Psoriasis and Acne

Question 1

MOA of adalimumab

Answer 1

IgG1 binds TNF-alpha

Question 2

MOA of etanercept

Answer 2

p75 TNF receptor and Fc IgG1 binds ups TNF-alpha

Question 3

MOA of inflixmab

Answer 3

variable region of mouse monoclonal antibody on human IgG1 binds up TNF-alpha

Question 4

Adverse effects of inflixmab

Answer 4

heart failure, murine protein HSR

Question 5

adverse effect of etanerecept

Answer 5

sepsis

Question 6

black box warnings of infliximab, etanercept, and adalimumab

Answer 6

infection including fungal/myco-bacterial/viral; neoplasia; TB

Question 7

MOA of ustekinumab

Answer 7

binds to p40 subunit to IL12 and IL23 and disrupts the over-expressed signal transduction, suppresses pro-inflammatory TH1 and Th17 cells

Question 8

adverse effects of ustekinumab

Answer 8

anaphylactic rxns, pts at increased risk of infections and neoplasia

Question 9

CIs for ustekinumab

Answer 9

live virus vaccination and test for latent TB before initial treatment

Question 10

what are the effects of retinoids

Answer 10

inhibits keratinization, alterations of cellular cohesiveness, tumor prevention/therapy, induction of apoptosis, immunologic and anti-inflammatory effects

Question 11

functions of vitamin A

Answer 11

embryonic growth, morphogenesis, differentiation/maintenace of epithelial tissues, reproduction, visual function

Question 12

RAR?

Answer 12

targets cellular differentiation and proliferation

Question 13

RXR?

Answer 13

induces apoptosis

Question 14

systemic toxicities of retinoids

Answer 14

1. similar to Vit A intoxication
2. hyperlipidemia
3. teratogens
4. depression/suicidal

Question 15

RAR leads to what adverse effects

Answer 15

mucocutaneous and musculoskeletal symptoms

Question 16

RXR leads to what adverse effects

Answer 16

physiochemical changes

Question 17

adverse effects of topical retinoids

Answer 17

erythema, desquamation, burning, and stinging. increases photosensitivity

Question 18

MOA calcipotriene

Answer 18

binds to Vit D receptor, complexes w/ RXR-alpha and binds DNA vit D response elements

Question 19

adverse effects of calcipotriene

Answer 19

hypercalcemia and hypercalciuria w/ extreme doses, increases photosensitivity

Question 20

what is more potent than calcipotriene

Answer 20

calcitriol (hormonally active form of vitamin D3)

Question 21

MOA of benzoly peroxide

Answer 21

pro-drug converted to benzoic acid, free radial liberator kills P. acnes

Question 22

adverse effect of benzoly peroxide

Answer 22

drying of skin, marked peeling, erythema

Question 23

why is it often combined w/ antibacterials?

Answer 23

to prevent development of antimicrobial resistance

Question 24

notes for treating acne w/ antimicrobials

Answer 24

resistance may arise so change treatment if no response in 4-8 weeks, combo therapy, simply regiment as much as possible

Question 25

MOA of corticosteroids

Answer 25

anti-inflammatory, anti-pruritic, vasoconstrictive. increases production of lipocortins and decreases formation and release of endogenous inflammatory mediators

Question 26

What are the following corticosteroids classified as: hydrocortison, betamethasone valerate, flucinonide, clobetasol propionate

Answer 26

Hydro - mild Beta - moderate Fluo - potent Clob - very potent

Question 27

what are adverse effects of flourinated steroids?

Answer 27

rosacea like skin rash around mouth so DONT apply to face!

Question 28

topical adverse effects of steroids

Answer 28

iatrogenic Cushing's syndrome, dermal atrophy, corticoid rosacea, perioral dermatitis, steroid acne, hypopigmentation, hypertrichosis

Question 29

MOA of salicylic acid

Answer 29

topical keratolytic, causes desquamation of horny layer of skin

Question 30

adverse effect of salicylic acid

Answer 30

prolonged use in pts w/ renal/hepatic impariment - salicylism; neonatal toxicity via breast milk and contact toxicity from drug applied to chest area

Question 31

Mild and severe features of salicylate intoxication

Answer 31

Mild: dizziness, tinnitus, N/V, tachycardia Sever: lethagy, hallucinations, seizures, renal and liver failure, edema

Question 32

MOA of acitretin

Answer 32

second gen retinoid. inhibits keratinization, alterations of cellular cohesiveness, tumor prevention/therapy, induction of apoptosis, immunologic and anti-inflammatory effects

Question 33

MOA of adapalene?

Answer 33

first gen retinoid. inhibits keratinization, alterations of cellular cohesiveness, tumor prevention/therapy, induction of apoptosis, immunologic and anti-inflammatory effects

Question 34

MOA of tazarotene?

Answer 34

third gen retinoid. inhibits keratinization, alterations of cellular cohesiveness, tumor prevention/therapy, induction of apoptosis, immunologic and anti-inflammatory effects