autoimmune disease Flashcards
name some aminosalicylates
mesalazine
sulfasalazine
Indications of aminosalicylates
- 1st line in UC
- Can be used in RA
MOA Aminosalicylates
- release 5-ASA. antinflammatory and immunosuppressive. acts topically on gutl delay delivery of active ingredients to the colon.
which aminosalicylates do you give in RA
- Sulfasalzine
SE aminosalicylates
- mes has less than sulf.
- GI upset - nausea, hyspepsia
- headache
- leucopenia
- thrombocytopenia
- renal impairment
men - sulfasaline; recersible oligospermia.
sulfasalzine - hypersensitivity reaction - fever, rash and liver issues
who to not give the aminosalicyaltes too
those with aspirin hyeprsensitivity as this is also a salicyalte
interactions of aminosaslicyaltes
- drugs that alter tummy pH e.g PPI - increase pH = coating of salicylates breaks down prematurely,
- lacutlose - lowers stool ph - stopping release in colon.
methotrexate indications
- DMD for RA
- Chemo for cancers including leukaemia, lymphoma and some solid tumours
- severe psoriasis that is resistant to other therapies
MOA methotrexate
- inhibits dihydrofolate reductase - which is needed for protein synthesis and cellular replication
- is also antinflammatory and immunosupressive
SE methotrexate
dose related =
- mucosal damage e.g. sore mouth/GI upset
- BM supression - neutropenia and infection
- hypersensitivity reactions inc cutaenous, hepatitis and pneumonitis
ltm = - hepatic cirrhosis - pulmonary fibrosis - accidental overdose if pt takes daily as normally should be once a week; severe toxicity if renal impairment and hepatotoxicity \+ seizures, headache, coma
reversal agent for methotrexate overdose
folinic acid + hydration and urinary alkalization
CI to methotrexate
pregnancy, severe renal impairment
Relative CI to methotrexate
-liver function abnormalities
what should patients be told (men and women) regarding pregnancy if on methotrexate
must take contraception during and for 3 months after stopping treatment as is teratogenic
interactions of methotrxate
drugs that inhibit its renal excretio
- NSAIDs
- penicillins
other folate antagonists
- trimethoprim and phenytoin = haematological abnormalities
- clozapine - increased risk of neutropenia
