Drugs Week 3 Flashcards Preview

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Flashcards in Drugs Week 3 Deck (18)
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1
Q

Corticosteroids

A

Action: Anti-inflammatory, immunosuppressive, anti-proliferative, vasoconstriction.

Uses: Eczema, contact dermatitis, psoriasis, itch, lichen planus…

Adverse effects: SKIN ATROPHY, striae, acne, suppression of the HPA axis.

Strength is categorized based on a standardized laboratory vasoconstriction assay. (graded from 7 - hydrocortisone (lowest) to 1 (highest) - prednisone 2) Use stronger grades on tougher skin like hands and feat. Use weaker grades on kids, babies, face.

2
Q

Retinoids (tretinoin, tazarotene, adapalene

A

Vitamin A analogs which work through nuclear receptors on DNA causing alteration of gene transcrition.

Action: Regulates cell growth, inhibit carcinogensis, alter enzymes involved with cellular differentiation.

Uses: acne, psoriasis, cosmetic skin improvement

Adverse effects: dryness, irritation, and sun sensitivity

3
Q

Calcipotriene

A

Mech of Action: Vitamin D analog that acts through DNA receptors to alter skin differentation

Uses: Psoriasis, eczema

Adverse effects: irritation, increased serum calcium

4
Q

Topical Calcieurin Inhibitors (TCIs) “NSAIDs”

A

Tacrolimus, and Pimicrolimus

Work through calcineurin to alter T-cell activation

Uses: Eczema (especially near the eyes), dermatitis,

Adverse effects: limited. Local irritation or burning.

Other notes: Use them strictly as directed.

5
Q

Sunscreens

A

UVM (290-320) and UVA (320-400)

Newer ones with Avobenzone/Heliplex/Mexoryl are better vs. UVA

SPF = Sun Protection Factor.

SPF 15 blocks 93%, SPF 30 blocks 97% Use SPF 15 or greater.

6
Q

Imiquimod: Aldara cream

A

An immune response modifier whose mode of action is not well understood. Increases local immune activity through TLRs.

Uses: Condyloma, AK, and BCC, common warts, molluscum, in situ carcinoma.

7
Q

Topical 5-fluorouracil

A

MOA: Inhibits thymidylate synthase resulting in reduced DNA synthesis. Acts selectively in actinic damaged skin cells.

Uses: Imiquimod and 5-FU used for AK

8
Q

Isotretinoin and acitretin

A

Another subset? of Retinoids. Vitamin A analogs that bind to nuclear receptors to alter cell differentiation.

Uses: Acne, psoriasis, ichtyosis, Darier’s disease, chemoprophylaxis of skin cancer in transplant patients (repair disordered keratinizaiton)

Adverse Effects: dryness, hyperlipidemia, TERATOGENIC, hepatitis, arthralgias, and hair loss.

Labs: lipids, LFT, and HCG (pregnancy)

9
Q

Dapsone

A

A sulfone. Action: inhibits myeloperoxidases in polymorphic neutrophils.

Use: Leprosy, dermatitis herpetiformis, linear IgA disease, bullous lupus, Sweet’s syndrome, spider bite (neutrophilic skin dz)

Adverse effects: Hemolysis(G6PD deficiency), Methemaglobinemia, Motor neuropathy

Labs: G6PD, CBC

10
Q

Methotrexate

A

Action: DHFR Inhibitor that disrupts DNA synthesis to block cell division. Immunosupprssive.

Uses: psoriasis, CTCL, lupus

A.E. :hepatoxicity, myelosuppression, pneumonitis

Lab: CBC, LFT, Liver Biopsy

11
Q

Bilogical Therapy

A

Newest generation of systemic therapy for psoriasis, psoriatic arthiritis, and RA. Biogenetically engineered proteins which disrupt/inhibit focused portions of the immune system involved in psoriasis.

Appear to be safe in long term control w/o organ toxicity.

A.E. Injection site irritation, Risk of infection, Exacerbate CHF, Reactivate TB, Risk for Cancer

12
Q

Ultraviolet Light Therapy

A

UVB, Narrow band UVB, PUVA, . Forms pyrmidine dimers in DNA and reduces langerhans cell and leukocytes

Actions: anti-inflammatory, and immunosuppression

Uses: psoriasis, pruritis, eczema, CTCL

A.E. burns, carcinogenic, photoaging

13
Q

Minoxidil (Rogaine)

A

Action: vasodilation adn direct stimulation of hair shaft growth. Only hair that would come back anywway.

Uses: Alopecia

14
Q

Finasteride (propecia)

A

Action: Blocks 5-alpha reductase enzyme in follicles to inhibit the conversion of testerone to dihydotestosterone.

Uses: Androgenic alopecia

15
Q

Liquid Nitrogen

A

Action: Freezes tissues (-196 C)

Uses: Warts, AK, skin cancer

16
Q

Alpha-hydroxy acids

A

Exfoliate, thicken epidermis, stimulate collagen growth. Results in fewer wrinkles, more pliable skin, with better hydration

17
Q

Tacrolimus

A

topical immunomodulator, inhibits t cell activation by preventing transcription of early cytokines.

Used to treat Atopic Dermatitis

18
Q

Pimecrolimus

A

calcineurin inhibitor used to treat Atopic Dermatits..