations, agitation, dyspnea, pulm congestion, rales, rhonchi, renal failure caused by cap leak syndrome

35
Q

Aldesleukin uses

A

Melanoma

36
Q

Interferon alpha 2b administered

A

IV or SC

37
Q

Interferon alpha 2b

A

Immunomodulator

38
Q

Interferon alpha 2b BBW

A

caution in autoimmune disease, cardiac disease, depression

39
Q

AE Interferon alpha 2b AE

A

caution in autoimmu, cardiac, depression, infection. Flu like rxn, neutropenia, leukopenia, anemia, alopecia, elevated LFTs, cough, dyspnea, pulm infiltrates, pneumonitis

40
Q

Monitor in Interferon alpha 2b use

A

CBC, LFT, CXR

41
Q

Ipilimumab MoA

A

CTLA-4 recomb antibody (cytotoxic t lympho assoc antigen 4) Bolsters antitumor response of immune system

42
Q

Ipilimumab BBW

A

adrenal insuff, diarrhea, Guillan Barre, hepatitis, hyperthyroid, hypothyroid, myastenia gravis, per neuropathy, pregnancy, serious rash

43
Q

Ipilimumab AE

A

dermatitis including TEN (toxic epidermal necrolysis), tiredness, diarrhea, itching, rash + BBW

44
Q

Ipilimumab used for

A

melanoma tx

45
Q

Sorafenib MoA and use

A

oral multikinase inhibitor (VEGF, PDGFR, KIT, Raf kinase) Tx melanoma

46
Q

AE Sorafenib

A

elevated LFTs, peripheral neuropathy, rash/desquam, anemia, bone marrow supp, neutropenia, Cat D, increased bleeding in GI system, respiratory system, brain

47
Q

Trametinib MoA

A

oral reversible MEK inhibitor

48
Q

Trametinib used in pts with

A

BRAF V600E/K mutations

49
Q

Trametinib AE

A

skin toxicity, dermatitis, erythema, hand-foot, diarrhea, stomatitis, anemia, decreased ejection fraction, HTN, hemorrhage, rare cardiomyopathy, interstitial lung disease, retinal pigment epithelial detachment

50
Q

Vemurafenib MoA

A

oral inhibitor of mutated BRAF, genotype required for mutation evaluation

51
Q

AE Vemurafenib

A

PGP and CYP interactions possible, elevated serum creatinine, QT prolongation, photosens, cutaneous SCC in 1/4 pts, SJS possible, uveitis, iritis, retinal vein occlusion

52
Q

Monitor in Vemurafenib use

A

LFT, skin, ECG and electrolytes, eyes

53
Q

Vemurafenib is Category

A

D

54
Q

Sorafenib is Category

A

D

55
Q

Trametinib is Category

A

D

56
Q

Ald, ipi, and interferon A are category

A

C

57
Q

MC AE in Vemurafenib

A

arthralgia, fatigue, rash, photosens, alopecia, N/D

58
Q

Diclofenac

A

tx actinic keratosis, PGE2 inhibitor. AE: rash, itch, dry skin, peeling, redness

59
Q

Trichloroacetic acid

A

tx actinic keratosis. chemical peel. AE: burning, inflammation, local tenderness