Pharmacology Flashcards: Dermatology, Rheumatology, Endocrinology

A set of Q/A style flashcards covering drug mechanisms, indications, and adverse effects from the provided dermatology, rheumatology, and osteoporosis/endocrinology notes.

What is the mechanism of action of acyclovir and its common viral targets?

Antiviral that inhibits viral DNA polymerase; active against HSV-1, HSV-2, and VZV (typically more for herpes).

What are the rare but serious adverse effects of acyclovir?

Acute kidney injury (AKI), neurotoxicity, thrombocytopenia.

What is the brand name for acyclovir?

Zovirax.

What is the brand name for valacyclovir?

Valtrex.

What is the antiviral spectrum of famciclovir and its brand name?

Active against HSV-1, HSV-2, VZV (typically more for shingles); brand Famvir.

Which topical antibiotic is used for mild-moderate acne and what are its local adverse effects?

Clindamycin; local dryness, itching, irritation. Brands include Cleocin T and Clindagel.

What is a common acne-producing macrolide antibiotic and its adverse effects?

Erythromycin (Akne-mycin); adverse effects include GI symptoms.

What is the role of benzoyl peroxide in acne therapy and its local adverse effects?

Antimicrobial (suppresses P. acnes) and keratolytic; can cause local dry skin and irritation. Brands include Benzagel, Clean & Clear, PanOxyl, etc.

What does salicylic acid do in acne treatment and its adverse effects?

Keratolytic; increases sloughing of the top skin layer; local dry skin/irritation.

What is tretinoin and its common adverse effects?

Retinoid (Vitamin A derivative) that increases cell turnover; adverse: dry skin, flaking/peeling, irritation, photosensitivity. Brand Retin A.

What is adapalene used for and its brand name?

Common topical acne medication; brand Differin gel.

What are the major adverse effects and teratogenic concerns with isotretinoin?

Severe acne; dry skin/mucosa; hypertriglyceridemia; liver enzyme elevation; suicidal ideation; teratogen. Brands include Accutane (no longer in use), Amnesteem, Claravis, Myorisan.

What is spironolactone’s role in acne and its notable adverse effects?

Anti-androgen (blocks androgen receptors and 5α-reductase); used for moderate acne; adverse: hypotension, hyperkalemia. Brand Aldactone.

What are doxycycline and minocycline’s notable adverse effects in acne therapy?

Doxycycline: significant photosensitivity; teratogen (Monodox, Periostat, Vibramycin). Minocycline: teratogen; hyperpigmentation/permanent teeth staining in children <8 (Minocin).

What is a common topical antibiotic used in acne and its GI-related adverse effects?

Erythromycin (macrolide) used in acne; GI symptoms (Brand Eryped, etc.).

What is ketoconazole’s mechanism, primary topical uses, and a common local adverse effect?

Inhibits fungal synthesis of ergosterol → membrane instability → cell death; primarily topical for tinea versicolor and psoriasis; adverse: local burning, pruritus. Brand Nizoral.

Name two common topical antifungals and their typical uses.

Clotrimazole (Lotrimin): for tinea and candidiasis; Miconazole (Monistat): vaginal or OP candidiasis, tinea.

What is itraconazole used for and its major adverse effects?

Oral antifungal for systemic mycoses, onychomycosis, oropharyngeal/esophageal candidiasis; adverse: GI symptoms.

What is fluconazole used for and its major adverse effects?

Oral for candidiasis, cryptococcosis, histoplasmosis, blastomycosis; adverse: prolonged QT/dysrhythmias, skin reactions, hepatotoxicity.

What is amphotericin B’s mechanism and its key adverse effects?

Binds ergosterol → fungal cell lysis; adverse: nephrotoxicity, fever/chills, bone marrow suppression, arrhythmias.

What are the topical antifungal preparations for candidiasis and their brand names?

Nystatin (topical for vaginal/OP candidiasis, diaper rash); Brand Nyamyc. Griseofulvin (oral for tinea pedis/onychomycosis) – adverse hepatotoxicity, carcinogenic/teratogenic, disulfiram-like rxn (no specific brand listed). Brand name not provided in notes.

What is terbinafine’s mechanism and its topical and systemic uses?

Inhibits fungal squalene epoxidase → decreased ergosterol synthesis → cell death; topical for various tinea infections; oral for tinea pedis/onychomycosis; adverse: hepatotoxicity, GI symptoms, headache, rare skin rash. Brand Lamisil.

Name common topical anti-inflammatory corticosteroids and one very potent option.

Hydrocortisone (Cort-aid, Cortisone 10 OTC); Triamcinolone; Clobetasol; Betamethasone. Potency increases from hydrocortisone to clobetasol.

What are tacrolimus and pimecrolimus and their uses?

Tacrolimus: calcineurin inhibitor; inhibits T cell function; Brand Protopic. Pimecrolimus: brand Elidel.

What is imiquimod used for and its common site effects?

Modifies anti-tumor immune response; Actinic keratosis, anogenital warts; itching, burning at application site.

What does 5-fluorouracil do and what are its indications and adverse effects?

Inhibits thymidylate synthase → decreased DNA synthesis; Actinic keratosis, basal cell carcinoma, SCC in situ; adverse: erythema.

What are the adverse effects of long-term prednisone use?

Metabolic syndrome/diabetes, Cushingoid features, HTN, psychiatric changes, impaired wound healing, striae, fluid retention, CHF, GI bleeding, weight gain, hepatotoxicity, osteoporosis, cataracts, glaucoma.

What is methotrexate’s mechanism and major adverse effects in autoimmune diseases?

Antimetabolite that inhibits dihydrofolate reductase; used in psoriasis, bullous pemphigoid, pemphigus vulgaris; adverse: alopecia, rash, GI symptoms, stomatitis, bone marrow suppression, hepatotoxicity, acute interstitial pneumonitis, teratogen. Brands Rheumatrex, Trexall, Otrexup, Rasuvo.

What is apremilast (Otezla) and its adverse effects?

PDE4 inhibitor; used for psoriasis and psoriatic arthritis; adverse: diarrhea, nausea, headache, depression.

What is cyclosporine (Sandimmune) and its major adverse effect in rheumatology?

Calcineurin inhibitor, inhibits T cell function; used in RA; nephrotoxicity.

What is mycophenolate’s mechanism and its rheumatology/nephrology indications and adverse effects?

Inhibits purine synthesis; used in RA and severe lupus, lupus nephritis; adverse: pancytopenia, GI symptoms.

What is azathioprine (Imuran) used for in autoimmune therapy?

Immunosuppressant (implied in notes as part of rheumatology therapy); adverse not specified in notes.

Which biologic agents are TNF-alpha inhibitors used for RA, and what are their common adverse effects?

Adalimumab (Humira), Etanercept (Enbrel), Infliximab (Remicade); adverse: injection reactions, serious infections (TB and atypical), worsening CHF, bone marrow suppression, skin cancer, demyelinating disease, drug-induced lupus, paradoxical psoriasis.

What is rituximab (Rituxan) and its major adverse effects?

Anti-CD20 on B cells; adverse: infusion reactions, serious infections, hepatotoxicity, PML, neutropenia.

What is dapsone used for and its main adverse associations?

Antibiotic used for dermatitis herpetiformis; hematologic abnormalities (rare). Brand not specified in notes.

What are the NSAIDs listed and their general adverse effects?

Diclofenac, Ibuprofen, Naproxen (nonselective COX-1/COX-2 inhibitors); adverse: dyspepsia, GI bleeding, nephrotoxicity, edema, increased risk of cardiovascular events. Celecoxib is COX-2 selective (brand Celebrex).

What are hydroxychloroquine’s mechanism and common adverse effects?

Inhibition of TLRs to impair antigen-presenting cell function; used for lupus (initial therapy), RA, and other autoimmune diseases; adverse: retinopathy, GI symptoms, rash, hematologic abnormalities. Brand Plaquenil.

What is sulfasalazine’s mechanism and key adverse effects?

Exact mechanism unknown; used in RA and spondyloarthropathies; adverse: pruritic rash, GI symptoms, discolored urine, bone marrow suppression, transient oligospermia; do not use in sulfa allergy. Brand Azulfidine.

What does leflunomide (Arava) do and its major adverse effects?

Inhibits pyrimidine synthesis → blockade of T cell proliferation; used for RA, psoriatic arthritis, ankylosing spondylitis; adverse: bone marrow suppression, hepatotoxicity, teratogen.

What are the common osteoporosis medications and a key adverse effect for bisphosphonates?

Alendronate (Fosamax), Ibandronate (Boniva), Zoledronic acid (Reclast); adverse: GI upset; osteonecrosis of the jaw.

What is denosumab (Prolia) and its notable adverse effects?

RANKL inhibitor; adverse: hypercholesterolemia, serious infections, osteonecrosis of the jaw.

What is raloxifene (Evista) and its common adverse effects?

Selective estrogen receptor modulator (SERM); adverse: thromboembolism, peripheral edema, hot flashes, arthralgia.

What is teriparatide (Forteo) and its major adverse effects?

Parathyroid hormone analog; stimulates bone formation; adverse: transient hypercalcemia, orthostatic hypotension, palpitations. Abaloparatide (Tymlos) is similar.

What is abaloparatide and its brand name?

Parathyroid hormone analog similar to teriparatide; brand Tymlos.

What is calcitonin (Miacalcin) used for and a potential risk?

Hormone that decreases osteoclast activity; osteoporosis (last resort); potential increased cancer risk.

What is colchicine’s mechanism and its common adverse effects?

Inhibits migration of neutrophils to sites of urate crystal inflammation; adverse: GI symptoms, fatigue, alopecia, hepatotoxicity, hypersensitivity reactions, lab abnormalities. Brand Colcrys.

What are the urate-lowering agents all listed with their general adverse effects?

Allopurinol (Zyloprim): rash, GI symptoms, hepatotoxicity, alopecia, neuropathy, lab abnormalities. Febuxostat (Uloric): similar plus arthralgia.

What is the brand name for allopurinol and febuxostat?

Allopurinol: Zyloprim; Febuxostat: Uloric.