drugs to treat interstitial lung disease

Question 1

What are the initial therapies for moderate to severe intersitial lung disease

Answer 1

Glucocorticoids (prednisolone)
Mycophenolate
Methotrexate
Azthioprine
Nintedanib

Question 2

Prednisone MOA, cautions, adverse reactions

Answer 2

GLucocorticoid

Cations:

• lead to hypothalamic-pituitary-adrenal axis suppression
• monitor for cushing syndrome and hyperglycemia

Adverse reactions:
-fluid retention, alteration in glucose tolerance, elevation in blood pressure, behavioral and mood changes, increased appetitie and weight gain

Question 3

Mycophenolate MOA, indications and contraindictions

Answer 3

MOA: immunosuppressive drug

• used for RA
• increase risk of fetal harm in first trimester

Indications:
-immunosuppressant especially in organ rejection prophylaxis

Contraindicions:
-Hypersensitivity to mycophenolate mofetil, MPA or Polysorbate 80

Question 4

Mycophenolate BB warning, adverse reactions and drug interactions

Answer 4

BB warning:
-embryofetal toxicity, malignancies and serious infections

adverse reactions:
-diarrhea, leukopenia, infection and vomiting

Drug interactions:

• reduced efficacy by magnesium and aluminum hydroxide and PPI
• reduce contraceptives

Question 5

methotrexate BB warning

Answer 5

Serious toxic reactions

• fetal and congenital death, anomalies
• impaired renal function
• bone marrow suppression
• GI toxicity
• hepatotoxicity
• Methotrexate induced lung disease
• diarrhea and ulcerative stomatitis
• Malignant lymphomas
• tumor lysis syndrome
• opertunistic infections

Question 6

Azathioprine MOA, indications, Contraindications, adverse reactions BB warnings

Answer 6

An immunosuppressive antimetabolite in oral form

Indications: renal homotransplantation and RA

Contradictions:

• pregnancy
• previously treated with alkylating agents increased risk for malignancy

adverse reactions:
-hematologic and gastrointestinal

BB warning:
-Malignancy