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2 - CPR (renal) > Drugs for Glomerulonephritis > Flashcards

Drugs for Glomerulonephritis Flashcards

1
Q

What 9 drugs can be used to treat Glomerulonephritis?

A 
Prednisone, Methylprednisolone
Rituximab
Cyclophosphamide
Mycophenolate
Azathioprine
Methotrexate
Cyclosporine, Tacrolimus
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2
Q

What 9 drugs can be used to treat Glomerulonephritis?

A 
Prednisone, Methylprednisolone
Rituximab
Cyclophosphamide
Mycophenolate
Methotrexate
Azathioprine
Cyclosporine, Tacrolimus
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3
Q

What are 2 Glucocorticoids?

A

Prednisone

Methylprednisolone

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4
Q

Which Glucocorticoid is non-fluorinated and is more potent?

A

Methylprednisolone

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5
Q

What is the MOA for Prednisone?

A
  • Binds Glucocorticoid Receptor and complexes with NF-KB and AP-1 transcription factor
  • (+) lipocortin
    ==> immunosuppression and no eicosanoid synthesis
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6
Q

What is Prednisone converted to in the liver?

A

Prednisolone

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7
Q

What is the outcome of Prednisone use?

A

Relieves pain and inflammation while waiting for DMARD effects and treats flares of autoimmune diseases

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8
Q

What is a possible syndrome and its attributes that is a side effect of the glucocorticoids?

A

Cushing’s syndrome

= buffalo hump, truncal obesity, striae, acne, hirsutism

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9
Q

Besides Cushing’s syndrome, what are some other side effects of taking Glucocorticoids?

A

CNS issues
Impaired glucose tolerance and salt/water retention
Osteoporosis
Infections

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10
Q

What is Rituximab?

A

Antibody that targets CD-20

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11
Q

Describe how Rituximab works

A
  • @ the pre-B cell stage, cells express CD-20 on their surface
  • Once Rituximab destroys CD-20, B cells are converted to Plasma cells
    = Decreased B cells but normal immunoglobins
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12
Q

What 1 thing can Rituximab treat?

A

Granulomatosis with Polyangiitis

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13
Q

Rituximab can treat Granulomatosis with Polyangiitis. But if it is used with _____ it can treat Rheumatoid Arthritis

A

With Methotrexate

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14
Q

What is a possible side effect of Rituximab?

A

Infusion - related hypersensitivity reactions

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15
Q

When using Rituximab, what can be (+) that may indicate a higher likelihood of responsiveness?

A

(+) rheumatoid factor or anti-ccp

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16
Q

MOA for Cyclophosphamide?

A

Forms irreversible DNA crosslinks

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17
Q

At low doses, what is the general effect of Cyclophosphamide?

A

Immunosuppressant

18
Q

At high doses, what is the general effect of Cyclophosphamide?

A

Cancer cell apoptosis

19
Q

What 1 thing can Cyclophosphamide treat?

A

Nephrotic Syndrome

20
Q

This drug forms irreversible DNA crosslinks and can treat Nephrotic Syndrome

A

Cyclophosphamide

21
Q

MOA for Mycophenolate?

A

(-) inosine monophosphate dehydrogenase

– noncompetitive and reversible

22
Q

MOA for Mycophenolate and what that causes?

A

(-) inosine monophosphate dehydrogenase

==> blocks guanine nucleotide synthesis in lymphocytes

23
Q

What are possible adverse effects of Mycophenolate?

A

Hematologic and GI toxicities

Fetal harm

24
Q

This drug can pretty much treat any of the Glomerulonephritis’s and is prophylaxis for transplant rejection

A

Mycophenolate

25
Q

MOA for Azathioprine?

A

Purine antimetabolite that forms 6-thio-gtp to impair lymphocyte function

26
Q

MOA for Azathioprine?

A

Purine antimetabolite that forms 6-thio-gtp to impair lymphocyte function

27
Q

What 3 things can Azathioprine treat?

A

Lupus nephritis
Granulomatosis with Polyangiitis
Microscopic polyangiitis

28
Q

What 3 things can Azathioprine treat?

A

Lupus nephritis
Granulomatosis with polyangiitis
Microscopic polyangiitis

29
Q

What is a possible side effect of Azathioprine?

A

Bone marrow suppression

30
Q

What is the MOA for Cyclosporine and Tacrolimus?

A

(-) calcineurin –> NFAT not (+) –> T cells not activated because certain cytokines like IL-2 are not produced

31
Q

What is the MOA for Cyclosporine and Tacrolimus?

A

(-) calcineurin –> NFAT not (+) –> certain cytokines like IL-2 not (+) –> T cells not (+)

32
Q

What 2 things can Cyclosporine and Tacrolimus treat?

A

Lupus nephritis

FSGS

33
Q

What is a possible adverse effect of Cyclosporine?

A

Nephrotoxicity

34
Q

What is a possible adverse effect of Tacrolimus?

A

Nephrotoxicity

35
Q

MTX

A

Methotrexate

36
Q

MOA for Methotrexate?

A

Blocks purine and thymidine synthesis

37
Q

Methotrexate is fast and effective. How long until effects are noticed?

A

3-6 weeks

38
Q

Methotrexate is a 1st line agent for what?

A

Rheumatoid Arthritis

39
Q

How is Methotrexate given?

A

Once per week

40
Q

What are possible adverse effects of methotrexate when given at high doses?

A 
Fetal death
Bone marrow suppression
Hepatic fibrosis
GI ulceration 
Pneumonitis
41
Q

What are possible adverse effects of Methotrexate when given at high doses?

A 
Fetal death
Bone marrow suppression
Hepatic fibrosis
GI ulceration
Pneumonitis
42
Q

At low doses, Methotrexate is very well tolerated. What should patients take weekly though?

A

Folate supplements

2 - CPR (renal) (27 decks)

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