Drugs

Question 0

Azelaic acid

Answer 0

• MOA: direct inhibition of P. Acnes, tyrosinase inhibitor (trt hyper pigmentation)
• use: hyper pigmentation

Question 1

Topical retinoids

Answer 1

• Tretinoin, Adapalene, Tazarotine (cat X)
• MOA: Comedolysis, antiinflammatory, normalization of epi
• really common in acne

Question 2

Topical dapsone

Answer 2

• MOA: anti-inflammatory, inhibits PMNs, anti-microbial

- if used with benzoyl peroxide -> yellow pigmentation (separate use by 20-30 mins)

Question 3

Erythromycin

Answer 3

• MOA: macrolide (50s subunit inhibition)
• Use: reduce lesions in P. Acnes (second line after tetracycline)
• resistance, GI upset: take with lipid

Question 4

Clindamycin

Answer 4

• MOA: 50s subunit binder: combo with benzoyl peroxide
• Use: decrease # of lesions
• pseudomembranous colitis risk

Question 5

Tetracycline

Answer 5

• MOA: 30s subunit binding

- Use: deep papules or nodules (tetracycline first line microbial)

Question 6

Minocycline

Answer 6

• doxy
• Sx: drug induced lupus (anti histone Ab)
• Sx: pseudo tumor cerebri
• Sx: blue/black pigment

Question 7

Triamicinalone

Answer 7

• MOA: phoslip 2a inhibition
• Use: acne emergencies (acne fulminans)
• use to prevent scarring

Question 8

Isoretinoin

Answer 8

• systemic (oral) retinoic acid derivative CAT X
• MOA: sebum suppression, anti inflammatory
• use: recalcitrant acne
• dryness (related to lack of oils)

Question 9

Psoralen + UVA

Answer 9

• MOA: increases skin sensitivity to light, slows growth of new skin
• use: generalized psoriasis
• Sx: skin cancer

Question 10

Acitretin

Answer 10

• MOA: binds nuclear txn factors, reduce hyperplasia
• Use: psoriasis
• Sx: lipid elevation

Question 11

Methotrexate

Answer 11

• MOA: DHFR inhibition
• Use: psoriasis
• Sx: hepatotoxicity, lung fibrosis

Question 12

Cyclosporine

Answer 12

• MOA: binds cyclophilin -> inhibits calcineurin -> inhibits IL2
• Use: psoriasis
• Sx: nephrotoxicity

Question 13

Azathiopine

Answer 13

• MOA: 6-MP analog -> inhibits de novo purine synthesis
• Use: psoriasis
• Sx: lots

Question 14

Etanerctept, inflixumab, adilimumab

Answer 14

• MOA: cytokine inhibition (TNFa inhibitor)
• Use: psoriasis
• Sx: infection (TB activation)

Question 15

Tacrolimus, pimcrolimus

Answer 15

• MOA: calcineurin inhibition -> IL2 down reg.
• Use: in atopic dermatitis in kids < 2, second line if roids don’t work
• risk if neoplasm and tons of others

Question 16

Mupirocin/retapamulin and cephlexin

Answer 16

• MOA: various

- Use: super infected dermatitis

Question 17

Acyclovir

Answer 17

• MOA: antiviral

- use: suspected eczema herpetica

Question 18

Scopolamine

Answer 18

• MOA: percutaneous muscarinic agonist

- use: motion sickness

Question 19

Nitroglycerin

Answer 19

• MOA: NO production -> vasodilation
• Use: angina
• tolerance can develop

Question 20

Clonadine

Answer 20

• MOA: central a-adrenergic agonist

- Use: anti-hypertensive

Question 21

Hormones: combipatch, estradiol, ortho Vera

Answer 21

• hormone replacement, contraceptive (ortho Vera)

Question 22

Fentanyl

Answer 22

• opioid analgesic

- chronic pain management

Question 23

Lidocaine

Answer 23

• topical analgesic/anesthetic

- herpes zoster

Question 24

Testosterone

Answer 24

- applied to sacrotum or lower back | - hormone replacement

Question 25

UVA/UVB therapy

Answer 25

- A penetrates more deeply, Atopic dermatitis | - B is more narrow band, psoriasis

Question 26

Griseofulvin

Answer 26

- treatment of choice for tinea capitis | - MOA: microtubule inhibition

Question 27

Terbenifine, itrocazole

Answer 27

- use: tinea

Question 28

Primetherim ivermectin

Answer 28

- scabies treatment | - use of ivermectin for immunocomp

Question 29

Keratin pearls

Answer 29

- Invasive squama cell carcinoma

Question 30

Vismodegib

Answer 30

- treatment of BCC, in people not candidates for surgery - MOA: involves inhibition of sonic hedgehog - cat X

Question 31

Stage IV melanoma trt

Answer 31

- palliative therapy primary | - lpilimumab, vemurafenib (CTLA MoAb, and other)