Medical Today

Definition

Psoriasis is a chronic, non-contagious disease characterized by inflamed hyperproliferative lesions covered with silvery-white scabs of dead skin.

Description

Psoriasis, which affects at least four million Americans, is slightly more common in women than in men. Although the disease can develop at any time, 10–15% of all cases are diagnosed in children under 10, and the average age at the onset of symptoms is 28 years of age. Psoriasis is most common in fair-skinned people and relatively rare in dark-skinned individuals, although the rate among African Americans appears to be slowly rising.

Pharmacology.

Leflunomide’s active metabolite (M1) inhibits dihydro-oratate dehydrogenase, thereby inhibiting pyrimidine biosynthesis. M1 exhibits immunomodulating and anti-inflammatory effects.

Administration and Adult Dosage.

PO for rheumatoid arthritis 100 mg/day for 3 days, then 20 mg/day. Reduce dose to 10 mg if 20 mg is not tolerated.

Pediatric Dosage.

Safety and efficacy not established.

Geriatric Dosage.

Same as adult dosage.

Dosage Forms.

Pharmacology.

Infliximab is a chimeric monoclonal antibody that binds to soluble and transmembrane forms of TNF a, thereby neutralizing the activity of TNFa and inhibiting TNFa binding to its receptor sites. It has no effect on lymphotoxin (TNFa).Infliximab induces pro-inflammatory cytokines including interleukins 1 and 6 and increases endothelial cell permeability by enhancing leukocyte migration.

Administration and Adult Dosage.