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Derm MSK > Pharm > Flashcards

Pharm Flashcards

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Dermatology Board Prep flashcards
1
Q

Polysporin

A

bacitracin and polymyxin

for scrapes and cuts

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2
Q

bacitracin MOA

A

disrupts gram positive cell wall

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3
Q

polymyxin MOA

A

polypeptide cationic detergent targets gram negative

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4
Q

neomycin

A

MOA: aminoglycoside that disrupts gram-
Adverse – contact dermatitis and systemic toxicity
Use: scrapes and cuts

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5
Q

Muprocin MOA

A

MOA: inhibits gram+ protein synthesis by inhibiting isol-tRNA synthetase

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6
Q

Muprocin adverse

A

Adverse: contact dermatitis, burning rash, not for systemic infection

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7
Q

Muprocin uses

A

Use: folliculitis, nonbullous impetigo, bullous impetigo

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8
Q

doxycycline MOA

A

inhibits protein synthesis by binding to the 30S ribosomal subunit

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9
Q

doxycycline adverse

A

photosensitivity, stained teeth

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10
Q

doxycycline uses

A

furuncle, lyme disease, rocky mountain spotted fever, ocular rosacea, acne

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11
Q

clindamycin MOA

A

inhibits protein synthesis by binding to the 50S ribosomal subunit

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12
Q

clindamycin uses

A

furuncle

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13
Q

TMP SMX MOA

A

overall inhibits folic acid synthesis
SMX inhibits the synthesis of DHF acid
TMP inhibits thymidine and DNA synthesis

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14
Q

vancomycin MOA

A

binds D-Ala-D-Ala to inhibit transpeptidase

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15
Q

Bullous impetigo treatment

A

Muprocin and nafcillin

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16
Q

scalded skin syndrome treatment

A

dicloxacillin or vancomycin

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17
Q

miconazole MOA

A

inhibits ergosterol synthesis

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18
Q

miconazole uses

A

tinea

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19
Q

terbinafine MOA

A

inhibits squalene epoxidase to interfere with ergosterol synthesis

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20
Q

metronidazole uses

A

rosacea

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21
Q

metronidazole MOA

A

inhibits nucleic acid synthesis in anaerobes

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22
Q

clindamycin adverse

A

pseudomembranous colitis

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23
Q

dapsone MOA

A

antifolate; inhibits bacterial synthesis of DHF acid

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24
Q

dapsone uses

A

acne, psoriasis, dermatitis herpetiformis and lichen planus

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25
Q

dapsone adverse

A

hemolytic anemia esp in G6P

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26
Q

sulfacetamide MOA

A

antifolate; PABA analog that inhibits dihydropteroate synthase

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27
Q

sulfacetamide adverse

A

SJS esp in HIV

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28
Q

calcineurin topical inhibitor examples

A

pimecrolimus, tacrolimus,

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29
Q

pimecrolimus, tacrolimus, MOA

A

inhibit calcineurin phosphatase to decrease IL2 and other cytokines

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30
Q

pimecrolimus, tacrolimus, uses

A

psoriasis, severe atopic dermatitis, auto-immune

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31
Q

pimecrolimus, tacrolimus, adverse

A

immunosuppression, nephrotoxic, hypertriglyceridemia, hypertension
Black box: lymphoma and skin cancer risk

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32
Q

imiquimod uses

A

warts, actinic keratoses, basal cell carcinoma

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33
Q

imiquimod MOA

A

activates immune cells via TLR7 and Langerhans

Stimulates TNFa and macrophages, and antiviral

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34
Q

methotrexate MOA

A

DHFRi that suppresses T cells, adenosine can be anti-inflammatory

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35
Q

methotrexate adverse

A
  • Adverse: can be toxic with NSAIDs, nausea, GI, liver enzymes, teratogen
  • Black box – myelosuppression
  • Potential risk for infection
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36
Q

methotrexate uses

A

RA, autoimmune, abortion

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37
Q

infliximab / Adalimumab MOA

A

TNFa monoclonal that binds TNFa and stops mediated lymphocyte activation

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38
Q

infliximab / Adalimumab uses

A

RA

39
Q

infliximab / Adalimumab / etanercept adverse

A
  • Adverse: headaches, URIs
  • Black box: fungal opportunistic infections (check TB test), lymphoma
  • Do not use TNFai in MS patients
40
Q

etanercept MOA

A

decoy fusion protein that binds TNFa and decreases TNFaR1 activity
Neutralizing antibodies cannot be produced

41
Q

anakinra MOA

A

IL1ra antagonist

reduces T cell activation by IL1

42
Q

anakinra adverse

A

nausea, GI, toxicity with TNFai

43
Q

tocilizumab MOA

A

IL6R antibody

IgG prevents IL6 from activating receptor and reduces T helper activation and thus reduces B cell synthesis

44
Q

tocilizumab adverse

A

dyslipidemia, hepatotoxicity, malignancy risk (avoid if patient has melanoma)

45
Q

utsekinumab MOA

A

IgG1 monoclonal antibody binds IL12p40 and IL23 to prevent cytokines from activating receptors and reduces IL23 effect

46
Q

utsekinumab uses

A

psoriatic arthritis, can also treat RA, Crohn’s, sarcoidosis

47
Q

utsekinumab adverse

A

: RPLS (reversible posterior leukoencephalopathy syndrome), headaches, seizures, CYP450, flu-like, URIs, infections, malignancy, allergic rxns

48
Q

Abatacept MOA

A

fusions protein binds CD80-86 on APCs to prevent binding of co-stimulatory CD28 and thus reduces activation of T cells

49
Q

abatacept indications

A

RA add on (avoid with TNFa or IL1)

50
Q

abetacept adverse

A

opportunistic infections and malignancy (lymphoma

51
Q

rituximab MOA

A

CD28 B cell monoclonal antibody that selectively depletes B cells and decreases autoimmune response

52
Q

rituximab adverse

A

cytokine release syndrome (fever, nausea), aplastic anemia

Black Box: PML

53
Q

leflunomide MOA

A

active metabolite A77-1726 inhibits dihydrooronate dehydrogenase to decrease pyrimidine synthesis and suppress T cells

54
Q

leflunomide adverse

A

hepatotoxic, teratogen

55
Q

leflunomide uses

A

Disease-modifying anti-rheumatic drugs

56
Q

sulfasalazine MOA

A

converted to 5ASA which reduces inflammation, IgA, IgM and T cell

57
Q

sulfasalazine adverse

A

SJS-TENs, GI, hemolytic anemia

58
Q

sulfasalazine uses

A

add on for RA, also Crohn’s and UC

59
Q

hydroxychloroquine MOA

A

antimalarial that suppresses APC, TLRs and decrease T cell activation

60
Q

hydroxychloroquine adverse

A

myopathy, retinopathy, SJS-TENS, pruritis, worsen psoriasis

61
Q

hydroxychloroquine uses

A

RA and psoriasis

62
Q

cyclosporine MOA

A

binds cyclophilin to block calcineurin NFAT activation to decrease IL1 and 2

63
Q

cyclosporine uses

A

RA, transplants, psoriasis, SLE

64
Q

cyclosporine adverse

A

renal dysfx, nephrotoxicity, HTN, malignancy

65
Q

belilmumab MOA

A

BLyS inhibitor for psoriasis

66
Q

rituximab uses

A

pemphigus vulgaris, RA, some cancers

67
Q

cephalosporins MOA

A

binds to PBPs to inhibit cell wall synthesis

68
Q

benzoyl peroxide MOA

A

oxidization to benzoic acid kills bacteria in skin

69
Q

benzoyl peroxide adverse

A

for acne;

itching, peeling, dermatitis

70
Q

azelaic acid uses

A

mild acne, 1st line rosacea, hyperpigmentation disorders

71
Q

retinoids MOA (isoteretinion)

A

binds at RAR to alter gene transcription to reduce cell hyperplasia
also has antimicrobial activity and enhances cell mediated toxicity

72
Q

retinoids uses (isoteretinion)

A

1st line mild to severe acne, psoriasis, photodamaged skin, wrinkles

73
Q

retinoids adverse (isoteretinion)

A

tumorigenic with UVR, erythema, dryness, irritation, IBD, ELE, dryness, photosensitivity, SJS-TENS, vasculitis, hypertriglyceridemia, teratogenic (MUST be on birth control)

74
Q

cholecalciferol (D3 form) MOA

A

activated in liver and kidney to increase serum calcium and decrease PTH

75
Q

cholecalciferol (D3 form) indications

A

osteoporosis prevention, rickets prevention, hyperparathyroidism, CKD

76
Q

Alendronate, risedronate MOA

A

bisphosphonates
bind hydroxyapatite crystal to inhibit osteoclast activity and attachment to bones, also decrease osteoclast survival by inhibiting farnesyl pyrophosphate synthase

77
Q

Alendronate, risedronate adverse

A

GI, reflux, esophageal cancer, jawbone osteonecrosis

78
Q

denosumab MOA

A

monoclonal antibody to RANKL to prevent osteoclast formation
avoid if hypocalcemia

79
Q

raloxifene MOA

A

SERM
partial agonist at bone estrogen receptors to counteract menopausal bone loss
decrease breast cancer risk
causes clots and hot flashes

80
Q

teriparatide MOA

A

PTH analogue that mimics anabolic PTH effects at low doses = activates osteoblasts

81
Q

teriparatide adverse

A

high doses can be catabolic and activate osteoclasts

o Black box: osteosarcoma

82
Q

abaloparatide MOA

A

less homology to PTH than teriparatide, PTHR1 receptor agonist primarily to be anabolic towards bone

83
Q

abaloparatide adverse

A

hypercalciuria, kidney stones, osteosarcoma

84
Q

calcitonin MOA

A

binds to osteoclasts to inhibit resorption and reduces Ca and PO4 resorption from kidney

85
Q

calcitonin adverse

A

Hypocalcemia

86
Q

NSAIDs

A

 MOA: Inhibits COX to decrease PG synthesis
 Use: Indomethacin (first line)
 Do not use: aspirin (may increase uric acid)
 Adverse: marrow suppression (indo), GI, cardio, renal

87
Q

colchicine

A

 MOA: inhibits tubulin to decrease mitosis, microtubules, phagocytosis
 Adverse: GI upset, diarrhea, hepatic and renal necrosis

88
Q

Allopurinol, febuxostat

A

xanthine oxidase inhibitors
• MOA: metabolized by XO to alloxanthine that irreversibly inhibits XO
• Adverse: GI (diarrhea), SJS-TENS, vasculitis
• Dangerous drug interaction with azathioprine or mercaptopurine due to XO inhibition
• Avoid with thiopurines, warfarin and aspirin

89
Q

probenecid

A

uricosurics
• MOA: organic acid that decreases body urate and thus decreases uric acid resorption
• Adverse: kidney stones, GI, aplastic anemia

90
Q

staph antibiotics

A

oxacillin, cefazolin

91
Q

MRSA antibiotics

A

vanco or dapto

92
Q

neisseria antibiotics

A

ceftriaxone

93
Q

pseudomonas antibiotics

A

cephalosporin; carbapenem or fluoroquinolone + tobramycin

Derm MSK (2 decks)

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