pharm derm

interfere with mitochondrial electron transport. Prophylaxis of plasmodium falciparum
Hydroxynaphthoquinone - Lipophilic analog of ubiquinone
Absorption incr w/ fatty meal

Active in liver and blood stages (both prevention and treatment)
Adverse effects: abdominal pain, nausea, vomiting, and headache
For malaria prophylaxis, unlike mefloquine, can start taking 2 days before entry to malaria infested area and 1 week after exit.

Toxicity:GI upset, fever, rash, headache, insomnia.
Prophylaxis for plasmodium falciparum

Prophylactic in Chloroquine-resistant areas. Effective against Chloroquine-resistant P. falciparum

Toxicity: GI distress, dizziness, headache.
Contraindicated in epilepsy and psychiatric disorders

Useful for Plasmodium falciparum, Plasmodium malariae

Toxicity: headache, dizziness, GI upset, These drugs may concentrate in melanin-containing structures
Rare: exfoliative dermatosis, permanent retinal damage with prolonged use, exacerbation of psoriasis

Eliminates the exoerythrocytic or hepatic forms of parasite
Adverse effects: Hemolysis (G6PD deficient individuals) Methemoglobinemia in NADH-methemoglobin reductase-deficient individuals

Used in areas w/ multidrug-resistant P falciparum

Antihelminth drugs

Adverse effects: Minimal when used for short-term. Long-term: mild reversible hepatotoxicity

Adverse effects: Not as well absorbed,
Transient abdominal pain/diarrhea in those with large parasite burden

Antiparasitic drugs

MOA: Organophosphate pesticide.Applied to the hair when dry; 4–6 hours later, the hair is combed to remove nits and lice

reduces sebaceous gland size and inflammation.
Synthetic retinoid All-cis used to treat SEVERE cystic acne unresponsive to other treatments.
Adverse Effects: Potential teratogen with a BLACK BOX warning, lipid abnormalities, headache, elevated liver function test, depression (suicide), ulcerative colitis

Stops the growth of bacteria
Clinical use: Acne vulgaris -Rosacea
Adverse Effects: May cause irritation, redness, dryness (reversible or temporary)

Stimulates mononuclear cells to produce Interferon –α, interleukins 1,-6,-8 & TNF- α due to activating NFkB.
Treat Skin cancer, genital warts
Adverse effects: local irritant reactions

Retinoid metabolite with vitamin A activity; Increases epidermal turnover. Has anti-inflammatory actions
Treats psoriasis

Biological agents

Immunosuppressive T-cell modulator that reduces CD2, CD-4 & CD-8 T-cells.
Given IV or IM once weekly, monitor weekly CD4, STOP if < 250 cells/uL.
Adverse effects: Increased risk of infection & malignancy

Immunosuppressive, decreases activation, adhesion & migration of T-CELLS.
SQ injection weekly, monitor platelet count monthly.
Adverse Effects: Thrombocytopenia

MONOCLONAL antibodies that bind TNF-α receptor
Weekly by SQ or IV injection
Adverse Effects: May cause life-threatening sepsis, pneumonia, TB, or lymphoma.

TNF fusion protein that has epitopes that bind TNF-α
Weekly by SQ or IV injection
Adverse Effects: May cause life-threatening sepsis, pneumonia, TB, or lymphoma.

Binds and activates all known retinoid receptors (RAR and RXR); hence regulates the transcription of genes that control proliferation & differentiation in both normal & neoplastic cells.
Topical treatment for skin lesions in AIDs-related Kaposi’s sarcoma.
Adverse Effects: Local irritation.

Binds and activates RXRs
Topically or orally for CUTANEOUS T-cell lymphoma.A
dverse effects: Contraindicated in pregnancy, avoid becoming pregnant for at least 1 month after discontinuing. Lipid monitoring required.

Histone deacetylase inhibitor
Administered orally for cutaneous T-cell lymphoma in patients recurrent disease (also other treatments have failed).

Adverse Effects: Pulmonary embolism, deep vein thrombosis (DVT), thrombocytopenia, anemia, GI upset.
Used for cutaneous T cell lyphoma

Fatty acid portion dissolves in hydrophobic region of cytoplasmic membrane and disrupts membrane integrity.
Peptide antibiotic, active against Gm (-) organisms including Pseudomonas aeruginosa, E. coli, Enterobacter, & Klebsiella

Adverse Effects: Maximum daily topical application to denuded skin or open wounds should not exceed 200 mg to avoid possible neurotoxicity & nephrotoxicity

Broad spectrum antimycotic, active against Dermatophytes, Candida & Tinea versicolor
Topically as cream or lotion. Also used as nail lacquer for mycosis of the fingernails and toenails.
Adverse effects: minimal

Selective inhibition of squalene epoxidase, a key enzyme for the synthesis of ergosterol (fungal cell wall).
Highly active against dermatophytes.
Adverse effects: Local irritation.

inhibits squalene epoxidase
Synthetic antifungal, effective against dermatophyte infections.
Cream, solution, also may use powder or powder aerosol for chronic tinea infections).
Resistance can occur, should NOT be used alone for infections of palms, soles of feet, or nails.

Inhibits mitotic spindle formation in fungi
Scalp infections (tinea capitus), & infections of non-hairy skin.
Oral form effective against dermatophyte infections caused by trichophyton, microsporum, & epidermophyton

Adverse effects: Headache, N/V, & photosensitivity.
Derived from penicillum mold, may cause penicillin cross-sensitivity
Hepatotoxic, monitor liver function before & after therapy.
Ultramicronized produce plasma levels similar to the micronized form at HALF the dose. Also fatty foods increase the absorption of griseofulvin.