ILD Pharmacology

Question 1

List the initial Therapy for Moderate to Severe Disease

Answer 1

1) Prednisolone (Glucocorticoids)
2) Mycophenolate
3) Methotrexate
4) Azathioprine
5) Nitedanib

Question 2

Cations and Warnings for prednisone

Answer 2

1) HPA axis suppression
- Cushing Syndrome
- Hyperglycemia

Question 3

Mycophenolate Indication

Answer 3

1) Rheumatoid Arthritis

2) Pts resistant to Methotrexate

Question 4

Contraindication of Mycophenolate

Answer 4

Hypersensitivity to any of the products in MYcophenolate

Question 5

BB Warning of Mycophenolate

Answer 5

1) Embryofetal Toxicity
2) Malignancies
3) Serious Infections

Question 6

Indication of Methotrexate

Answer 6

1) Neoplastic Disease
2) Psoriasis
3) Rheumatoid Arthritis (Polyarticular-Course Juvenile Rheumatoid Arthritis)

Question 7

Contraindications of Methotrexate

Answer 7

1) Pregnancy

2) Pts w/ Psoriasis or RA who have alcoholism, alcoholic liver disease or other liver disease

Question 8

Drug interactions with Methotrexate

Answer 8

1) NSAIDs (Increase Methotrexate levels –> Death from hematologic and GI toxicity)
2) Oral Antibiotics (Decrease Methotrexate intestinal absorption or enteroheptaitc circulation)
3) Penicillins (Reduce renal clearance of methotrexate)
4) Hepatotoxins (Increased risk of hepatotoxicity)
5) Decrease clearance of Theophylline

Question 9

List the oral antibiotics that interact with Methotrexate

Answer 9

1) Tetracycline
2) Chloramphenicol
3) Nonabsorbable broad spectrum antibiotics

Question 10

List hepatotoxins you should avoid if prescribing Methotrexate

Answer 10

1) Azathioprine
2) Retinoids
3) Sulfa-salazine

Question 11

Indications of Azathioprine

Answer 11

1) Prevention of rejection in renal homotransplantation

2) Management of RA to reduce signs and symptoms

Question 12

Contraindications of Azathioprine

Answer 12

DONT USE WITH RA in PREGNANT WOMEN

Question 13

BB Warning

Answer 13

Increased risk of Malignancy

Question 14

What is Azathioprine

Answer 14

Immunosuppressive Antimetabolite

Question 15

Nintedanib Indication

Answer 15

Idiopathic pul fibrosis

Question 16

Cautions of Nintedanib

Answer 16

1) Elevated liver enzymes
2) Embryofetal Toxicity
3) Bleeding
4) GI Perforation

Question 17

Nintedanib should be admin with P-gp and CYP3a4 inhibitors