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Pharmacology > 06.1 Immunosuppression & Rheumatoid Arthritis > Flashcards

06.1 Immunosuppression & Rheumatoid Arthritis Flashcards

1
Q

How do corticosteroids prevent inflammation?

A

BInd to nuclear receptors

Inhibit gene expression of immune/inflammatory response

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2
Q

What are some examples of antiproliferative immunosuppressants?

A

Azathioprine
Cyclophosphamide
Mycophenolate mofetil

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3
Q

What are some examples of calcineurin inhibitors?

A

Ciclosporin

Tacrolimus

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4
Q

How does azothioprine work?

A

Inhibits purine synthesis in high mitotic cells

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5
Q

What are some ADRs of azothioprine?

A

Infection
Malginancy
Due to marrow suppression

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6
Q

When is azothiprine used?

A

FA, IBD, transplants, leukaemia

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7
Q

What is interesting about the metabolism of cyclophosphamide?

A

It is a prodrug that is activated by CYP450

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8
Q

What are some ADRs of cyclophosphamide?

A 
Bladder cancer
Lymphoma
Leukaemia
Infertility
Teratogenesis
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9
Q

What is mycophenolate mofetil used for?

A

Organ transplants

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10
Q

What is the mechanism of action of cyclophosphamide?

A

Forms DNA cross links in T cells leading to apoptosis

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11
Q

What is the mechanism of action of mycophenolate mofetil?

A

Inhibits guanasine production in T/B lymphocytes

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12
Q

What are some ADRs of mycophenolate mofetil?

A

Leukoneutropaenia
Myelosuppression
Infection risk

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13
Q

How does ciclosporin work?

A

Binds to lymphocyte ciclophillin
Ciclophillin ciclosporin complex inhibits calineurin
Calcineurin normally allows transcription of interleukin and inflammatory cytokines

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14
Q

What are some ADRs of ciclosporin?

A 
Convulsions
Peptic ulcers
Pancreatitis
Kidney damage
Liver damage
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15
Q

How does tacrolimus work?

A

Binds to calmodulin to prevent calcium from activating calcineurin
Calcineurin normally allows transcription of interleukin and inflammatory cytokines

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16
Q

What are some ADRs of tacrolimus?

A

Cardiac damage
Hyperkalaemia
Diabetes
Cancer

17
Q

What ae the two primary ways that methotrexate can work?

A

Malignancy - antifolate

Non malignancy - inhibiting purines, increases adenosine (?!?) which leads to decereased activity of T cells

18
Q

What are some ADRs of methotrexate?

A 
Mucositis
Marrow suppression
Hepatitis
Cirrhosis
Infection risk
Teratogen
19
Q

What is a DMARD?

A

Disease modifying antirheumatic drugs

Lead to an actual clinical improvement in the condition, not just anti inflammatory

20
Q

Where is sulfasalazine used?

A

RA/IBD

21
Q

What are some examples of anti TNF drugs?

A

Infliximab

Adalimumab

22
Q

How does retuximab work?

A

Binds to CD20 receptors

Causes B cell death

23
Q

What is the stepwise approach of managing rheumatoid arthritis?

A

Methotrexate
ADD Sulfasalazine
ADD TNF antagonist
ADD retuximab

Pharmacology (24 decks)

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