anti metabolites

Question 1

what is the mechanism of action of anti metabolites?

Answer 1

interfere with DNA synthesis

Question 2

Name two anti metabolites?

Answer 2

1. Azathioprine

2. Methotrexate

Question 3

What is the mechanism of action of Azathioprine?

Answer 3

1. Azathiprine is converted to 6-mercaptopurine
2. in turn acts as an immunosupressant
3. TPMT enzyme is responsible to break down the active metabolite

Question 4

What should be tested prior to commencing to Azathioprine?

Answer 4

1. TPMT testing
2. TPMT deficiency is an autosomal recessive condition
3. ## Patients with low TPMT activity - very high levels of Azathioprine
4. risk of excessive bone marrow supression and hepatotoxicity

Question 5

What is Azathioprine used for?

Answer 5

1. Crohn’s disease
2. Ulcerative colitis
3. Rheumatoid arthritis
4. SLE

Question 6

What are the 2 side effects of methotrexate?

Answer 6

1. bone marrow depression

2. increased risk of infection

Question 7

What is the mechanism of action of methotrexate

Answer 7

1. folate antagonist

2. inhibits DNA synthesis

Question 8

Name some conditions methotrexate is used for?

Answer 8

1. Crohn’s

2. Rheumatoid arthritis

Question 9

What are the main side effects of methotrexate?

Answer 9

1. teratogenic - must be on contraception

2. Given with folic acid to reduce GI side effects