Psoriasis drug-related

Create a care plan for this patient s psoriasis, including statement of the drug-related problems, goals of therapy, patient-specific detailed therapeutic plan, and monitoring plan and follow-up. 

More than 1500 retinoids have been synthesized. Two in particular, 13-cw-retinoic acid (isotretinoin) and etretinate (Figure 38-4), have generated considerable interest as agents for the treatment of dermatological disorders. 13-cA retinoic acid inhibits sebum production, is the drug of choice for treatment of severe cystic acne, and is useful in the treatment of other forms of acne. Etretinate is used in Europe for treatment of psoriasis and related disorders. 

Adverse reactions to alphai-antitrypsin concentrate as replacement therapy are rare. In an international randomized clinical trial, 29% of the patients had adverse reactions (0.004 drug-related adverse events per infusion) of which more than 90% were classified as mild or moderate there was one case of psoriasis [25 "]. 

Medicines related to vitamin D are also effective but an unwanted side effect of the early ones was to cause the body to retain too much calcium, which is detrimental. More than 1500 different compounds have been synthesised to try and find one that would act on the psoriasis without raising the level of calcium in the blood. Calcipotriol cream was the one that performed best and is now widely used. Another chemical, etretinate, was introduced in 1975 and found to be just as effective. It was eventually superseded by acitretin when it was discovered that the body converted etretinate to acitretin and it was the latter which was the active agent. Acitretin is now the prescribed drug and it is very effective with three quarters of those treated reporting noticeable improvement and for about a third of patients their psoriasis cleared up completely. Psoriasis can also be treated with successive oral doses of methoxsalen followed by UV irradiation of the affected area. 

Colchicine with its microtubule-disrupting properties limits the chemotactic and phagocytic activity of polymorphonuclear lymphocytes. It also induces the release of prostaglandin E, a suppressor of leukocyte function by increasing the level of cyclic adenosine monophosphate [39]. Furthermore, the ability of colchicine in inhibition of IL-1 production and histamine release makes it an excellent drug for a number of dermatitis-related complexities like psoriasis, Behget s syndrome, recurrent aphthous stomatitis, leukocytoclastic vasculitis and urticarial vasculitis, bullous disease, scleroderma, fibromatosis. Sweet s syndrome, amyloidosis, and many more [40]. 

Some diseases, including dermatosclerosis, dermatomyositis, systemic lupus ery-thematosis, psoriasis, and myasthenia gravis, etc. may be the result of a disorder of immune responses. The Ganoderma lucidum spore extract showed inhibiting effects on DHT, decreased the primary antibody response in mice and also, in a dose related manner, suppression of murine splenocytes or human tonsil mononuclear cell proliferation in vitro. It inhibited a mixed lymphocyte reaction and decreased the IL-2 level. These results indicate that the inhibitory actions on both the cellular and humoral immunity might explain the use of this drug for the treatment of autoimmune disorders [52]. 

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