<prompt> All of the following are true about Imiquimod EXCEPT:Direct antiviral activityIndirect antiviral activityAntitumor activityIt release cytokines  <response>: IMIQUIMOD: Mechanism of Action An unknown mechanism in treating actinic keratosis and external genital was; immune response modifier, stimulates the release of inflammatory cytokines and proliferationmigration of immune cells No direct antiviral activity Absorption Appears to be dependent on the area of application rather than the amount applied Peak plasma concentration Aldara: 0.1-3.5 ngmL Peak plasma concentration Zyclara: 0.323 ngmL Elimination Excretion: Urine USES: Actinic Keratosis Indicated for topical treatment of clinically typical, nonhyperkeratotic, nonhyperophic actinic keratoses on the face or scalp in immunocompetent adults Zyclara 2.5 or 3.75: Apply qDay to the skin of affected area either entire face or balding scalp for two 2-week treatment cycles separated by 2-week no-treatment period Aldara 5: Apply 2 times a week for 16 weeks to one defined treatment area contiguous area 25 cm2; examples of dosing schedules include Monday and Thursday or Tuesday and Friday Superficial Basal Cell Carcinoma Target tumor should have maximum 2 cm diameter and be located on trunk excluding anogenital skin, neck, or extremities excluding hands and feet; treatment area should include 1 cm margin of skin around tumor Aldara 5: Apply 5 times a week for 6 weeks to biopsy-confirmed superficial basal cell carcinoma and include 1 cm margin of skin around tumor External Genital Was Indicated for the treatment of external genital and perianal wascondyloma acuminata Zyclara 3.75: Apply a thin film to the entire treatment area and rub in until the cream is no longer visible; may wash with mild soap and water after 8 hours of application; use 1 packet or 1 full actuation of the pump Aldara 5: Apply 3 times a week until total clearance of was or for a maximum of 16 weeks; examples of application schedules are Monday, Wednesday, Friday or Tuesday, Thursday, Saturday; use 1 packet only for each application Bladder Cancer Orphan Orphan designation for the treatment of carcinoma in situ of the urinary bladder. Adverse Effects 10 Application site reaction 33 UI 15 Erythema 54-61 Erosion 29-31 Excoriationflaking 18-25 Edema 12-17 Itching 20 1-10 Sinusitis 7 Burning 6 Headache 5 Carcinoma squamous 4 Diarrhea 3 Bleeding 3 Stinging 3 Pain 3 Eczema 2 Induration 2 Tenderness 2 Irritation 2 Back pain 1 Fatigue 1 Atrial fibrillation 1 REF KD Tripathi 8th ed 