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Intro to D&D Midterm > Pharm - atopic derm/psoriasis > Flashcards

Pharm - atopic derm/psoriasis Flashcards

1
Q

psoriasis is what kind of disorder

A

immune and inflammatory

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2
Q

name 5 local psoriasis treatment options

A

topical CS
coal tar
vitamin D analogues
UV light
calcineurin inhibitors

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3
Q

can anti TNF drugs be used in psoriasis?
name them

A

yes

adalimumab
golimumab
etanercept
infliximab
certolizumab

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4
Q

name 4 calcineurin inhibitors that can be used for psoriasis

A

tacrolimus
pimecrolimus
cyclosporin
voclosporin

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5
Q

name 2 classes of drugs used in psoriasis

A

hydrating agents
antipruritics

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6
Q

___ in ___ preparations can be used as hydrating agents in psoriasis

A

water in oil

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7
Q

what class of antipruritics are preferred in psoriasis patietns

A

1st generation antihistamines like diphenhydramine and hydroxyzine

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8
Q

are antidepressants used in psoriasis?
what is the concern?

A

yes – for their sedation and antihistamine effect

concern - falls in the elderly and anticholinergic effects

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9
Q

what does calcipotriene do
is it a steroid?

A

NOT a steroid

a synthetic vitamin that slows the growth of skin cells
used in psoriasis

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10
Q

explain how calcineurin inhibitors work

A

prevent the dephosphorylation of NFAT

when NFAT is dephosphorylated, it goes into the nucleus and increases expression of genes encoding for IL-2, which promotes the release and activity of T cells

suppressess mainly T CELL ACTIVITY

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11
Q

true or false

calcineurin inhibitors suppress mainly B cell activity

A

false - T cell

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12
Q

calcineurin inhibitors cause decreased ____, ____ and _____

A

decreased NFAT, IL-2, and T cell activation

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13
Q

what is the black box warning of calcineurin inhibitors

A

increase in malignancies

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14
Q

major issue with calcineurin inhibitors is that they are _____ toxic

A

nephro

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15
Q

calcineurin inhibitors have highly variable ______
explain*****

A

highly variable pharmacokinetics

they have highly variable absorption – need to always be administered under same conditions

may have competition for biotransformation and elimination

KINETICS ARE NOT DEPENDABLE

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16
Q

which calcineurin inhibitor is the “best of the bunch” as far as not having highly variable kinetics

A

pimecrolimus

17
Q

since calcineurin inhibitors have variable pharmacokinetics, what should be monitored

A

concentration 2 hours post dose (cyclosporin) and at C0 (tacrolimus)

18
Q

which calcineurin inhibitor has the most highly variable GI absorption

A

cyclosporin

19
Q

since calcineurin inhibitors are known to cause nephrotoxicity, what should be monitored?

A

labs like creatinine and BUN

pt should always be hydratedq

20
Q

why is IFNY used in psoriasis pts

A

because in psoriasis patients the response to IFN is attenuated or absent

21
Q

name 2 PDE4 inhibitors

A

apremilast
crisaborole

22
Q

differentiate between the safety of the 2 PDE4 inhibitors apremilast and crisaborole

A

apremilast is an older drug. enters the brain and may cause severe side effects like anorexia and depression

crisaborole however does not enter the brain and does not have these severe psych side effects

23
Q

true or false

crisaborole is not a steroid

A

TRUE

it is a PDE4 inhibitor

24
Q

aside from crisaborole and apremilast, name 2 other PDE4 inhibitors and what they’re used for

A

roflumilast and cilomilast

used in COPD and emphysema for their anti inflammatory effects in smooth muscle

25
Q

name 3 main medications that can trigger or exacerbate acne

A

anabolic steroids
sex sterouds
corticosteroids

26
Q

carbamazepine can do what

A

trigger or exacerbate acne

27
Q

lithium can….

A

trigger acne

28
Q

what is an important consideration of retinoic acid drugs

A

highly lipophilic – can enter the body even topically

29
Q

name some side effects of retinoids**8

A

teratogenic (oral)
very lipophilic and can enter the body even when given topically
may worsen acne at first, cause dry, cracked skin, skin eruptions, lesions

30
Q

what are RARS

A

retinoic acid receptors

retinoids bind to

31
Q

name some drugs that put you at risk for stephens johnson syndrome

A

NNRTI (in HIV+ pts)
anticonvulsants
sulfonamides
anti malarials
antibiotics
NSAIDS (oxicams)
antifungals

32
Q

toxic epidermal necrolysis

A

“scalded” skin disease – developed from SJS
skin sheets off
females with SJS more likely to develop than men

33
Q

what is a clear sign of the beginnings of stevens johnson syndrome

A

a BLISTERING RASH

34
Q

What population is MOST likely to develop SJS

A

HIV infected patients

35
Q

why do drug manufacturer’s not test for the potential risk of SJS

A

cant be tested for unless its in humans

36
Q
A

Intro to D&D Midterm (29 decks)

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