| • | are derived from quinine, a compound extracted from the bark of the cinchona tree native to S. America |
mechanism of action: unclear
| • | photodermatologic properties but no effect on MED |
adverse effects:
| • | may induce leukopenia within first few months of treatment |
| • | exacerbation of psoriasis (conflicting reports; widely used by rheumatologists for the treatment of psoriatic arthritis) |
| • | blue/black pigmentation of the pre-tibia, palate, face, and nail beds (reversible over time) |
| • | deposits in the cornea (reversible; produce only slight symptoms such as halos around bright objects) |
| • | irreversible retinopathy (dose related) |
indications:
| • | malaria, RA are the chief indications |
| • | favorable risk/benefit in LE, PMLE, PCT, REM |
| • | PMLE – PUVA is more effective, therefore the aminoquinilone are mainly indicated when PUVA cannot be given |
| • | PCT – theory = uropophyrins and chloroquine compete for the same binding sites in liver tissue |
lupus:
| • | full effect is obtained within a month |
| • | cutaneous symptoms respond better than do systemic involvement |
| • | mainly used in combination with glucocorticoids in LE |
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