NEW
Font size
WorksheetsPharmacology Week 4 Part 3
Total questions: 26
Worksheet time: 13mins
Anthralin is best described as:
Gentle long-contact therapy preferred
Caustic, with short-contact therapy preferred
First-line systemic therapy
Requires no monitoring because it is non-irritating
Pimecrolimus in psoriasis is:
FDA-approved first-line systemic therapy
Off-label and avoids steroid-induced atrophy
Contraindicated because it always causes atrophy
An oral PDE-4 inhibitor
Methotrexate in psoriasis is:
Gold standard systemic therapy
Not used systemically
Safe in pregnancy
Limited primarily by cumulative renal toxicity
For patients on methotrexate, folic acid 1 mg daily is used to:
Increase methotrexate potency
Reduce GI adverse effects
Prevent HPA axis suppression
Prevent leukotriene production
Methotrexate is:
Pregnancy contraindicated
Preferred during pregnancy
Only topical
Used without any adjuncts ever
Cyclosporine for psoriasis is:
Ineffective
Highly effective but limited by cumulative renal toxicity
Contraindicated because it causes skin atrophy
A topical vitamin D analog
Acitretin counseling includes:
Contraception required only during therapy
Contraception required during therapy and for 3 years after discontinuation
Safe with alcohol use
Stop contraception immediately after last dose
Acitretin and alcohol counseling includes:
Alcohol required to improve absorption
Avoid alcohol during therapy and for 2 months after stopping
Alcohol is allowed only on weekends
Alcohol avoidance is unnecessary
Apremilast is best described as:
Injectable TNF-alpha inhibitor
Oral PDE-4 inhibitor that requires no laboratory monitoring
Systemic steroid requiring taper
Antifungal that blocks 11-beta-hydroxylase
Biologic response modifiers for psoriasis include:
TNF-alpha inhibitors, IL-17 inhibitors, IL-23 inhibitors
H1 antagonists, H2 antagonists, leukotriene inhibitors
Beta-blockers, ACE inhibitors, ARBs
Penicillins, cephalosporins, sulfonamides
Biologics are generally considered in psoriasis when:
Disease is always mild
Other systemic agents fail or traditional systemic therapy is contraindicated
Topical moisturizers fail after one day
The patient has Addison’s disease
Corticosteroids broadly include:
Only mineralocorticoids
Glucocorticoids and mineralocorticoids
Only antihistamines
Only biologics
Addison’s disease is best described as:
Hyperfunction of adrenal cortex with excess cortisol
Hypofunction of adrenal cortex with deficiency of cortisol and aldosterone
Primary thyroid failure
Excess catecholamine production from adrenal medulla
Treatment of Addison’s disease is:
Phototherapy
Corticosteroid replacement therapy
TNF-alpha inhibition
High-dose topical clobetasol only
Hydrocortisone dosing for Addison’s disease is:
2–4 mg daily
20–40 mg PO daily
200–400 mg PO daily
Only IV bolus once weekly
Hydrocortisone replacement is commonly divided as:
Half in the evening, half at bedtime
Two-thirds in the morning and one-third in the afternoon/evening
All at midnight
Only in the afternoon
The purpose of divided hydrocortisone dosing in Addison’s disease is to:
Avoid mineralocorticoid activity entirely
Mimic physiologic diurnal cortisol secretion
Increase gastric pH
Prevent histamine release
Cushing’s syndrome is best defined as:
Hypocortisolism
Hypercortisolism
Aldosterone deficiency only
Isolated histamine excess
Pharmacologic therapy for Cushing’s syndrome is used when:
Surgery is not possible
Surgery is always first and pharmacotherapy is never used
Only mild disease is present
The patient has contact dermatitis
Ketoconazole treats hypercortisolism primarily by:
Activating beta-2 receptors
Inhibiting multiple CYP enzymatic steps in cortisol synthesis
Increasing aldosterone synthesis
Blocking H1 receptors competitively
Ketoconazole specifically inhibits which enzymes in cortisol synthesis?
5-alpha-reductase and aromatase
11-beta-hydroxylase and 17-alpha-hydroxylase
COX-1 and COX-2
ACE and neprilysin
A critical monitoring requirement with ketoconazole for Cushing’s syndrome is:
Daily CBC only
Intensive weekly liver function monitoring
Monthly TSH only
No monitoring required
A serious risk of ketoconazole therapy for Cushing’s syndrome is:
Severe, potentially fatal hepatotoxicity
Skin atrophy
Red Man Syndrome
Cataracts within 24 hours
Systemic steroid tapering is required if the patient has been taking:
5 mg prednisone daily for 7 days
At least 20 mg prednisone daily for 21 days or more
Any dose of topical hydrocortisone for 2 days
One IM epinephrine dose
Long-term systemic corticosteroid risks include all EXCEPT:
Osteoporosis
Hyperglycemia
Infection risk
Increased vaccine efficacy
Risk mitigation for long-term corticosteroid therapy includes:
Highest effective dose and no taper
Lowest effective dose, proper tapering, and ongoing monitoring
Avoid monitoring to reduce anxiety
Only adding antihistamines
