Drugs Flashcards
Eculizumab
- used in renal transplantation as a complement inhibitor
- an IgG4 antibody
- blocks C5 from being cleavedinto C5a and C5b
Rituximab
- selectively targets cells with CD20
- used for the treatment of Non-Hodgkin’s Lymphoma and chronic lymphocytic leukemia (CLL) - b cell lymphoma
Certuximab
- anti-epidermal growth factor receptor (EGFR)
- treats colon and head/neck cancers
Ado-Trastuzumab
- anti-Her2 antibody
- approved for metastatic breast cancer
5-ASAs
- common first treatment for Crohn’s Disease
- 5-aminosalicylates (Aspirin) and antibiotics
- most people do not respond to these treatments, and the next option is often prednisone
Certolizumab Pegol
-Has FAB region of a monoclonal antibody attached to a pegylated carrier that allows for a more sustained systemic effect
Adalimumab
- Humira
- Antibodies against TNF + Fc region of IgG to lengthen its half life
- used to treat Crohn’s disease, psoriasis, and psoriatic arthritis, and RA
- also can be injectable
- Side Effects: Infections such as TB; rare leukemias and vasculitis
Cyclosporin
-targets calcineurin
-Used in transplant therapy as an immunosuppressive agent
-When calcineurin is blocked, NF-AT remains inactive and IL-2 transcription is suppressed
-CYP3A can be used to determine dosing
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Tacrolimus
- targets calcineurin
- Used in transplant therapy as an immunosuppressive agent
- When calcineurin is blocked, NF-AT remains inactive and IL-2 transcription is suppressed
- CYP3A can be used to determine dosing
Belatacept
- interferes in the reaction of T cells with co-stimulatory molecules
- fusion of extracellular domain of CTLA-4 and the Fc region of Ig
- binds to B7 with higher affinity than CD28 and prevents signal 2/T cell proliferation
Basiliximab
- monoclonal antibody that blocks the binding of IL-2 to the IL-2R
- inhibits clonal expansion of T cells
Sirolimus
- blocks mTor (signalling pathway downstream of IL-2R
- also used as an immunosuppressant
Methotrexate
- DMARD of 1st choice
- high dose cancer therapy inhibiting purine synthesis by disrupting folic acid synthesis
- low dose immunosuppressant leading to the accumulation of adenosine which suppresses T cell activation and B cell proliferation
FTY720
-blocks the S1P receptor so that T cells are unable to leave the draining lymph node
Tocilizumab
- Actemra
- IL-6R blocker
- Use for Rheumatoid Arthritis if TNFs did not work
- prone to infections such as TB
Etanercept
- Enbrel
- binds to soluble TNF alpha inhibiting its actions
- Used to treat Rheumatoid Arthritis, Ankylosing Spondylitis
- Side Effects: TB and other opportunistic infections
Infliximab
- Remicade
- chimeric monoclonal antibody
- binds and inactivates TNF alpha (soluble and membrane bound)
- Used to treat Rheumatoid Arthritis in conjunction with Methotrexate (or other DMARDs), and psoriasis
- Side Effects: URI, headache, nausea, diarrhea
Anakinra
- Kineret
- Kineret
- recombinant IL-1
- Blocks IL-1
- Can be used to treat Rheumatoid Arthritis alone or with other drugs
- Side Effects: injection site reaction, infections, neutropenia
Abatacept
- Orencia
- Blocks the binding of B7 with CD28 on T cells
- Used to treat Rheumatoid Arthritis
- Prone to infections such as TB
Tofacitinib
- Xeljanz
- Advantage is that it is an oral pill that can be taken 2 times daily
- Blocks Janus Kinase (JAK)
- Used to treat Rheumatoid Arthritis when methotrexate alone does not work
- Prone to infections such as TB
Acetaminophen
- NOT an NSAID
- Used to treat pain, fever and is also a weak anti-inflammatory
- frequently used in children and pregnant women (NSAIDs contra-indicated during pregnancy)
Dexamethasone
- Glucocorticoid
- anti-inflammatory and immunosuppressant
- 27 times more potent than cortisol
- -Used to treat Rheumatoid Arthritis
- Also given to patients with bacterial meningitis prior to antibiotic treatment
Prednisone
- Glucocorticoid
- pro-drug that is converted into its active form by 3-beta-hydroxysteroid dehydrogenase (3-B-HSD)
- Used to treat inflammatory responses (asthma), Crohn’s disease, and Systemic Lupus erythematosus (SLE)
- Many side effects: moon face, buffalo hump, truncal obesity, muscle weakness, abdominal stria, emotional disturbances
Leflunomide
- 2nd line of defense
- inhibits pyrimidine synthesis blocking proliferation of active lymphoctes
Betamethasone
- glucocorticoid used for skin irritation
- same immunosuppressive and anti-inflammatory actions as prednisone and dexamethasone but is applied topically
Fluticasone
- used to treat allergic rhinitis
- Flonase
Aspirin
- developed from Willow Tree bark/leaves
- salicylate
- irreversible inhibition of COX enzymes - at low doses preferentially inhibits COX-1 and is therefore used as an anticoagulative therapy
- Adverse GI effects
Ibuprofen/Naproxen
- Naproxen trade name is Aleve
- Propionic Acid derivatives
- COX1 and COX2 inhibitors
- GI upset, discontinue prior to surgery
- Difference: Naproxen has a longer half life than Ibuprofen
Indomethacin
- Indole acetic acid derivative
- Not an OTC medication
- delays premature labor; also used in patients with patent ductus arteriosus
- contra-indicated with GI disease due to high incidence of GI side effects
Piroxicam
- Feldene
- prescribed mostly for osteoarthritis
Tenoxicam
- Used to treat chronic pain such as arthritis
- Not effective for acute pain such as post-operative pain
Meloxicam
-COX2 selective inhibitor at lower doses
Ketorlac
- anti-inflammatory providing mild pain relief
- equivalent to codeine
- often given post-operatively
Tolmetin
-used for arthritis pain but has GI side effects
Diclofenac
- Used to treat post-operative pain and post-trauma pain,
- acute migraines
- dysmennorrhea - pain associated with endometriosis
Celecoxib
- Celebrex
- Inhibits p450
- interacts with ACE inhibitors
Misoprostol
- Cytotec
- PGE1
- Prevents NSAID induced gastric ulcers and is often combined with diclofenac
- also used for labor induction
- Abortifacient
- used for patent ductus arteriosus
Dinoprostone
- PGE2
- Cervidil/Prepidil
- cervical ripening
Dinoprost
- PGF2 alpha
- labor induction; Abortifacient
Carboprost
- PGF2 alpha
- Hemabate
- post-partum hemorrhage
Epoprostenol
- PGI2
- Flolan
- vasodilator used in pulmonary hypertension if other treatments fail
Latanoprost
- PGF2 alpha
- used to treat glaucoma
Travoprost
- PGF2 alpha
- used to treat glaucoma
Apocynin
-Nautral inhibitor of NADPH oxidase
Epinephrine
- primary therapy for anaphylactic shock
- also used for bronchial asthma
Theophylline
-used to treat bronchial asthma
Cromolyn
-blocks leukotriene release stabilizing mast cells so that they do no degranulate
Omalizumab
- anti-IgE antibody
- used in children with severe bronchial asthma to neutralize and eliminate IgE
Daclizumab
- Zenapax
- IL-2R blocker
- used to prevent solid organ graft rejection
- Also given to MS patients
