Drugs Flashcards
what do steroids suppress the action of?
B and T cells by decreasing transcription of cytokines
what cells do steroids make apoptose?
T cells
what three endocrine issues can steroids cause?
cushing syndrome
osteoporosis
hyperglycemia
diabetes adrenocortical atrophy
what female repro issue can steroids cause?
amenorrhea for female
what can happen in GI with steroids?
peptic ulcers
what can happen to bone with steroids?
avascular necrosis and osteoporosis
what can happen with eyes in steroid use?
cataracts
what is the anti malarial used in SLE?
hydroxychloroquine
what is a secondary effect that HCQ has that helps with antiphospholipid syndrome?
slightly anti coagulant
what two situations mean you should not give HCQ?
retinopathy and G6PD deficiency
what should patients on HCQ have yearly?
eye exam for retinopathy
what are the two main side effects of hCQ?
rash and N/V
what is MoA of methotrexate
dihydrofolate reductase inhibitor…so decrease DNA synthesis
what four inflammatory conditions is methotrexate used in?
RA, IBD, psoriasis, vasculitis
what are the three main side effects of methotrexate?
nausea
fatigue
mucosal ulceration
what is biggest toxicity associated with methotrexate use?
hepatotoxicity
what pregnancy class is methotrextae?
class X
what is MoA of leflunomide?
enzyme inhibitor of dihydroorate dehydrogenase…leads to low levels of pyrimidine synthesis
what cell does leflunomide really inhibit production of?
T cells
what is leflunomide often used for?
SLE RA and psoriatic arthritis
what pregnancy category is leflunomide?
category X
what is the MoA of azathioprine?
purine analog that inhibits the purine synthesis
what molecule activated azathioprine?
HGPRT..turns it into 6-mercaptopurine
what inflammatory disorders is azathioprine used for?
SLE, systemic vasculitis and myopathies
what vasculitidies is azathioprine the maintenance therapy for?
ANCAs
what are the main SEs of azathioprine?
GI, liver tox, myelosuppression!!!
what three drugs can azathioprine interact with?
allopurinal, trimehtoprim, ACE inhibitors
what pregnancy class is azathioprine?
not teratogenic
what is MoA of mycophenolate mofetil?
reversibly inhibits IMP dehydrogenase to slow purine synthesis in B and T cells
what is number one indication for mycophenolate mofetil?
lupus nephritis
what are some indications for mycophenolate mofetil other than lupus nephritis?
SLE, scleroderma lung disease, vasculitis
what is most common SE of mycophenolate mofetil?
dyspepsia…GI upset
what can happen to bone marrow on mycophenolate mofetil?
myelosuppression
what is the MoA of cyclophosphamide?
alkylates DNA…crosslinks at the guanine residues
what is indication for cyclophosphamide in auto immine disorders?
SLE, vasculitis, systemic sclerosis
name the three main SEs of cyclophosphamide
nausea
alopecia
myelosuppression
what is risk with cyclophosphamide in GU?
hemorrhagic cystitis and bladder cancer
how can you prevent bladder cancer and hemorrhagic cystitis when taking cyclophosphamide?
give MESNA
what can happen to repro tract on cyclophosphamide?
infertility
name the three most used TNF-a inhibitors
atanercept
infliximab
adalimumab
what is big black box warning with TNF-a inhibitors?
TB re activation and Hpe B reactivation
what is the MoA of rituximab?
MAB at CD20
when is rituximab used
RA, ANCA vasculitis,
name three adverse effects of rituximab
arthralgias
serum sickness
infections
what is a major infection concern with rituximab?
reactivation of Hep B and PML
what autoimmune conditions are indications for IVIG?
kawasakis
immune thrombocytopenia
SLE
inflammatory myopathy
