Dermatological pharmacology Flashcards Preview

MS 2 - Unit 2 > Dermatological pharmacology > Flashcards

Flashcards in Dermatological pharmacology Deck (19):
1

What class of drugs are Isotretinoin,
Acitretin?

Retinoids

Stimulate epithelial cell turnover; also anti-inflammatory

Teratogenic effects (washes out in three weeks)

Good as adjunct to other therapies

2

What is the MOA of a retinoid for dermatologic use?

Stimulate epithelial cell turnover; also anti-inflammatory

3

What would you use isotretinoin for?
Acitretin?

isotretinoin for acne

acitretin for psoriasis

both have "retin" in the name.

4

MOA for UV light therapy ?

different classes: UVA, UVB, UVC

Immunosuppression of T-cells via type I or type II reactions --> mono- or bifunctional adducts in DNA

5

Uses for UV light therapy? Side effects?

Inflammatory conditions: atopic dermatitis, CTCL, lichen planus, psoriasis (not useful for non-inflammatory conditions)

Skin cancer, thinning/leathering of skin

Usually used with psoralens (photosensitizing agents that increase efficacy); phenothiazines, thiazides, sulfonamides, NSAIDs, tetracycline, benzodiazapenes also sensitize skin to light therapy


6

What is a biologic?

Blocks TNF-a

used for Inflammatory conditions, arthritis

side effects: Few (may unmask neurologic disease, latent infections (must do PPDs), malignancies)

Expensive

7

MOA for methotrexate? Uses? Side effects?

Folate analouge; inhibits dihydroxyfolate reductase

used for Inflammatory conditions (psoriasis), conditions needing immunosuppression

Side effects: Hepatotoxicity (develops slowly, can give up to 4.5 g over life); pulmonary toxicity (develops quickly); leukopenia; rarely, renal toxicity. Nausea, vomiting

Misc: PO, IM (1/week); any drug increasing unbound protein may cause methotrexate toxicity (sulfa, salicylates, TCN, phenytoin)


8

Cyclosporin - class, uses, side effects?

Immunosuppressant

Inflammatory conditions (psoriasis)

Raises blood pressure, damages kidneys if used long-term

9

Hydrocortisone - class, uses, side effects?

Steroid

Uses: Dermatitis, psoriasis

Side effects: Atrophy/thinning of skin (collagen), stretch marks, talangiectasias, acne, cataract or glaucoma if applied near eye. Systemically, affects hypothalamic-pituitary-adrenal axis --> growth retardation

misc: Seven classes, w/class I being the strongest and class VII being the weakest; side effects may be permanent

10

Monophasic dermatologic vehicles include:

Powders;
Greases;
Liquids

11

Biphasic dermatologic vehicles include:

Lotions: liquid + powder
Paste: Ointment + powder
Creams: Grease + liquid

12

Long-term application of corticosteroids near the eye can cause:

glaucoma;
cataracts

13

What UV rays are associated with skin cancer?

UVA - penetrates more deeply, associated with aging and cancers

14

Phototherapy can be useful in the short-term to treat:

Psoriasis;
Atopic dermatitis;
CTCL;
lichen planus
**common theme is inflammatory conditions**

15

What is a good medication to treat extensive psoriasis in patients with no joint involvement?

Methotrexate

One bad side effect is pulmonary toxicity (within 2 weeks of starting drug)

16

Should retinoids be given during pregnancy?

No
can result in profound growth abnormalities

17

TNF-alpha is a key mediator of inflammation in what dermatologic condition?

Psoriatic arthritis
upregulation of cytokines

18

What are the side effects of biologics?

Infections (rare);
Malignancies;
Site reactions where administered;
unmasking of neurologic disease ie MS

use for psoriasis with joint involvement

19

How long should women wait before becoming pregnant after being given Soriatane (acetretin)?

Soriatane is a retinoid, which can be reverse-metabolized to etretinate, which has an extremely long half-life. Wait 3 years before becoming pregnant!