Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

(5) Pharmacology > (6.1) Immunosupressants and Arthritis > Flashcards

(6.1) Immunosupressants and Arthritis Flashcards

1
Q

Briefly describe the pathology of Arthritis.

A

1) T cell activation

2a) Produce Fibroblasts & Osteoclasts
3a) Produce collengenases

2b) Produce Rheumatoid factors -> activate IgG -> activates Macrophages
3b) Produce IL1, IL6, TNF Alpha -> Inflammatory cell influx

4) Pannus formation = effused joint, thickened synovium
5) Cartilage & bone erosion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the gold standard treatment of Rheumatoid Arthritis? What is its mechanism of action?

A

Methotrexate

= Folic acid antagonist -> -DNA & RNA synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Suggest 2 indications of Sulfasazaline.

A
  • Inflammatory bowel disease

- Rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Before prescribing Sulfasazaline, what allergies do you need to check?

A

Sulfasazaline is a combination of two drugs, hence check allergies to:

  • Aspirin-like
  • Sulpha group
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is Sulfasazaline good in treating Inflammatory bowel disease?

A

Poor GI breakdown, need bacterial enzymes in lower GI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What common ADRs do all immunosupressants have? How do you monitor the patients?

A
  • Risk of malignancy
  • Risk of infection
  • Hepatitis
  • FBC (check myelosupression)
  • LFT (hepatic function)
  • Creatinine and U&E (renal function)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Briefly describe the mechanism of action of Methotrexate. Suggest 4 indications.

A
  • Folic acid antagoinist -> -DNA&RNA synthesis
  • RA (gold standard)
  • Psoriasis
  • Malignancy
  • Crohn’s disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is special about prescribing Methotrexate?

A

Weekly prescription, orally, IM, S/C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Suggest 4 ADRs (not the typical immunosupressant ones) of Metotrexate.

A
  • Tetratogenic, Abortifacient
  • Pneumonitis
  • Mucotitis (responsive to folate supplements)
  • Cirhosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which drug should be avoided when treating RA?

A

Methotrexate, tetratogenic & abortifacient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Briefly describe the mechanism of action of Corticosteroid. In the case of RA, what particular targets does it have?

A
  • Lipid soluble -> enters cells -> nucleus
  • Transactivation = -gene transcription
  • Transrepression = -inflammatory response
  • IL1 & IL6 produced by macrophages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Suggest some complications of long term Corticosteroids use.

A

Cushing’s Syndrome

A) Easy infection

B) Oppose insulin effects

  • Hyperglycaemia -> Cataract & Glaucoma
  • Hyperglycaemia -> avascular necrosis -> ulcers
  • Lipogenesis -> moon shaped face & weight gain
  • Proteolysis -> purple striae & bruising & muscle wasting & hair thinning

C) -Ca absorption -> Osteoporosis

D) CNS effects

E) Cross activity with Minerolocorticoid

  • Hypertension
  • Hypernaetramia & Hypokalaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is special about prescribing Methotrexate?

A

Weekly prescription, orally, IM, S/C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Briefly describe the mechanism of action of Azathioprine. Suggest 4 indications.

A
  • An antimetabolite of Purine-> -DNA&RNA synthesis
  • Inflammatory bowel disease
  • Atopic dermatitis
  • RA
  • SLE & Vasculitis (as maintenance)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which drug should be avoided when treating RA?

A

Methotrexate, tetratogenic & abortifacient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Briefly describe the mechanism of action of Cyclophosphamide. Suggest 2 indications.

A
  • Form crosslink with DNA -> -synthesis
  • ANCA vasculitis
  • Lupus nephritis (Mycophenolate Mofetil preferred)
17
Q

Suggest 2 ADRs (not the typical immunosupressant ones) of Cyclophosphamide.

A
  • Bladder cancer

- Infertility

18
Q

Suggest 3 steroid sparing drugs.

A
  • Methotrexate
  • Azathioprine
  • Cyclophosphamide
19
Q

Briefly describe the mechanism of action of Azathioprine. Suggest 4 indications.

A
  • An antimetabolite of Purine-> -DNA&RNA synthesis
  • Inflammatory bowel disease
  • Atopic dermatitis
  • RA
  • SLE & Vasculitis (as maintenance)
20
Q

Why is the appropriate dosage of Azathioprine complex to determine?

A

wide genetic polymorphism of the enzymes needed to metabolise it

21
Q

Briefly describe the mechanism of action of Cyclophosphamide. Suggest 2 indications.

A
  • Form crosslink with DNA -> -synthesis
  • ANCA vasculitis
  • Lupus nephritis (Mycophenolate Mofetil preferred)
22
Q

Suggest some ADRs (not the typical immunosupressant ones) of Cyclophosphamide.

A
  • Bladder cancer

- Infertility

23
Q

Briefly describe the mechanism of action of of Mycophenolate Mofetil. Suggest 2 indications.

A
  • Impairs B & C cells proliferation
  • Lupus nephritis
  • Transplantation immunosupression
24
Q

Suggest 1 ADRs (not the typical immunosupressant ones) of Mycophenolate Mofetil.

A
  • Neutropenia
25
Q

Briefly describe the mechanism of action of Calcineurin inhibitors. Name 2 drugs of its group. Suggest 2 indications.

A
  • Binds to Calcineurin receptor on T lymphocytes -> -IL2 production -> - T cell activity
  • Ciclosporin & Tacrolimus
  • Eczema
  • Transplantation suppression
26
Q

Why did Calcineurin fall out of favour?

A
  • Nephrotoxicity
  • Hypertension
  • Hyperuricaemia
  • Hyperlipidaemia
  • Nausea
  • Diarrhoea

(5) Pharmacology (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions