Psoriasis and Acne Flashcards
MOA of adalimumab
IgG1 binds TNF-alpha
MOA of etanercept
p75 TNF receptor and Fc IgG1 binds ups TNF-alpha
MOA of inflixmab
variable region of mouse monoclonal antibody on human IgG1 binds up TNF-alpha
Adverse effects of inflixmab
heart failure, murine protein HSR
adverse effect of etanerecept
sepsis
black box warnings of infliximab, etanercept, and adalimumab
infection including fungal/myco-bacterial/viral; neoplasia; TB
MOA of ustekinumab
binds to p40 subunit to IL12 and IL23 and disrupts the over-expressed signal transduction, suppresses pro-inflammatory TH1 and Th17 cells
adverse effects of ustekinumab
anaphylactic rxns, pts at increased risk of infections and neoplasia
CIs for ustekinumab
live virus vaccination and test for latent TB before initial treatment
what are the effects of retinoids
inhibits keratinization, alterations of cellular cohesiveness, tumor prevention/therapy, induction of apoptosis, immunologic and anti-inflammatory effects
functions of vitamin A
embryonic growth, morphogenesis, differentiation/maintenace of epithelial tissues, reproduction, visual function
RAR?
targets cellular differentiation and proliferation
RXR?
induces apoptosis
systemic toxicities of retinoids
- similar to Vit A intoxication
- hyperlipidemia
- teratogens
- depression/suicidal
RAR leads to what adverse effects
mucocutaneous and musculoskeletal symptoms
RXR leads to what adverse effects
physiochemical changes
adverse effects of topical retinoids
erythema, desquamation, burning, and stinging. increases photosensitivity
MOA calcipotriene
binds to Vit D receptor, complexes w/ RXR-alpha and binds DNA vit D response elements
adverse effects of calcipotriene
hypercalcemia and hypercalciuria w/ extreme doses, increases photosensitivity
what is more potent than calcipotriene
calcitriol (hormonally active form of vitamin D3)
MOA of benzoly peroxide
pro-drug converted to benzoic acid, free radial liberator kills P. acnes
adverse effect of benzoly peroxide
drying of skin, marked peeling, erythema
why is it often combined w/ antibacterials?
to prevent development of antimicrobial resistance
notes for treating acne w/ antimicrobials
resistance may arise so change treatment if no response in 4-8 weeks, combo therapy, simply regiment as much as possible
MOA of corticosteroids
anti-inflammatory, anti-pruritic, vasoconstrictive. increases production of lipocortins and decreases formation and release of endogenous inflammatory mediators
What are the following corticosteroids classified as: hydrocortison, betamethasone valerate, flucinonide, clobetasol propionate
Hydro - mild
Beta - moderate
Fluo - potent
Clob - very potent
what are adverse effects of flourinated steroids?
rosacea like skin rash around mouth so DONT apply to face!
topical adverse effects of steroids
iatrogenic Cushing’s syndrome, dermal atrophy, corticoid rosacea, perioral dermatitis, steroid acne, hypopigmentation, hypertrichosis
MOA of salicylic acid
topical keratolytic, causes desquamation of horny layer of skin
adverse effect of salicylic acid
prolonged use in pts w/ renal/hepatic impariment - salicylism; neonatal toxicity via breast milk and contact toxicity from drug applied to chest area
Mild and severe features of salicylate intoxication
Mild: dizziness, tinnitus, N/V, tachycardia
Sever: lethagy, hallucinations, seizures, renal and liver failure, edema
MOA of acitretin
second gen retinoid.
inhibits keratinization, alterations of cellular cohesiveness, tumor prevention/therapy, induction of apoptosis, immunologic and anti-inflammatory effects
MOA of adapalene?
first gen retinoid.
inhibits keratinization, alterations of cellular cohesiveness, tumor prevention/therapy, induction of apoptosis, immunologic and anti-inflammatory effects
MOA of tazarotene?
third gen retinoid.
inhibits keratinization, alterations of cellular cohesiveness, tumor prevention/therapy, induction of apoptosis, immunologic and anti-inflammatory effects
