Skin/Scales Pharm Review
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| Treatment of Tinea Capititis = ? | * Topical antifungals are ineffective!! They do not reach the hair root.... * DOC: Terbinafine or Grisofulvin
..... * can use -azoles too (Flu/Itra)
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| What is Nystatin used to treat ? | * Candidia
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| Terbin. MoA = ? | * inhibit Squalene from going to Lanosterol and Squalene builds up to kills the fungus
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| Gris. MoA = ? | * Inhibits Microtubules, thus inhibiting cell mitosis
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| -Azoles MoA = ? | * one step down from the MoA of Terbin.. * They inhibit Lanosterol from being turned in to Ergosterol (which causes the cell membrane to weaken bc cholesterol is not made)
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| Toxicity associated with Amp. B = ? | * Renal
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| Some other drugs that have nephrotoxicity = ? | * cisplatin -- cyclosporine -- gentamicin -- NSAIDs -- vancomycin
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| Tinea Cruris TmT = ? | * and basically any other Tinea besides Capitis... * Any topical anti-fungal
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| Risk factors for tinea cruris (2 hands and 1 foot or v/v) = ? | * Tinea Pedis and Onychomycosis
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| Good TmT for onychomycosis = ? | * since it is a nail, topicals WILL NOT WORK.... * Terb. or Flu/Itra Orals
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| -Azoles and absorption issues = ? | * Itra needs an acidic environment to work, so if on a PPI, H2 antag, or antacids, use Flu. or Vori.
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| Azole that has visual disturbances ? Which anti-fingal is associated with disulfiram-like reactions ? | * Vori. (V for Vision).... * Gris.
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| What do we use Flucytosine for ? MoA = ? | * CryptoCandidia (Cryptococcal and Candidia infections).... * Noarrow Spectrum and can not be used alone.... * MoA = DNA Syn. -
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| Atopic dermatitis (eczema) TmT = ? | * DOC are steroids and can use Tacrolimus (or any other Calcineurin -) for face and skin fold areas where you should NOT USE steroids
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| MoA of the Calcieurin Inhibitors (Cyclosporine and Tacrolimus) = ? | * Cyclosporine = - cyclophillin to stop Calcieurin from being made .... * Tacro. = binds and stops FKBP from doing the same.... * BOTH stop the creation of IL-1 (-) so we don't get T-Cell activation
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| SEs of the Calcieurin Inhibitors = ? | * Tacro = link to lymphomas and cancers (use for face and folds)... * Cyclosporine = No infants or kids, and use only if Roids and phototherapy does not work
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| TmT for Uticaria = ? | *Use and Antihistamine (H1 antag ) to stop the itching... * 1st Gen = chlorpheniramine and diphenhydramine.... * 2nd Gen = fexofenadine and loratadine
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| H1 antag. Generation that can be used to induce sedation ? | * 1st Gen, bc it can cross the BBB easily
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| Treatment of Psoriasis (Plaque) = ? | * DOC = topical steroids
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| Other Plaque tmts we can use ? | * Topical vitamin D analogs = Calcipotriol – hypoproliferative effect
alternative or adjunct to topical steroid
-- Topical retinoids = Tazarotene (alternative to topical steroid)
-- Calcineurin Inhibitors = Tacrolimus -- MTX -- immunosuppressors
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| Plaque medications in general ? | * work better in combo and not so much by themselves
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| MTX MoA = ? Cyclosporine MoA = ? | * MTX = - DHFR, which is needed to help DNA Syn (DNA Syn - ).... * Cyclo. = already mentioned ( IL-2 - )
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| TNF-alpha inhibitors and Retinoids SEs = ? | * Infliximab & Etanercept = can increase malignancies and infections.... * Acitretin = for severe Psoriasis ONLY ! Watch TGs and Liver... Cate. X = NO PREGS and cant have kids even 3 yrs after drug is stopped !
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| Where to use HIGH dose steroids = ? | * for non-face/groin areas and best for palms and soles of the feet (places that have low absorption, unlike the face/folds that have the HIGHEST absorption rates)
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| How to pick the appropriate vehicle to deliver the medication = ? | * Lotions & creams: for exudative lesions
.... * Sprays & gels: for hairy regions
..... * Ointments: for chronic scaly lesions
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