Drugs Flashcards
T/F: esomeprazole causes constipation
False - it causes diarrhoea
Many cells produce TNF-alpha during an acute phase reaction leading to systemic inflammation.
Which of these is the main one?
Name the others (6).
TNF-alpha produced chiefly by activate ‘macrophages’.
Others include:
- CD4+ T-cells
- NK cells
- Neutrophils
- Mast cells
- Eosinophils
- Neurons.
TNF-alpha has a multitude of effects on multiple cells. What are the effects on the following 3 immune cells:
- T-cell
- B-cell
- Monocyte
- T-cell: promotes T-cell proliferation
- B-cell: promotes Ab formation
- Monocyte: increases differentiation
Name 5 TNF-inhibitors.
Who is the odd-one-out in terms of MOA?
Adalimumab Certolizumab Etanercept Golimumab Infliximab
- Etanercept is a soluble TNF receptor
- The rest are recombinant monoclonal Ab that bind TNF.
What 4 rheumatological conditions are TNF-inhibitors indicated in?
- RA
- Psoriatic arthritis
- Ankylosing Spondylitis
- Juvenile Idiopathic Arthritis
Which gastroenterological conditions are TNF-inhibitors indicated?
IBD: UC and CD
Which skin disorder and vascular disease is TNF-inhibitors indicated?
Skin - Psoriasis
Vascular - Giant cell arteritis
What is the function of IL-6?
- Mediator of fever and acute phase reaction
- Has both pro-inflammatory cytokine and anti-inflammatory myokine (cytokine released by muscle)
Name 3 IL-6 inhibitors.
How do they differ in MOA?
mAb to IL-6 receptor: Tocilizumab, Sarilumab
mAB to IL-6: Sirukumab
Which 3 conditions are IL-6 inhibitors indicated?
- RA
- Giant cell arteritis
- Juvenile idiopathic arthritis
Which one condition is IL-6 inhibitor use a possibility?
SLE - trials underway with positive results
What is the function of IL-1?
Pro-inflammatory cytokine.
Which 5 immune cells does IL-1 beta affect?
- Np
- Monocytes
- T-cells (Th17/T-alpha/gamma)
- ILC3 (innate lymphoid cell type 3)
- Osteoclasts
What is the effect of IL-1 beta on the following organ systems:
- Cartilage
- Bone
- Blood vessels
- Hypothalamus
- Pancreas
- Cartilage - matrix enzyme production causing damage
- Bone - osteoclast activation leading to bone loss
- Blood vessels - intimal inflammation leading to atherogenesis
- Hypothalamus - fever and pain response
- Pancreas - beta-cell apoptosis leading to DM
What are 3 IL-1 inhibitors?
What are the MOA?
- Anakinra: IL-1 receptor antagonist
- Rilonacept: soluble decoy receptor that bind IL-1
- Canakinumab: anti-IL-1-beta mAB
What are 3 anti-IL-1 inhibitors?
- Anakinra: IL-1 receptor antagonist
- Rilonacept: soluble decoy receptor that bind IL-1
- Canakinumab: anti-IL-1-beta mAB
Which 3 conditions are IL-1 inhibitors indicated?
- Rheumatoid arthritis
- Gout
- Juvenile Idiopathic Arthritis
What are the 2 [IL-12 / IL-23] inhibitors?
Ustekinumab and Briakinumab - both mAb to IL-12/IL-13
What 2 conditions are [IL-12 / IL-23] inhibitors indicated?
- Psoriasis
2. Psoriatic arthritis
What are the 3 IL-17A inhibitors?
BIS:
Brodalumab
Ixekizumab
Secukinumab
What 3 conditions are IL-17A inhibitors indicated?
PPA:
Psoriasis
Psoriatic arthritis
Ankylosing spondylitis
Name 3 anti-CD20 agents.
ROO:
Rituximab
Ofatummumab
Ocrelizumab
What 4 conditions are treated by anti-CD20 agents?
RRAP
RA (rheumatoid arthritis)
RRMS (relapsing remitting multiple sclerosis)
AAV (ANCA-associated vasculitis)
PPMS (primary progressive multiple sclerosis)
Name 2 anti-BAFF agents.
TB:
Tabalumab
Belimumab
Which 1 condition is treated with anti-BAFF agents?
SLE
What are the 2 CTLA4-Ig (fusion protein) agents?
BA:
Belatacept
Abatacept
What condition is CTLA4-Ig (fusion protein) agents indicated in?
RA (Rheumatoid Arthritis)
