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BDS 2: CHHD > Anti-inflammatory and Immunosuppressant Drugs > Flashcards

Anti-inflammatory and Immunosuppressant Drugs Flashcards

1
Q

What are the different types of anti-inflammatory drugs? (4)

A
  • Steroidal anti-inflammatory drugs
  • NSAIDs
  • Non-selective NSAIDs
  • COX-2 Inhibitors
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2
Q

Where is the mechanism of actions of NSAIDs?

A

NSAIDs inhibit the production of prostaglandins from arachidonic acid by COX enzymes

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3
Q

What type of affects does aspirin have on the body? (3)

A
  • Analgesic
  • Anti-inflammatory
  • Anti-thrombotic
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4
Q

Where is aspirin metabolised and excreted?

A

Metabolised in the liver and excreted through the kidneys

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5
Q

Which patients should avoid aspirin?

A
  • With liver disease

- On dialysis

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6
Q

How does aspirin affect platelets?

A

Permanently affects platelet cohesiveness for the entire life span of the platelets (10-14 days)

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7
Q

How does aspirin affect primary homeostasis?

A

Prolongs bleeding time

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8
Q

Give some examples of non-selective NSAIDs (5)

A
  • Ibuprofen
  • Naproxen
  • Diclofenac
  • Mefenamic acid
  • Indomethacin
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9
Q

What type of affects do non-selective NSAIDs have on the body? (3)

A
  • Analgesic
  • Anti-inflammatory
  • Antipyretic actions
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10
Q

What do non-selective NSAIDs inhibit?

A
  • Inhibit both COX-1 and COX-2
  • Inhibition of COX-1 accounts for NSAIDs side effects and toxicity
  • Inhibition of COX-2 accounts for anti-inflammatory actions
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11
Q

What are some side effects of NSAIDs? (4)

A
  • Gastric irritability
  • Platelet dysfunction
  • Acute renal failure
  • Leukotriene overproduction (leading to bronchoconstriction)
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12
Q

Give 2 examples of COX-2 inhibitors

A
  • Celecoxib

- Etoricoxib

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13
Q

Give 3 Antimitotic agents

A
  • Azathioprine
  • Cyclophosphamide
  • Chlorambucil
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14
Q

Give 2 Calcineurin inhibitors

A
  • Ciclosporin

- Tacrolimus

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15
Q

What do Antimitotic agents do?

A

Inhibit cell division

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16
Q

What do Calcineurin inhibitors do?

A

Inhibit macrophages and T cell interaction

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17
Q

Give 3 Biological response modifiers

A
  • Adalimumab
  • Infliximab
  • Etanercept
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18
Q

What is the mode of action of corticosteroids? (2)

A
  • Anti-inflammatory action

- Immunosuppressive action

19
Q

What is the mechanism of action of corticosteroids? (2)

A
  • Reduces inflammatory reaction by limiting the capillary dilatation and permeability of the vascular structures
  • Restrict the accumulation of polymorphonuclear leukocytes and macrophages and reduce the release of vasoactive kinins
20
Q

When would you use corticosteroids? (5)

A
  • Primary or secondary adrenocortical insufficiency
  • Autoimmune atrophy (ie arthritis)
  • Connective tissue disease
  • Leukemias
  • Inflammatory bowel disordes
21
Q

What measurements need to be found out before corticosteroid use? (5)

A
  • Blood pressure
  • Body weight
  • Height
  • HbA1c, triglycerides and potassium
  • Eye assessment
22
Q

What are some endocrine side effects of corticosteroids? (3)

A
  • Adrenal insufficiency
  • Weight gain
  • Diabetes Mellitus
23
Q

What are some GI side effects of corticosteroids? (4)

A
  • Peptic ulceration
  • Haemorrhage
  • Abdominal distension
  • Oesophageal ulceration
24
Q

What are some psychiatric side effects of corticosteroids? (4)

A
  • Confusion
  • Irritability
  • Delusions
  • Suicidal thoughts
25
Q

What are some musculoskeletal side effects of corticosteroids? (2)

A
  • Osteoporosis

- Proximal Myopathy

26
Q

What is a cardiovascular side effects of corticosteroids? (3)

A

Hypertension

27
Q

What are some ophthalmic side effects of corticosteroids? (3)

A
  • Glaucoma
  • Cataract
  • Blurred vision
28
Q

What are some skin side effects of corticosteroids? (3)

A
  • Thinning of skin
  • Easy brushing
  • Delayed wound healing
29
Q

How can you minimise side effects of corticosteroids? (3)

A
  • Prescribe low effective dose for the minimum time possible
  • Withdraw from treatment gradually
  • Take corticosteroids in the morning and on alternate days
30
Q

What should you prescribe to someone with high risk of GI bleeding when they’re taking corticosteroids?

A

Prescribe a proton pump inhibitor for gastrointestinal protection

31
Q

What type of affects does Azathioprine have on the body? (2)

A
  • Immunosuppressive

- Antimetabolite

32
Q

What is the mechanism of action for Azathioprine?

A

Inhibits purine and DNA synthesis necessary for the proliferation of cells, especially leukocytes and lymphocytes

33
Q

What is Azathioprine used to manage? (6)

A
  • Rheumatoid arthritis
  • Preventing renal transplant rejection
  • Crohn’s disease
  • Recurrent oral ulceration
  • Behçet’s disease
  • Colitis
34
Q

What pre-treatment screen needs to be carried out before Azathioprine is prescribed?

A

Thiopurine methyl transferase test

35
Q

What are some side effects of Azathioprine? (5)

A
  • Myelosuppression
  • Hepatotoxicity
  • Leucopenia
  • Thrombocytopenia
  • Infections
36
Q

What are some side effects of Ciclosporin? (6)

A
  • Hypertension
  • Nephrotoxicity
  • Neurotoxicity
  • Gingival hypertrophy
  • Lymphoproliferative disorders
  • Malignancies
37
Q

What is Mycophenolate mofetil?

A

Antibiotic substance derived from Penicillium stoloniferum

38
Q

What does Mycophenolate mofetil do? (2)

A
  • Blocks biosynthesis of purine nucleotides by inhibiting inosine monophosphate dehydrogenase
  • Prevents the proliferation of T-cells, lymphocytes and the formation of antibodies from B-cells
39
Q

What are some side effects of Mycophenolate mofetil? (6)

A
  • Fever
  • Hyperglycaemia
  • Hypertension
  • Easy bruising / Bleeding
  • GI bleed
  • Depression
40
Q

What do biological response modifiers do?

A

Act directly to neutralise specific target immune components

41
Q

What are some things biological response modifiers are used to treat? (5)

A
  • Rheumatoid arthritis
  • Ankylosingspondylitis
  • Psoriasis
  • Crohn’s disease
  • Malignancies
42
Q

Give some examples of biological response modifiers (3)

A
  • Adalimumab
  • Infliximab
  • Etanercept
43
Q

What is the mechanism of action for biological response modifiers?

A

TNF-alpha inhibitors

BDS 2: CHHD (28 decks)

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