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Pharmacology > Vascular Drugs > Flashcards

Vascular Drugs Flashcards

1
Q

What is the MOA of apremilast?

A

PDE4 inhibitor
Role in chronic inflammation

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2
Q

What are the contraindications to apremilast?

A

Hypersensitivity
Pregnancy/lactation
Children <18 years
Severe renal impairment
Depression/suicidality
Galactose intolerance

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3
Q

What are the adverse effects of apremilast?

A

GI effects, URTI, weight loss, depression, headache, hypersensitivity

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4
Q

What baseline and ongoing monitoring is required for apremilast?

A

Baseline - FBC, UEC, LFT, BhCG

Ongoing - Nil

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5
Q

How is apremilast dosed?

A

Day 1: 10mg mane
2: 10mg BD
3: 10mg mane, 20mg nocte
4: 20mg BD
5: 20mg mane, 30mg nocte
6: 30mg BD

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6
Q

What are the contraindications to propranolol?

A

Hypersensitivity
Hypoglycaemia
Heart block
HR/BP abnormalities
Frequent wheezing

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7
Q

What are the adverse effects of propranolol?

A

Wheezing
Cool peripheries
GI effects
Sleep disturbance, somnolence
Cognitive impairment
Urticaria
Alopecia

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8
Q

What baseline and ongoing monitoring is required for propranolol?

A

HR, BP, peripheral pulses, auscultation of lungs and heart, palpate for HSM
Glucose
ECG
Consider TTE

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9
Q

How would you start propranolol in an uncomplicated infant?

A

Outpatient
1mg/kg in two divided doses
Increase to 2mg/kg after 1 week
If IH not responding and drug tolerated, increase to 3mg/kg
Adjust dose with weight increases
Follow up every 2-3 months

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10
Q

Which infants require impatient monitoring for initiation of propranolol?

A

Premature
<5 weeks age corrected
<2.5kg
Hypoglycaemia
Significant comorbidities
PHACES
Poor social support

Lower initial dose eg 0.5mg/kg/day
Monitor HR/BP every 30 mins for 4 hrs
Measure BSL pre and post

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11
Q

What are the indications for pentoxyfylline?

A

Venous ulcers
Raynaud’s phenomenon
Livedoid vasculopathy
NLD
Generalised GA

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12
Q

What are the contraindications to pentoxyfylline?

A

Hypersensitivity
Recent severe haemorrhage
Cardiac disease
CVA
Renal or hepatic impairment
Children <18yrs

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13
Q

What drugs interact with pentoxyfylline?

A

Anticoagulants/antiplatelets

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14
Q

What are the adverse effects of pentoxyfylline?

A

Bleeding
GI effects
Headache, dizziness
Angina, palpitations

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15
Q

How is pentoxyfylline dosed and what is the onset of action?

A

400mg tds

2-4 months

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16
Q

What are MOAs of tranexamic acid?

A
  1. Antifibrinolytic
  2. Inhibits VEGF/angiogenesis
  3. Blocks transfer of melanin to keratinocytes
17
Q

What are the contraindications to tranexamic acid?

A

Hypersensitivity
Pregnancy
Impaired colour vision
Hx of thrombosis/haemorrhage

18
Q

What are the adverse effects of tranexamic acid?

A

GI effects

Thrombosis
Visual disturbances
Rash

19
Q

What baseline screening is required and how do you start tranexamic acid?

A

Coagulation profile

250mg BD for 8-12 weeks

NO ongoing monitoring required

20
Q

What are the indications for sirolimus?

A

Angiofibromas
Kaposi sarcoma
Capillary/venous/lymphatic malformation
Tufted haemangioma/KHE
GvHD, SSc, pachyonychia congenita

21
Q

What are the contraindications to sirolimus?

A

Hypersensitivity
Pregnancy/lactation
Children <18 years

22
Q

What drugs interact with sirolimus?

A

CYP3A4 drugs
ACE inhibitors
Grapefruit juice
Other immunosuppressants
Other Calcineurin inhibitors
Live vaccines

23
Q

What are the adverse effects of sirolimus?

A

Skin: acne, folliculitis, nail fragility, alopecia, hypertrichosis, poor wound healing, epistaxis, mouth ulcers
GI: n/v/d, transaminitis, pancreatitis
CVS: hypertension, tachycardia, peripheral oedema
Endo: DM, hyperlipidemia, subfertility (males)
General: headache, fever, fatigue, dizziness, myalgia
Infection eg URTI, HsV, cystitis, pneumonia
Malignancy eg NMSC, lymphoprolif

24
Q

What baseline and ongoing monitoring is required for sirolimus?

A

Baseline
Blood pressure
FBC, UEC, LFT, CMP, BhCG, lipids, BSL
Urinalysis
Immunosuppression screen
D-dimer, fibrinogen

*Ongoing
Blood pressure
Sirolimus level (aim 5-10 ng/dl)
FBC, UEC, CMP, LFT, lipids, BSL
D-dimer, fibrinogen

*Monthly for 3 months and then every 3-4 months

25
Q

What are the indications for apremilast?

A

Plaque psoriasis
Psoriatic arthritis
Palmoplantar psoriasis
Behcet disease
Aphthous ulcers

Pharmacology (13 decks)

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