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CPR Pharm > Exam 3 Iszard ANCA Vasculities drugs > Flashcards

Exam 3 Iszard ANCA Vasculities drugs Flashcards

1
Q

What is ANCA?

A

Anti-Neutrophil Cytoplasmic Antibodies (ANCA)

• An autoimmune condition characterized by the inflammation of the blood vessels caused by an attack of the immune
system incorrectly and aggressively attacking cells.

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2
Q

What are the two types of antineutrophil cytoplasmic antibodies?

A

●Indirect immunofluorescence assay, using alcohol-fixed buffy coat leukocytes

●Enzyme-linked immunosorbent assay (ELISA), using purified specific antigens

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3
Q

What drugs can induce ANCA vasculitis?

A
  1. Hydralazine
  2. Propylthiouracil
  3. Methimazole
  4. Carbimazole
  5. Minocycline
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4
Q

What can be seen with ANCA-associated vasculitis when the vasculitis involves the renal medulla?

A

Interstitial nephritis

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5
Q

Decrease production of prostaglandins and leukotrienes

Decreased production and increased apoptosis of immune cell types

Decreased production of cytokines and their receptors

Decreased transmigration of neutrophils and macrophages from blood into tissues

Decreased expression of cell adhesion molecules

are effects of what?

A

How glucocorticoids affect the immune system

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6
Q

How do glucocorticoids affect the immune system?

A
  1. Decrease production of prostaglandins and leukotrienes
  2. Decreased production and increased apoptosis of immune cell types
  3. Decreased production of cytokines and their receptors
  4. Decreased transmigration of neutrophils and macrophages from blood into tissues
  5. Decreased expression of cell adhesion molecules
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7
Q

What are the consequences of glucocorticoid use?

A
  1. Decreased inflammation and its manifestations
  2. Immune suppression
  3. Decreased allergic/hypersensitivity reactions
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8
Q
  • Blood in the urine.
  • Foamy urine.
  • Swelling in the legs.
  • High blood pressure.
  • Burning or difficulty when urinating.
  • Back pain below the ribs.
  • Swelling of the hands and feet.

are symptoms of what?

A

Goodpasture Syndrome

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9
Q

What are the symptoms of Good pasture syndrome?

A
  1. Blood in the urine.
  2. Foamy urine.
  3. Swelling in the legs.
  4. High blood pressure.
  5. Burning or difficulty when urinating.
  6. Back pain below the ribs
  7. Swelling of the hands and feet.
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10
Q

Should immunocompromised patients take glucocorticoids?

A

no- problematic

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11
Q

Should DM patients take glucocorticoids?

A

no- problematic

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12
Q

Should patients with peptic ulcers or infections take glucocorticoids?

A

no- problematic

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13
Q

should patients with CV conditions such as HTN, CHF, or angina take glucocorticoids?

A

no- problematic

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14
Q

Should patients with psychiatric conditions take glucocorticoids?

A

no- problematic

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15
Q

should patients with osteoporosis or posterior postmenopausal women take glucocorticoids?

A

no problematic

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16
Q

should children take glucocorticoids?

A

no problematic

17
Q

What is type of drug is cyclophosphamide?

A

an alkylating agent

18
Q

What drug is indicated for

  1. Malignant diseases
  2. Minimal change nephrotic syndrome in pediatric patients
A

Cyclophosphamide

Malignant Diseases: malignant lymphomas: Hodgkin’s disease, lymphocytic lymphoma, mixed-cell type lymphoma, histiocytic lymphoma, Burkitt’s lymphoma; multiple myeloma, leukemias, mycosis fungoides, neuroblastoma, adenocarcinoma of ovary, retinoblastoma, breast carcinoma

Minimal Change Nephrotic Syndrome in Pediatric Patients: biopsy proven minimal change nephrotic syndrome patients who failed to adequately respond to or are unable to tolerate adrenocorticosteroid therapy

19
Q

Can cyclophosphamide be used in adults?

A

Unknown—he safety and effectiveness for the treatment of nephrotic syndrome in adults or other renal disease has not been established.

20
Q

What are contraindications of cyclophosphamide ?

A
  1. Hypersensitivity to cyclophosphamide

2. Urinary outflow obstruction

21
Q

Myelosuppression, Immunosuppression, Bone Marrow Failure and Infections
• Urinary Tract and Renal Toxicity • Cardiotoxicity
• Pulmonary Toxicity
• Veno-Occlusive Liver Disease
• Embryo-Fetal Toxicity

are warnings for what drug?

A

Cyclophosphamide

22
Q

What are adverse reactions of cyclophosphamide?

A

Adverse reactions reported most often include

  1. neutropenia
  2. febrile neutropenia
  3. fever
  4. alopecia
  5. nausea
  6. vomiting
  7. diarrhea.
23
Q

What are the contraindications of rituximab?

A

none

24
Q
  • FATAL INFUSION REACTIONS
  • TUMOR LYSIS SYNDROME (TLS)
  • SEVERE MUCOCUTANEOUS REACTIONS
  • PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY (PML)

is BBW for what drug?

A

Rituximab

25
Q
  • Non-Hodgkin’s Lymphoma (NHL)
  • Chronic Lymphocytic Leukemia (CLL)

• Rheumatoid Arthritis (RA) in combination with methotrexate in adult patients with moderately-to
severely-active RA who have inadequate response to one or more TNF antagonist therapies

are indications for what drug?

A

Rituximab

26
Q

What are the indications for rituximab?

A

• Non-Hodgkin’s Lymphoma (NHL)
• Chronic Lymphocytic Leukemia (CLL)
• Rheumatoid Arthritis (RA) in combination with methotrexate in adult patients with moderately-to
severely-active RA who have inadequate response to one or more TNF antagonist therapies

27
Q

When should rituximab use be limited?

A

Severe infections

28
Q

What drug intreaction with rituximab can cause renal toxicity?

A

Cisplatin

29
Q

infusion reactions, fever, lymphopenia, chills, infection and asthenia are adverse reactions for what?

A

Rituximab in NHL

30
Q

Infusion reactions and neutropenia are common adverse reactions in what?

A

Rituximab in CLL

31
Q

Can rituximab cause cardiovascular events?

A

yes

32
Q

What are the indications of Azathioprine?

A
  1. Prevent renal transplant rejection

2. Management of active RA

33
Q

What drugs can be continues when on azathioprine?

A
  1. Aspirin
  2. NSAIDs
  3. low dose glucocorticoids
34
Q

When are the contraindications of azathioprine

A
  1. Drug HS
  2. Pregnancy
  3. RA patients previously treated with alkylating agents may have a prohibitive risk of malignancy
35
Q

What is the warning of azathioprine?

A

Malignancy

-patients receiving immunosuppressants, including Azathioprine are at increased isk of developing lymphoma and other malignancies, particularly of the skin

36
Q

What cancers are post renal transplant patients most at risk for?

A
  1. skin cancer
  2. reticulum cell tumor
  3. lymphomatous tumor

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