Pharmacology part 2 Flashcards
What medication has been approved for EPP?
Afamelanotide is used in Europe to prevent phototoxicity in adults with erythropoietic protoporphyria.[1] It is an implant that is injected and placed under the skin; an implant lasts two months.[1]
PUVA is a reaction between what? How do you dose the psoralen?
8 methoxypsoralen and UVA.
Psoralen 0.4mg/kg 1-2 hrs before UVA
SE of PUVA?
Phototoxic reactions, NMSC ( SCC» BCC) and cataracts
How does UVB work?
Decreases DNA synthesis and increasing p53 and cause cell cycle arrest and keratinocyte apoptosis
What is the nm wavelength range for broad band UVB? nbUVB?Excimer?
broadband UVB is 280-320nm
narrow band 311-313nm
Excimer is 308nm
How does Blue light PDT work? Discuss from ALA to apoptosis. What nm?
ALA (aminoleuvulinic acid) converted to protoporphyrin 9 within cells, which when exposed to light is activated to a higher energy state and causes apoptosis. NM is the soret band at 410nm.
Whats the soret band? What is it used for?
Blue light band 410nm
What wave length is Red light PDT?
Red light band 635nm
How long do you incubate methyl aminolevulinate for? How many Joules/m2 for how long?
Incubate for 3-4hrs and then light exposure at 37J/m2 for 7 minutes
How long do you incubate aminolevulinic acid for? How many Joules/m2 for how long?
Incubate for 1-4 hrs, then expose at 10J/cm2 for 16 minutes
How do the chemical sunscreen work?
They absorb radiation and convert it to longer, lower-energy wavelengths
What are chemical sunscreens targeted to UVB?
octinoxate, octisalate,PABA, cinnamates, octylcrylene, padimate O
What are chemical sunscreens targeted to UVA?
avobenzone, oxybenzone, ecamsule, meradimate
Most common chemical sunscreen ingredient culprit-is it a UVB irritant? UVA irritant?
1 is UVA onxybenzone. Other ones are cinnamate and PABA, which are UVB.
How does eflornithine work? Most common SE?
Inihibits ornithine decarboxylase. used in treatment of female facial hirsutism. Most common SE is acne
How does hydroquinone work?
auto-oxidizes melanin, tyrosinase and phenol oxidases
also competes with tyrosinase as a substrate for tyrosinase
How does topical Pimecrolimus and tacrolimus work?
binds to FK506 binding protein and forms a complex which inhibits calcineurin from dephosphorlating NFAT-1 (transcription factor), decreasing transcription of cytokine IL2
What does of pimozide do you give for delusions of parasitosis? What are some common SE? (name 2)
3-5mg/day. Extrapyramidal adverse effects (drug-induced movement). Cardiac effects (arrhythmia from prolonged QT).
Whats the dosage on IVIG?
2g/kg total over 3 days.
What are 3 disease you can give IVIG for?
Kawasaki, SJS, Dermatomyositis
SE of IVIG? name 4
Infusion-related ( headaches, myalgias, flushing, fever, wheezing), fluid overload, Aseptic Meningitis, thromboembolic events (MI and stroke as a result of increased serum viscosity).
How does finasteride work? dutasteride?
Finasteride is a type 2 5 alpha reductase inhibitor. Dutasteride is a type 1 &2 5 alpha reducatase inhibitor
SE of finasteride/dutasteride? name 3
gynecomastia, decrease libido/ejaculation/impotence, increase in high-grade prostate cancer, but decrease in overall risk of prostate cancer
How does calcipotriene and calcitriol work? What is the end cytokine and enzymes affected?
the product + vitamin D receptor complex binds to DNA decreasing keratinocyte proliferatoin and epidermal differentiation. Decreases IL2/IL6. Increases involucrin/transglutaminase, enhancing cornified envelope formation.
What do you use danazol and stanozolol for? name 4
hereditary angioedema, cryofibrinogenemia, lipodermatosclerosis, livedoid vasculitis
What are some SE of danazol? name 2 categories
male hormonal-related SE (hirsutism, deeper voice, alopecia, acne, menstrual irreg), Muscle Cramps, Myalgias, Myopathy (in patients on statins)
What is clofazimine used for? name 3
leprosy, erythema dyschromicum perstans, SLE/DLE
SE of clofazimine?
orange-brown skin and body fluid
MOA of colchicine?
binds tubulin dimers in leukocytes causing mitotic arrrest in metaphase
SE of colchicine?
GI SE (cramping, diarrhea, abdominal pain), bone marrow suppression, neuropathy, and myopathy
MOA of nicotinamide?
inhibits PARP-1 decreasing NFkB transcription. Also decreases leukocyte chemotaxis, decreases mast cell degranulation
What is nicotinamide used in?
Pellagra, BP, NMSC chemoprevention (23% reduction in new skin cancers)
What is potassium iodide used for? Common SE? Name 4.
sporotrichosis, erythema nodosum/induratum. Common SE include GI SE #1, hypothyroidsim, iododerma, exacerbation of dermatitis herpetiformis, Also wiht metallic taste/sore burning mouth.
MOA of thalidomide?
Inhibits TNFa, IFNy, IL12.
What is thalidomide used for?
Prurigo nodularis, kaposi sarcoma, erythema nodosum (FDA approved), lupus erythematosus, neutrophilic disorders, GVHD
SE of thalidomide?
teratogenic (phocomelia), peripheral neuropathy (proximal muscle weakness, distal sensory pain/loss), venous thrombosis, sedation /drowsiness (most common)
What are substrates of CYP3A4?
Warfarin, H1 antihistamines, statins, OCPs, cyclosporin, tacrolimus, pimozide, protease inhbitors, dapsone. The house and senate are waring over political power in DC.
