CF Drugs Flashcards
What does CFTR do?
CFTR functions as an anion channel (which is regulated by PKA-dependent phosphorylation of its regulatory domain and binding of ATP tothe nucleotide binding domains) and conducts Cl- and HCO3- into airways CFTR also functions as a negative-regulator of the amiloride-sensitive epithelial Na+ channel (ENaC) that is responsible for moving Na+ out of airways.
Drugs for CF?
-Ivacaftor-Orkambi
Ivacaftor is approved to treat which CF patients?
G551D patients only
How does Ivacaftor work?
Improving chloride transport through themutated channels.
How is Ivacaftor metabolized?
In the liver by CYP3A4/5 and is itself an inhibitor of CYP3A and P-gp (drug-drug interactions).
AEs of Ivacaftor?
-URT symptomatology (infections)-GI pain and rash-oropharyngeal pain
How does Orkambi work?
This combination product adds a conformation stabilizer drug to the action of ivacaftor. Thus,the combined agent both improves delivery of more fully functional protein to the apical surface of the cell and also potentiates the effect of the protein produced.
How is Lumacaftor metabolized?
Minimally metabolized but does function as a strong inducer of CYP3A4.
Other drugs for CF?
-mucolytics (Dornase Alfa)
How does Dornase Alfa work?
A recombinant human (rh)DNAase takenby nebulizer, this drug cleaves and depolymerizes extracellular DNA, separating DNA fromproteins and thus facilitating proteolytic enzyme activity.
Net effect of Dornase Alfa?
The net result is a substantialreduction in the viscoelasticity and surface tension of the purulent sputum.
