3 - Mycophenolate Mofetil Flashcards
MMF is a prodrug
True
The active antimetabolite of MMF is mycophenolic acid
True
Mycophenolic acid has antibacterial properties
True
Mycophenolic acid has antiviral properties
True
Mycophenolic acid has antifungal properties
True
Mycophenolic acid has antitumour properties
True
Mycophenolic acid has immunosuppressive properties
True
MMF has greater bioavailability and tolerability than Mycophenolic acid
True
MMF is an ester of mycophenolic acid
True
MMF is converted to mycophenolic acid by esterases in the plasma, liver and kidney
True
Mycophenolic acid is inactivated in the liver via glucuronidation
True
Mycophenolic acid is inactivated in the liver
True
Glucuronidation of mycophenolic acid in the liver yields the inactive compound mycophenolic acid glucuronide
True
Mycophenolic acid glucuronide (inactive metabolite of mycophenolic acid) is secreted into bile and recycled to the liver via enterohepatic recirculation
True
The enterohepatic recirculation of mycophenolic acid glucuronide is vital for maintaining mycophenolic acid serum levels
True
Mycophenolic acid glucuronide (inactive metabolite) is converted back to mycophenolic acid by beta-glucuronidase
True
The high levels of beta-glucuronidase (to convert mycophenolic acid glucuronide to mycophenolic acid) found in the epidermis accounts for the efficacy of MMF
True
The high levels of beta-glucuronidase (to convert mycophenolic acid glucuronide to mycophenolic acid) found in the GI tract accounts for the most common adverse effects of MMF
True
The first peak of MMF plasma levels occurs in the first hour
True
A second MMF plasma level peak occurs after 6-12 hours due to enterohepatic recirculation of mycophenolic acid glucuronide
True
Over 90% of the administered MMF dosage is excreted in urine as mycophenolic acid glucuronide (inactive metabolite)
True
Dose reduction of MMF is not necessary in renal impairment
True (renal impairment does not have a significant impact on mycophenolic acid)
MMF and mycophenolic acid is bound to serum albumin
True
A decrease in MMF dosing may be necessary in situations which alter albumin levels
True (altered albumin levels may occur in liver or renal disease or concomitant use of medications that compete for albumin binding sites)
Exposure to increased amounts of unbound mycophenolic acid (active metabolite/drug) may be a predictor of infections
True
Exposure to increased amounts of unbound mycophenolic acid (active metabolite/drug) may be a predictor of haematologic toxicity
True
Mycophenolic acid inhibits inosine monophosphate dehydrogenase in the de novo purine synthesis pathway
True (just like MTX - an antimetabolite)
By inhibiting inosine monophosphate dehydrogenase in the purine synthesis pathway, mycophenolic acid deprives T and B lymphocytes of purine metabolites necessary for growth and replication (hence causes selective immunosuppression)
True
The immunosuppressive effects of MMF are related to the effects of purine biosynthesis affecting lymphocytes
True