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MSK II: Test 1 > Pharm: Derm > Flashcards

Pharm: Derm Flashcards

1
Q

bacitracin

A
  • antibacterial agent

MOA: inhibits cell wall synthesis

tx: gram positive organism a - i.e. strep and staph, and some anaerobes

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2
Q

mupirocin

A
  • antibacterial agent

MOA: inhibits protein synthesis

tx: gram positive bacteria including MRSA

** tx for impetigo caused by S. aureus and B-hemolytic strep

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3
Q

polymyxin B sulfate

A
  • antibacterial agent

MOA: binds phsopholipids and increases permeability of cell wall
** a main ingredient in neosporin

tx: gram negative organisms

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4
Q

Neomycin

A
  • antibacterial agent

MOA: binds 30s

tx: gram negative organisms

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5
Q

gentamicin

A
  • antibacterial agent

MOA: binds 30s

tx: gram negative

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6
Q

Clindamycin

A
  • antibacterial agent for acne

MOA: binds to 50s

Note: activitity against P. acnes

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7
Q

Erythromycin

A
  • antibacterial agent for acne

MOA: binds 50s

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8
Q

Metronidazole

A
  • antibacterial agent for acne

MOA: interacts with DNA causing srang breakage

tx: acne roscea

NOTE: CI during pregnancy

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9
Q

Acyclovir/penciclovir

A

topical antiviral

MOA: converted to pharmacologically active triphosphate metabolites, inhibit DNA synthesis and viral replication

Topical – modest benefit for herpes labialis

Also used systemically for HSV and VZV infections

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10
Q

docosanol

A

topical antiviral

MOA: inhibits fusion between the plasma membrane and the HSV envelope, thereby preventing viral entry and replication

When applied within 12 hours of the onset of prodromal symptoms, five times daily, median healing time was shortened by 18 hours compared with placebo in recurrent orolabial herpes

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11
Q

ciclopirox olamine

A

Topical antifungal

MOA: inhibits uptake of precursors of macromolecule synthesis

Uses: topical dermatomycosis, candidiasis, tinea versicolor, mild-to-moderate onychomycosis

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12
Q

Allylamine - terbinafine

A

Topical antifungal

MOA: inhibits squalene epoxidase

Uses: tinea corporis, tinea cruris, and tinea pedis

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13
Q

butenafine

A

Topical antifungal

MOA: inhibits squalene epoxidase

Uses: tinea corporis, tinea cruris, and tinea pedis

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14
Q

nystatin

A

Topical antifungal

MOA: binds ergosterol in fungal cell membrane altering permeability

Nystatin limited to topical cutaneous and mucosal uses = Thrush

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15
Q

amphotericin B

A

Topical antifungal

MOA: binds ergosterol in fungal cell membrane altering permeability

Amphotericin B broad antifungal spectrum but rarely used topically
= Cumulative organ toxicity (ampho-terrible)

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16
Q

imiquimod

A

imunomodulator

MOA: may be related to stimulation of peripheral mononuclear cells to release interferon-α and macrophage stimulation to produce interleukins-1, -6, -8, and TNF-α

Uses: external genital and perianal warts in adults, actinic keratoses on the face and scalp, biopsy-proven primary basal cell carcinomas on the trunk, neck, and extremities (< 2 cm diameter)

ADRs: local inflammation, pruritus, erythema, superficial erosion

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17
Q

tacrolimus/pimecrolimus

A

imunomodulator

MOA: inhibit T-lymphocyte activation and prevent release of inflammatory cytokines and mediators from mast cells

Uses: treatment of atopic dermatitis and psoriasis

**traditionally used to prevent heart, liver, and kidney allograft rejection due to potent immunosuppressive activity (oral forms)

Topical ADRs: transient erythema, burning, and pruritus

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18
Q

retinoic acid, tretinoin

A

topical acne prep
= acid form of Vitamin A

MOA: may decrease cohesion b/w epidermal cells and increase cell turnover

AE: erythema, mild peeling, dryness, increased photosensitivity

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19
Q

adapalene

A

acne: topical retinoic acid derivative

MOA: may decrease cohesion b/w epidermal cells and increase cell turnover

  • photochemically more stable and less irritating than tretinoin

used to tx mild-moderate acne vulgaris

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20
Q

tazarotene

A

acne: topical retinoic acid derivative

MOA: may decrease cohesion b/w epidermal cells and increase cell turnover

approved for psoriasis, acne and photoaging

NOTE: CI for pregnant women!

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21
Q

Isotretinoin

A

= accutane: oral retinoid

MOA: reduces sebacerous gland size, reduces sebum production

tx: severe cystic acne!

PK: t1/2 10-20 hours; hepatic metabolism; highly protein bound (99-100%)

ADRs: resemble hypervitaminosis A (dryness and itching)

DONT USE DURING PREGNANCY!

22
Q

benzoyl peroxide

A

acne preparation

MOA: releases free-radical oxygen and oxidizes bacterial proteins in the sebaveous follicles

tx: p. acnes

23
Q

acitretin

A

systemic psoriasis tx - retinoic acid derivative
* not as effective as other systemic therapies

tx: severe psoriasis

SE: similar to isotretinoin
CI: pregnant women

24
Q

tazarotene

A

psoriasis tx

topical retinoid - extended response

25
Q

calcipotriene

A

psoriasis tx

MOA: synthetic vitamin D3 analog

– as effective as topical glucocorticoids but slower onset; no long-term glucocorticoid adverse effects

26
Q

cyclosporine

A

tx psoriasis

MOA: inhibits calcineurin and thus IL-2, IL-2 and blocks T cell activation

tx for psoriasis, RA, and transplants

ADRs: nephrotoxicity, hypertension, hepatotoxicity, gingival hyperplasia, and hirsutism

Used in extensive disease in patients who are unresponsive to other agents

TB must be ruled out prior !!

27
Q

etanercept

A

TNF inhibitor: tx psoriasis

MOA: prevents TNF mediated immune responses

ADRs: risk of serious life-threatening infections (sepsis, pneumonia), exacerbation of congestive heart failure, and cause demyelinating disease in predisposed patients

TB must be ruled out prior !!

28
Q

infliximab

A

TNF inhibitor: tx psoriasis

MOA: prevents TNF mediated immune responses

ADRs: risk of serious life-threatening infections (sepsis, pneumonia), exacerbation of congestive heart failure, and cause demyelinating disease in predisposed patients

TB must be ruled out prior !!

29
Q

adalimumab

A

TNF inhibitor: tx psoriasis

MOA: prevents TNF mediated immune responses

ADRs: risk of serious life-threatening infections (sepsis, pneumonia), exacerbation of congestive heart failure, and cause demyelinating disease in predisposed patients

30
Q

hydrocortisone

A

anti-inflamm: topical corticosteroid

tx: psoriasis, dermatitis

Low to medium efficacy produce remission in disorders responsive to corticosteroids: seborrheic dermatitis, psoriasis of genitalia and face

ADRs: suppression of pituitary-adrenal axis
Atrophy, steroid rosacea, steroid acne, allergic contact dermatitis

31
Q

triamcinolone

A

anti-inflamm: topical corticosteroid

tx: psoriasis, dermatitis

ADRs: suppression of pituitary-adrenal axis
Atrophy, steroid rosacea, steroid acne, allergic contact dermatitis

32
Q

acetonide

A

anti-inflamm: topical corticosteroid

tx: psoriasis, dermatitis

ADRs: suppression of pituitary-adrenal axis
Atrophy, steroid rosacea, steroid acne, allergic contact dermatitis

33
Q

betamethasone

A

anti-inflamm: topical corticosteroid

tx: psoriasis, dermatitis

low efficacy : (betamethasone valerate)= produce remission in disorders responsive to corticosteroids: seborrheic dermatitis, psoriasis of genitalia and face

high efficacy: betamethasone dipropionate: useful in disorder less responsive to corticosteroids: psoriasis of palms and soles, sarcoidosis

ADRs: suppression of pituitary-adrenal axis
Atrophy, steroid rosacea, steroid acne, allergic contact dermatitis

34
Q

salicyclic acid

A

keratolytic/ peeling agent

Uses: acne, seborrheic dermatitis, psoriasis, hyperkeratosis (corns, plantar warts, calluses); in combination with antifungal sodium thiosulfate for tinea versicolor

NOTE: can be destructive to tissues at concentrations greater than 6%

Salicylate toxicity can occur (nausea, vomiting, dizziness, loss of hearing, tinnitus, lethargy, diarrhea, psychic disturbances)

lower dose: used for acne
higher dose: used for warts

35
Q

antihistamine

A

antipruritic agent

First generation H1-receptor antagonists
Diphenhydramine, promethazine
- Some anticholinergic activity, sedating, useful in nocturnal pruritus

Second generation H1-receptor antagonists
Cetirizine, loratadine, desloratadine, fexofenadine
- Do no cross blood-brain barrier, lack anticholinergic side effects, non-sedating

36
Q

mioxidil

A

= rogaine: promotes hair growth

MOA: unknown
Originally developed as an antihypertensive (PO dosing)

Percutaneous absorption minimal but systemic effects on BP should be monitored in those with cardiac disease

37
Q

finasteride

A

= propecia : promotes hair growth
- tx. alopecia and BPH

MOA: competitive and selective inhibitor of steroid 5α-reductase; blocks the conversion of testosterone to dihydrotestosterone (DHT)

ADRs: decreased libido, ejaculation disorders, erectile dysfunction

Pregnant women should not handle drug

38
Q

rate of absorption

A
  • concnetration gradient (c)
  • partition coefficient (Km)
  • diffusion through skin (d)

rate is indirectly proportional to the thickness of stratum cornea

J = C x Km x D/x

39
Q

what do you use for acute inflammation with oozing, vesiculation and crusting?

A

tinctures, wet dressings, and lotions - these evaporate and take off the fluid

40
Q

what to use for chronic inflamm. with xerosis, scaling and lichenification?

A

cremes and ointments

41
Q

drying –> lubricating preparations

A

tinctures < wet dressings < lotions < gels < aerosols < powders < pastes < creams < ointments

42
Q

what makes up neosporin?

A

bacitracin, polymyxin B, neomycin

43
Q

tx approach for impetigo?

A

nonbullous impetigo: topical mupirocin therapy for 5 days

extensive impetigo with bullous formation: oral antimicrobials

44
Q

-azoles

A

topical antigungal

MOA: inhibits synthesis of ergosterol (an essential component of fungal membranes)

Uses: tinea corporis (ring worm), tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea versicolor, and cutaneous candidiasis, such as vaginal yeast infections, infections of the skin, diaper rash, and thrush (candidiasis of the oral mucosa and tongue, and sometimes the palate, gingivae, and floor of the mouth)

45
Q

tolnaftate

A

antifungal agent

MOA: unknown

Uses: tinea pedis, tinea cruris, and tinea corporis

46
Q

tx of tinea capitis

A

itraconazole

47
Q

tx of tinea pedis, cruris, corporis?

A

topical antifungals

48
Q

tx of thrush?

A

oral nystatin, clomitazoe, or fluconazole

49
Q

tx of esophageal candidiasis?

A

systemic antifungal

50
Q

tx of vuvovaginalis?

A

topical antifungla, oral fluconazole

51
Q

acne treatment approach?

A

Comedonal (non-inflammatory) acne:

  • Topical retinoid
  • Alternatives: azelaic acid, salicylic acid

Mild papulopustular and mixed acne:
- Topical retinoid AND topical antimicrobial (BPO alone or BPO +/- topical antibiotic)

Moderate papulopustular and mixed acne
- Topical retinoid AND oral antibiotic AND topical BPO

Moderate nodular acne
- Topical retinoid AND oral antibiotic AND topical BPO

Severe nodular/conglobate acne
- Oral isotretinoin

52
Q

topical therapy for psoriasis?

A

Emollients – used as basic adjunct; reduces scaling, itching, and related discomfort

Keratolytics – reduce hyperkeratosis; enable other topical drugs to penetrate

Topical glucocorticoids – rapid response; control inflammation and itching; mainstay of topical treatment

Anthralin – used for widespread, refractory plaques

Calcipotriene – as effective as topical glucocorticoids but slower onset; no long-term glucocorticoid adverse effects

Tazarotene – extended response; maintenance therapy

MSK II: Test 1 (7 decks)

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