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MSK II: Test 1 > Pharm: Derm > Flashcards

Pharm: Derm Flashcards

(52 cards)

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1
Q

bacitracin

A
  • antibacterial agent

MOA: inhibits cell wall synthesis

tx: gram positive organism a - i.e. strep and staph, and some anaerobes

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2
Q

mupirocin

A
  • antibacterial agent

MOA: inhibits protein synthesis

tx: gram positive bacteria including MRSA

** tx for impetigo caused by S. aureus and B-hemolytic strep

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3
Q

polymyxin B sulfate

A
  • antibacterial agent

MOA: binds phsopholipids and increases permeability of cell wall
** a main ingredient in neosporin

tx: gram negative organisms

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4
Q

Neomycin

A
  • antibacterial agent

MOA: binds 30s

tx: gram negative organisms

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5
Q

gentamicin

A
  • antibacterial agent

MOA: binds 30s

tx: gram negative

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6
Q

Clindamycin

A
  • antibacterial agent for acne

MOA: binds to 50s

Note: activitity against P. acnes

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7
Q

Erythromycin

A
  • antibacterial agent for acne

MOA: binds 50s

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8
Q

Metronidazole

A
  • antibacterial agent for acne

MOA: interacts with DNA causing srang breakage

tx: acne roscea

NOTE: CI during pregnancy

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9
Q

Acyclovir/penciclovir

A

topical antiviral

MOA: converted to pharmacologically active triphosphate metabolites, inhibit DNA synthesis and viral replication

Topical – modest benefit for herpes labialis

Also used systemically for HSV and VZV infections

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10
Q

docosanol

A

topical antiviral

MOA: inhibits fusion between the plasma membrane and the HSV envelope, thereby preventing viral entry and replication

When applied within 12 hours of the onset of prodromal symptoms, five times daily, median healing time was shortened by 18 hours compared with placebo in recurrent orolabial herpes

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11
Q

ciclopirox olamine

A

Topical antifungal

MOA: inhibits uptake of precursors of macromolecule synthesis

Uses: topical dermatomycosis, candidiasis, tinea versicolor, mild-to-moderate onychomycosis

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12
Q

Allylamine - terbinafine

A

Topical antifungal

MOA: inhibits squalene epoxidase

Uses: tinea corporis, tinea cruris, and tinea pedis

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13
Q

butenafine

A

Topical antifungal

MOA: inhibits squalene epoxidase

Uses: tinea corporis, tinea cruris, and tinea pedis

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14
Q

nystatin

A

Topical antifungal

MOA: binds ergosterol in fungal cell membrane altering permeability

Nystatin limited to topical cutaneous and mucosal uses = Thrush

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15
Q

amphotericin B

A

Topical antifungal

MOA: binds ergosterol in fungal cell membrane altering permeability

Amphotericin B broad antifungal spectrum but rarely used topically
= Cumulative organ toxicity (ampho-terrible)

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16
Q

imiquimod

A

imunomodulator

MOA: may be related to stimulation of peripheral mononuclear cells to release interferon-α and macrophage stimulation to produce interleukins-1, -6, -8, and TNF-α

Uses: external genital and perianal warts in adults, actinic keratoses on the face and scalp, biopsy-proven primary basal cell carcinomas on the trunk, neck, and extremities (< 2 cm diameter)

ADRs: local inflammation, pruritus, erythema, superficial erosion

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17
Q

tacrolimus/pimecrolimus

A

imunomodulator

MOA: inhibit T-lymphocyte activation and prevent release of inflammatory cytokines and mediators from mast cells

Uses: treatment of atopic dermatitis and psoriasis

**traditionally used to prevent heart, liver, and kidney allograft rejection due to potent immunosuppressive activity (oral forms)

Topical ADRs: transient erythema, burning, and pruritus

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18
Q

retinoic acid, tretinoin

A

topical acne prep
= acid form of Vitamin A

MOA: may decrease cohesion b/w epidermal cells and increase cell turnover

AE: erythema, mild peeling, dryness, increased photosensitivity

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19
Q

adapalene

A

acne: topical retinoic acid derivative

MOA: may decrease cohesion b/w epidermal cells and increase cell turnover

  • photochemically more stable and less irritating than tretinoin

used to tx mild-moderate acne vulgaris

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20
Q

tazarotene

A

acne: topical retinoic acid derivative

MOA: may decrease cohesion b/w epidermal cells and increase cell turnover

approved for psoriasis, acne and photoaging

NOTE: CI for pregnant women!

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21
Q

Isotretinoin

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A

= accutane: oral retinoid

MOA: reduces sebacerous gland size, reduces sebum production

tx: severe cystic acne!

PK: t1/2 10-20 hours; hepatic metabolism; highly protein bound (99-100%)

ADRs: resemble hypervitaminosis A (dryness and itching)

DONT USE DURING PREGNANCY!

22
Q

benzoyl peroxide

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A

acne preparation

MOA: releases free-radical oxygen and oxidizes bacterial proteins in the sebaveous follicles

tx: p. acnes

23
Q

acitretin

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A

systemic psoriasis tx - retinoic acid derivative
* not as effective as other systemic therapies

tx: severe psoriasis

SE: similar to isotretinoin
CI: pregnant women

24
Q

tazarotene

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A

psoriasis tx

topical retinoid - extended response

25
calcipotriene
psoriasis tx MOA: synthetic vitamin D3 analog – as effective as topical glucocorticoids but slower onset; no long-term glucocorticoid adverse effects
26
cyclosporine
tx psoriasis MOA: inhibits calcineurin and thus IL-2, IL-2 and blocks T cell activation tx for psoriasis, RA, and transplants ADRs: nephrotoxicity, hypertension, hepatotoxicity, gingival hyperplasia, and hirsutism Used in extensive disease in patients who are unresponsive to other agents TB must be ruled out prior !!
27
etanercept
TNF inhibitor: tx psoriasis MOA: prevents TNF mediated immune responses ADRs: risk of serious life-threatening infections (sepsis, pneumonia), exacerbation of congestive heart failure, and cause demyelinating disease in predisposed patients TB must be ruled out prior !!
28
infliximab
TNF inhibitor: tx psoriasis MOA: prevents TNF mediated immune responses ADRs: risk of serious life-threatening infections (sepsis, pneumonia), exacerbation of congestive heart failure, and cause demyelinating disease in predisposed patients TB must be ruled out prior !!
29
adalimumab
TNF inhibitor: tx psoriasis MOA: prevents TNF mediated immune responses ADRs: risk of serious life-threatening infections (sepsis, pneumonia), exacerbation of congestive heart failure, and cause demyelinating disease in predisposed patients
30
hydrocortisone
anti-inflamm: topical corticosteroid tx: psoriasis, dermatitis Low to medium efficacy produce remission in disorders responsive to corticosteroids: seborrheic dermatitis, psoriasis of genitalia and face ADRs: suppression of pituitary-adrenal axis Atrophy, steroid rosacea, steroid acne, allergic contact dermatitis
31
triamcinolone
anti-inflamm: topical corticosteroid tx: psoriasis, dermatitis ADRs: suppression of pituitary-adrenal axis Atrophy, steroid rosacea, steroid acne, allergic contact dermatitis
32
acetonide
anti-inflamm: topical corticosteroid tx: psoriasis, dermatitis ADRs: suppression of pituitary-adrenal axis Atrophy, steroid rosacea, steroid acne, allergic contact dermatitis
33
betamethasone
anti-inflamm: topical corticosteroid tx: psoriasis, dermatitis low efficacy : (betamethasone valerate)= produce remission in disorders responsive to corticosteroids: seborrheic dermatitis, psoriasis of genitalia and face high efficacy: betamethasone dipropionate: useful in disorder less responsive to corticosteroids: psoriasis of palms and soles, sarcoidosis ADRs: suppression of pituitary-adrenal axis Atrophy, steroid rosacea, steroid acne, allergic contact dermatitis
34
salicyclic acid
keratolytic/ peeling agent Uses: acne, seborrheic dermatitis, psoriasis, hyperkeratosis (corns, plantar warts, calluses); in combination with antifungal sodium thiosulfate for tinea versicolor NOTE: can be destructive to tissues at concentrations greater than 6% Salicylate toxicity can occur (nausea, vomiting, dizziness, loss of hearing, tinnitus, lethargy, diarrhea, psychic disturbances) lower dose: used for acne higher dose: used for warts
35
antihistamine
antipruritic agent First generation H1-receptor antagonists Diphenhydramine, promethazine - Some anticholinergic activity, sedating, useful in nocturnal pruritus Second generation H1-receptor antagonists Cetirizine, loratadine, desloratadine, fexofenadine - Do no cross blood-brain barrier, lack anticholinergic side effects, non-sedating
36
mioxidil
= rogaine: promotes hair growth MOA: unknown Originally developed as an antihypertensive (PO dosing) Percutaneous absorption minimal but systemic effects on BP should be monitored in those with cardiac disease
37
finasteride
= propecia : promotes hair growth - tx. alopecia and BPH MOA: competitive and selective inhibitor of steroid 5α-reductase; blocks the conversion of testosterone to dihydrotestosterone (DHT) ADRs: decreased libido, ejaculation disorders, erectile dysfunction Pregnant women should not handle drug
38
rate of absorption
- concnetration gradient (c) - partition coefficient (Km) - diffusion through skin (d) rate is indirectly proportional to the thickness of stratum cornea J = C x Km x D/x
39
what do you use for acute inflammation with oozing, vesiculation and crusting?
tinctures, wet dressings, and lotions - these evaporate and take off the fluid
40
what to use for chronic inflamm. with xerosis, scaling and lichenification?
cremes and ointments
41
drying --> lubricating preparations
tinctures < wet dressings < lotions < gels < aerosols < powders < pastes < creams < ointments
42
what makes up neosporin?
bacitracin, polymyxin B, neomycin
43
tx approach for impetigo?
nonbullous impetigo: topical mupirocin therapy for 5 days extensive impetigo with bullous formation: oral antimicrobials
44
-azoles
topical antigungal MOA: inhibits synthesis of ergosterol (an essential component of fungal membranes) Uses: tinea corporis (ring worm), tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea versicolor, and cutaneous candidiasis, such as vaginal yeast infections, infections of the skin, diaper rash, and thrush (candidiasis of the oral mucosa and tongue, and sometimes the palate, gingivae, and floor of the mouth)
45
tolnaftate
antifungal agent MOA: unknown Uses: tinea pedis, tinea cruris, and tinea corporis
46
tx of tinea capitis
itraconazole
47
tx of tinea pedis, cruris, corporis?
topical antifungals
48
tx of thrush?
oral nystatin, clomitazoe, or fluconazole
49
tx of esophageal candidiasis?
systemic antifungal
50
tx of vuvovaginalis?
topical antifungla, oral fluconazole
51
acne treatment approach?
Comedonal (non-inflammatory) acne: - Topical retinoid - Alternatives: azelaic acid, salicylic acid Mild papulopustular and mixed acne: - Topical retinoid AND topical antimicrobial (BPO alone or BPO +/- topical antibiotic) Moderate papulopustular and mixed acne - Topical retinoid AND oral antibiotic AND topical BPO Moderate nodular acne - Topical retinoid AND oral antibiotic AND topical BPO Severe nodular/conglobate acne - Oral isotretinoin
52
topical therapy for psoriasis?
Emollients – used as basic adjunct; reduces scaling, itching, and related discomfort Keratolytics – reduce hyperkeratosis; enable other topical drugs to penetrate Topical glucocorticoids – rapid response; control inflammation and itching; mainstay of topical treatment Anthralin – used for widespread, refractory plaques Calcipotriene – as effective as topical glucocorticoids but slower onset; no long-term glucocorticoid adverse effects Tazarotene – extended response; maintenance therapy

MSK II: Test 1 (7 decks)

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