Review of Pharmacology - 9E (2015)

Review of Pharmacology
• Azathioprine is steroid sparing agent for pemphigus vulgaris, bullous pemphigoid,
dermatomyositis, atopic dermatitis, SLE, psoriasis and Behcet’s disease.
• 5-FU is used for actinic keratoses and superficial basal cell carcinoma.
Sun protection factor (SPF)
defines a ratio of minimal dose of
sunlight that produce erythema
on skin with sunscreens to that
without sunscreen.
5. Calcineurin inhibitors
Cyclosporine is used for atopic dermatitis, psoriasis, alopecia areata, pemphigus vulgaris,
bullous pemphigoid, lichen planus and pyoderma gangrenosum. Tacrolimus and
pimecrolimus are other agents in this group.
6. Biological agents
• Alefacept and efalizumab are aproved for moderate to severe psoriasis.
• Etanercept is approved for psoriasis, rheumatoid arthritis and ankylosing
spondylitis.
• Infliximab is approved for Crohn’s disease and rheumatoid arthritis and is in
phase III trials for treatment of psoriasis.
• Denileukin diftitox is indicated for advanced cutaneous T cell lymphoma.
Other Topics and Adverse Effects
7. Sunscreens
These may protect from UV-A (avobenzone, oxybenzone, titanium oxide and zinc oxide) or
UV-B (cinnamates, salicylates etc.). Sun protection factor (SPF) defines a ratio of minimal
dose of sunlight that produce erythema on skin with sunscreens to that without sunscreen.
It provides valuable information regarding UVB protection but is useless for UVA efficacy.
8. Other agents
• Cholestasis associated pruritis may respond to cholestyramine, ursodeoxycholic acid, ondansetron,
rifampicin and nalmefene (opioid antagonist).
• Pruritis of uremia is most effectively treated with UVB radiation. It may also respond
to naltrexone and omeprazole.
• Capsaicin is approved for the treatment of post herpetic neuralgia and painful diabetic
neuropathy.
• Masoprocol is a potent 5-LOX inhibitor with antitumor activity effective for topical
treatment of actinic keratosis.
AGE-RELATED MACULAR DEGENERATION
• It is of two types Dry and wet. Dry form is most common but untreatable. Vitamin
supplements with zinc, lutein and zeaxanthin may delay its progression. Wet form
or neovascular ARMD is amenable to therapy.
• Photodynamic therapy with verteporfin (a radiosensitizer) is the approved therapy
of neovascular ARMD.
• New strategies include intravitreal administration of anti-VEGF compounds.
These include pegaptanib, ranbizumab, aflibercept and bevacizumab.
• Anecorvate is an angiogenesis inhibitor indicated for ARMD.
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TREATMENT OF POISONINGS
Poisoning
Treatment
1. Ergot Alkaloids Nitroprusside
2. β-blockers Glucagon and Calcium
3. Organophosphates Atropine
4. Carbamates Atropine
5. Benzodiazepines Flumazenil
6. Zolpidem Flumazenil
Contd...
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