Final Version Flashcards
MOA: inhibits phospholipase A2 and COX2 and works on concentration, distribution and function of peripheral leukocyte and macrophages?
Prednisone
What category does prednisone being in?
Corticosteroids
Other corticosteroids that work like prednisone
Methylprednisolone and dexamethasone
MOA: alkylating agent and signal 3 inhibitor
Non cell cycle specific
Inhibits b and T cells
Cyclophosphamide
MOA:
Antimetabolite and signal 3 inhibitor
Cell cycle specific
Inhibits T cells more than B cells
Azathiorpine
MOA: Antimetabolite and signal 3 inhibitor Cell cycle specific Inhibits B and T cells Used for Crohn's disease
Methotrexate
Mao: inhibits the synthesis of purines and signal 3 inhibitor.
Inhibits B and T cells
Mycophenolate
MOA:
Calcineurin phosphatase and signal 1 inhibition
T cell suppression
Cyclosporine
MOA:
CD3 receptor and signal 1 inhibition
T cell suppression
Muromonab-CD3
MOA:
T cell suppression
Lymphocyte immune globulin
Murine immunoglobulin
Muromonab-CD3
Horse immune globulin
Lymphocyte immune globulin.
Human IgG1 monoclonal antibody
Daclizumab
IL-2 receptor and signal inhibition
Daclizumab
Human immune globulin that helps passive immunity increase and helps prevent certain infection diseases in susceptible individuals
Gammagard
Suppresses immune response of Rh-negative individuals to Rh-positive blood cells
Rh0Gam
Antiviral and immunoregulatory activity but is not completely understood
Interferon beta
MOA:
Has phagocyte activating effects and antibody dependent cellular toxicity
Interferon gamma
Types of cytotoxic and proliferative agents
Cyclophosphamide, azathiorpine, methotrexate, mycophenolate
Category of T cell suppressants and other antibody immunosuppressive
Cyclosporine, micromanab-CD3, lymphocyte immune globulin, Daclizumab, Rh0 Immune globulin (Rh0Gam), immune globulin (gammagard)
Immunomodulators and immunostimulants
Interferon bets and interferon gamma
Used for relapsing/remitting multiple sclerosis
Interferon beta
Used for chronic granulomatoses disease and osteoporosis
Interferon gamma
ADRs:
nephrotoxicitt
hypertension
embryotoxic
cyclosporine
ADRs:
fever and chills
sensitivity for Murine products
Muromonab-CD3
used for hemolytic disease of the newborn
Rh0Gam
used for hypogammaglobulinemia and to prevent infections in HIV patientes
imuune globulin (Gammagard)
used for renal, liver, and heart trasnplant rejections and may be used with corticosteroids and azathiorpine
used for rheumatoid arthritis
cyclosporine
used for renal, liver, pancreas, an heart trasnplant rejection
muromonab-CD3
used for renal trasnplant rejection
lymphocyte immune globulin and daclizumab
used for rheumatoid arthritis, leukemias, and other tumors
cyclophosphamide
used for renal allotransplantation and rhumatoid arthrits in adults only
azathiorpine
used for Crohn’s disease, rheumatoid arthritis, leukemias and other tremors
methotrexate
used for renal, liver, and heart transplant rejections. used with cyclosporine and other corticosteroids
mycophenolate
used for allergic disorders, hematalogic disorders, hepatic and renal disease, and collagen disorders
corticosteroids
ADR: no serious effects for short period long period: latogenic cushing's syndrome osteoporosis, infections, and ulcers
corticosteroids
ADR:
N/V/D
bone marrow suppression
aspermia
cyclophosphamide
ADR:
N/V
bone marrow suppression
infections
azathiorpine
ADR:
N/V
bone marrow suppression
Hepatotoxicity
methotrexate
ADR:
GI
neutropenia
infections
mycophenolate
ADR: fever and chills
sensitivity for equine products
lymphocyte immune globulin
ADR:
GI disorders
daclizumab
ADR:
mild side effects
contraindicated in Rh+ patients
Rh0 immune globulin (Rh0Gam)
ADR:
mild side effects
Immune Globulin (Gammagard)
ADR: flu-like symptoms depression suicidal ideation injection site reactions
interferon beta
ADR:
flu-like symptoms
Interferon Gamma
why can some immunosuppressives go in and activate the immune system?
drug allergy and drug hypersensitivity
what are the types of drug allergy/hypersensitivity?
anaphylaxis serum sickness drug fever vasculitis drug induced lupus
what factors affects the incidence of allergic reactions?
age and gender genetic factors associated illness (AIDS) previous drug administration drug-related factors
Anaphylactic (immediate response drug allergy)
Type 1
serum sickness or Arthus reaction drug allergy
Type 3
cytotoxic reaction
Type 2
in this type of reaction, the initial exposure to drugs makes IgE antibodies and IgE gets fixed to tissue mast cells and blood basophils. when re-exposed, mast cells and basophils release histamine, leukotrienes, and other mediators
Type 1/ anaphylactic (immediate response reaction)
this type of drug allergy requires IgG and IgM antibodies that activate complement cascade
antibodies to tissue constituents or drug can be demonstrated
type 2 or cytotoxic reactions
The antagonists for this type of allergic reactions are prednisone, isoproterenol, epinephrine, and thephylline and even though desensitization can be tried, it may be hazardous
Type 1 or anaphylactic reaction
this type of drug allergy is most common and manifestations occur 7-21 days after exposure of drug through fever, urticaria, arthralgia, and lymphadenopathy but go away when drug is stopped. corticosteroids can be used to help
type 3 or serum sickness
this type of drug reaction involves IgM and IgG but NOT IgE.
these generate drug-antibody complexest that deposit in the blood vessels after activating complement
type 3 or serum sickness
type of drug reaction that mainly targets cells in the circulatory system. the reaction may disappear after stopping the drug for several months and corticosteroids may suppress severe reactions
type 2 or cytotoxic
in this type of drug reaction, vascular permeability increases and neutrophils after aggregating and invading the cell wall, induce a hemorrhagic vasculitic lesion
serum sickness
this type of drug reaction is mediated by sensitized T lymphocytes and macrophages and cause contact dermatitis. can be helped with corticosteroids
Type 4 or cell-mediated (delayed) hypersensitivity reaction
MOA:
irreversible inhibition of COX-1 and COX-2
inhibits prostaglandin synthesis but not lipoxygenase
Aspirin
MOA:
reversible inhibition of COX-1 and COX-2
diflusinal, indomethacin, sulindac, diclofenac, tolemetin, ketorolac, naproxen, ibuprofen, ketoprofen, fenoprofen, flurbiprofen, oxaprozin, piroxicam, meloxicam, meclofenamate, mefenamic, nabumetone, etodolac, meloxicam and salicylate salts
(basically all drugs but aspirin)
MOA: same as the other drugs but just have MORE COX-2 selectivity than COX-1
Etodolac, Nabumetone and Meloxicm
this drug is not a true salicylate
diflusinal
This drug is only taken once daily
oxaprozin
this drugs is activated by the liver
nabumetone
MOA:
only inhibits COX-2
celecoxib
MOA:
analgesia by elevating pain threshold by weakly inhibiting COX-1, COX-2 and COX-3
antipyresis by acting on hypothalamic heat-regulating centers
acetaminophen
Use: analgesic antipyretic antiinflammatory antirheumatic (suppresses antigen-antibody reactions and prostaglandin mediated autoantibodies)
aspirin and salicylate salts
use:
analgesic
antiinflammatory
weak antipyretic (recommended not to be used as one)
diflusinal
use:
rheumatoid arthritis NOT for juvenile RA
osteoarthrits
tocolytic agent (suppress premature labor)
indomethacin
use:
rheumatoid arthritis and osteoarthrits
sulindac
use:
rheumatoid arthritis
osteoartritis
post-op analgesia
etodolac
use:
rheumatoid arthritis
osteoarthritis
analgesia/dysmenorrhea
diclofenac, ibuprofen, keoprofen and meclofenamate
use:
rheumatoid arthritis
Juvenile arthritis
osteoartritis
tolmetin
use:
moderate to severe acute pain
ketorolac (toradol)
use: rheumatoid arthritis Juvenile RA osteoarthritis analgesia dymenorrhea
naproxen
use:
rheumatoid arthritis
osteoarthritis
analgesia
fenoprofen
use:
rheumatoid arthritis
osteoarthritis
flurbiprofen, oxaprozin, piroxicam and nabumetone
Use:
osteoarthritis
meloxicam
use:
analgesia and dysmenorrea
NOT for RA or osteoarthritis
mefenamic acid
use: osteoarthritis RA dymenorrhea acute pain familial adenomatous polyposis
celecoxib
use:
antipyretic and analgesic
osteoarthrits (relief of pain)
acetaminophen
ADR:
Minor (rash) rare
potential hepatotoxicity and nephrotoxicity
acetaminophen
ADR:
minor disturbances for GI, CNS, respiratory rash and sulfonamide allergy
celecoxib
ADR:
GI
CNS: headaches
nabumetone
ketorolac
ADR:
contraindicated for GI inflammation
pre-existing renal problems
autoimmune and hemolytic anemia
mefenamic acid
ADR:
GI
CNS: headaches
rahs/dermatitis
meclofenamate
ADR:
GI
meloxicam
piroxicam
oxaprozin
ADR:
GI
CNS: dizziness and headache
flurbiprofen
diclofenac
ADR:
GI: 30% of patients
CNS: headache
ketoprofen
ADR: GI pre-existing renal hypersensitivity CNS: headache
fenoprofen
ADR:
GI < indomethacin
CNS < indomethacin
hypersensitivit
naproxen
ADR: GI less than aspirin or indomethacin ocular disturbances hypersensitivity (rash/dermatitis) chronic use inhibits renal prostaglandin production
ibuprofen
this drug should be avoided during pregnancy or breast-feeding
ibuprofen
ADR:
GI
CNS: headache
causes Anaphylactoid reactions (caution!!)
tolmetin
ADR:
GI: less severe than indomethacin
etodolac
ADR: GI: less severe than indomethacin rash/dermatitis potential fatality pancreatitis
sulindac
ADR: GI: severe prolonged gestation renal CNS: headache and aggravate depression
indomethacin
ADR: GI: mild headache renal hypersensitivity
diflusinal
ADR:
GI: not too bad
no effect on platelets
hypermagnesemia
salicylates
ADR: GI hepatic hypersensitivity reyes syndrome salicylism
Aspirin
category:
salicylic acid derivatives
aspirin
salicylate salts
diflusinal
category:
acetic acid derivatives
indomethacin etodolac diclofenac tolmetin ketorolac sulindac
category:
propionic acid derivatives
ibuprofen naproxen ketoprofen oxaprozin fenoprofen flurbiprofen
category:
enolic acid derivatives
piroxicam
meloxicam