High Yield Derm Pharm Flashcards
(35 cards)
1–Clotrimazole/miconazole and 2–terbinafine(lamisil)/naftifine
What class are they?
3–What do they treat?
4–What is the MOA?
1– azoles
2–Allyamines
3–they are antifungal agents
4– MOA: inhibit squalene epoxidase, a key enzyme in ergosterol biosynthesis
How do you treat MRSA?
–dependent on a thorough evaluation and requires oral or parenteral antibiotic therapy
What are the most commonly used topical antibacterial agents? What are they treating?
Should you use them alone? Why?
–Clindamycin and Erythromycin used for acne
–DONT USE IN MONOTHERAPY!
–They should be used in combination with retinoids, benzoyl peroxide in order to decrease resistance
**If you have a dry lesion you use a _____ agent, if you have a wet lesion you use a _____ agent
examples of each?
–wet/lubricating i.e. pastes, creams, ointments
–drying i.e. tinctures, wet dressings, lotions
areas of body with highest absorption?
—face, scalp, axilla
Why might you use a compress wrap along with topical treatments?
—Increased the absorption
Amphotericin B treats what? why isn’t it used?
–Broad antifungal activity for systemic fungal infections
–Rarely used topically
–“amphoterrible”; cumulative organ toxicity
Tolnaftate (Tinactin) used for?
–BOOM antifungal athletes foot
Nystatin used for? why not used topically?
- -suspension antifungal against Oral thrush
- -limited bioavailability when used topically
Oral antifungal agents?
–Azoles (Keto, Itra, Flucon, Voricon); systemic Yeast infxn
–Griseofulvin; dermatophyte infxn (hair, skin, nails). NOT CANDIDIA infxns
–Terbinafine; high first pass; builds up in skin, nails, fat. tinea infxns
Antiviral agents?
How do they work?
What mode of application best treats herpes labialis, HSV, and VZV infxns?
—-Acyclocivr, valacyclovir, penciclovir, famiciclovir
–MOA: converted to pharmacological active triphosphate metabolites and inhibit viral DNA synthesis and viral replication
–Systemic is more effective than topical for these issues
Imiquimod belongs to what class?
What does it treat?
What cancer does it treat?
MOA?
–Immunomodulators
–external genital and perinal warts in adults, actinic kearatosis of scalp
–basal cell carcinoma of the trunk/neck/extremities < 2cm in diameter
–Is an immune simulator but the exact MOA is unknown; see itching and redness because it is an immune stimulator
Tacrolimus and Pimiecrolimus are what class?
What do they treat?
How do they work?
–Immunomodulator
– on boards = used in organ transplant rejection but may also be used for atopic dermatitis/psoriasis; they suppress immune response
–MOA; inhibit T-lymphocyte activation and prevent release of inflammatory cytokines and mediators from mast cells
**Retinoic Acid, Adapalene, Tazarotene, and Isoretinoin are used for what?
MOA? What to watch out for?
**isoretinoinMOA? How do you give it? When to use/not use?
–acne TX
- -retinoids/retinoid derivatives react w/ retinoid nuclear receptor and increase/reduce gene transcription
- -avoid sun exposure (increase UV sunburn risk)
- -NOT 4 PREGO WOMEN
- *administer orally,
- *Isotretinoin MOA; reduces sebaceous gland size and reduces sebum production
- *used in unmanagable cystic acne and cutaneous/extracutaneous malignant neoplasms
- *dryness, itching of skin and membranes
Acne prep:
Benzoyl peroxide MOA?
– release free-radical oxygen which oxidizes bacterial proteins in the sebaceous follicles decreasing the number of anaerobic bacteria and decreasing irritating-type free fatty acids
Acne Prep:
Azelaic Acid MOA?
–antimicrobial against P. acnes as well as in vitro inhibitory effects on the conversion of testosterone to dihydrotestosterone
Topical Psoriasis Drug classes
are topicals better than systemic drug txs?
- -Emollients (keep skin moist)
- -Corticosteroids
- -Vitamin D
–NO, systemic drugs are better for this issue
Systemic Psoriasis Drugs
When are they used?
- -Methotrexate
- -Acitretin
- -Cyclosporine
–used when it covers > 10% of body or in the more debilitating cases
Methotrexate MOA?
–inhibit dihydrofolate reductase
Cyclosporine MOA?
inhibit calcineurin and thereby inhibits transcription of interleukin-1 and -2 receptors; blocks T-cell activation
Etanercept, infliximab, adalimumab are what class?
What do they treat?
MOA?
Why are they risky?
–TNF inhibitors
–Treat psoriasis
–MOA; prevent TNF-mediated immune response
–might cause lymphoma and other cancers
Alefacept is a what?
treats what?
MOA?
–immunosuppressive
–psoriasis
–fusion protein that interferes with lymphocyte activation
–stop when CD4 counts remain below 250cells/uL
Ustekinumab treats what?
MOA?
Is a newer drug and probably wont be on the boards or on the test but will see in our third year rotations
– psoriasis
–interferes with proinflammatory cytokines IL-12 and IL-23
–linked to cardiovascular events
Corticosteroids do what?
lowest efficacy?
Medium efficacy?
highest efficacy?
–anti-
inflammatory/immunosuppressive agents
–lowest = hydrocortisone (seb. dermatitis)
–medium = hydrocortisone valerate (seb. dermatitis)
– highest = Clobetasol propionate (psoriasis, sarcoidosis)
