Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

cardiovascular system 1 > Immune system and malignant disease > Flashcards

Immune system and malignant disease Flashcards

1
Q

Why do we give folic acid and how often to patients on methotrexate?

A

To reduce the possibility of methotrexate toxicity (unlicensed)
Give weekly on different days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Example of Antiproliferate Immunosuppresant

A

Azathioprine
Mycophenolate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Indication of Azathioprine

A

IBD. RA, autoimmune condition, suppression of transplant rejection, severe refractory eczema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Important interaction of Azathioprine

A

Increases the risk of haematological toxicity when given with allopurinol
Reduce the dose of Azathioprine to 1/4 when given with allopurinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Azathioprine is broken down into

A

MERCAPTOPURINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Side effect of Azathioprine

A

Bone marrow depression, increased risk of infection, leucopenia, thrombocytopenia, pancreatitis.
Nausea
Neutropenia and thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Side effect of Azathioprine may require drug withdrawal. True/false

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Side effect of Azathioprine that requires immediate withdrawal

A

Hypersensitivity rxn such as Dizziness, malaise, rash, N andV, fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

All immuosupressant are teratogenic. True/false

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Azathioprine pre treatment screening

A

TPMT enzyme metabolises thiopurine drugs
AbsentTPMT activity- Don’t give thiopurine drugs
Reduced TPMT activity- treat under specialist care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risk of myelosuppression increases in patients with reduced TPMT activity on Azathioprine. True/false

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List examples of thiopurine

A

Tioguanine
Mercaptopurine
Azathioprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Patient and carer advice for Azathioprine

A

Report any signs of bone Marrow suppression such as inexplicable bruising or bleeding, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Facts about Mycophenolate

A

Metabolised to mycophenolic acid
More selective MOA than Azathioprine
Incorporating Azathioprine and mycophenolate reduces risk of rejection but higher risk of blood disorder and infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Caution with mycophenolate

A

Increased risk of skin cancer ( avoid exposure to strong sunlight)
Risk
Risk of hypogammaglobulinaemia ) ( low antibodies production) or bronchiectasis ( abnormal widening of the bronchi leading to infection when used in combination with other immunosuppresant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

State what to do if recurrent infections develop when taking mycophenolate

A

Measure serum immunoglobulin levels
Consider bronchiectasis or pulmonary fibrosis if persistent respiratory symptoms eh cough and dyspnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Conception and contraception with mycophenolate

A

MHRA advises to exclude pregnancy in women of child bearing potential before treatment
2 pregnancy test 8-10days apart are recommended
Women should use atleast 1 method of contraception before and during tx and for 6weeks after discontinuation
Two method of contraception preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How.long should male patients and their partners use contraception while on mycophenolate

A

During tx and for 90days after discontinuation

19
Q

Patients and carer advice while on mycophenolate

A

Warn patients to report any signs of bone marrow suppression eg infections, bruising or bleeding
Female patients should be part of PPP

20
Q

Facts about corticosteroids in immunosuppression

A

Marked anti tumour effect in leukamia, hodgkin disease and non hodgkin lymphomas
Enhance appetite and sense of well being in end stage malignant disease
They are powerful immunosuppresant
Used to prevent organ transplant
rejection and in high doses to treat rejection episode

21
Q

Facts about Ciclosporin

A

Potent immunosuppressant
Marked nephrotoxic
Used in organ and tissue transplant
Prevention of graft rejection following bone marrow, kidney, liver , pancreas, heart, lung and heart -lung transplant

22
Q

What drug is used in the prophylaxis and treatment of graft-versus-hot disease

A

Ciclosporin

23
Q

Ciclosporin should be prescribed by brand. True or false

A

True

23
Q

Monitoring requirements for ciclosporin

A

Blood concentration
With systemic use- dermatological and physical examination ( for atopic dermatitis and psoriasis)
Liver function ( if given with NSAID)
Serum potassium
Blood lipids before and after 1month of treatment
Kidney function and blood pressure ( discontinue in htn that cannot be co trolled develop)

23
Q

Contraindications of ciclosporin

A

Uncontrolled infection, Uncontrolled blood pressure and malignancy

24
Q

List the two major electrolytes to monitor with ciclosporin

A

Serum k and Mg

24
Q

Why monitor serum K while on ciclosporin

A

Risk of hyperkalaemia esp in renal dysfunction

25
Q

Why monitor Magnesium in patients on ciclosporin

A

Causes hypomagnesaemia

26
Q

Ciclosporin patients and carer advice

A

With systemic use, counsel pt on administration of different formulations
Avoid excessive exposure to UV light including sun light
Avoid use of UVB or PUVA in psoriasis and atopic dermatitis
Ocular use: may affect driving and skilled task ( increased risk of blurred vision)
RBC aphasia, bone marrow suppression ( neutro, thrombocytopenia)

27
Q

Other Monitoring requirements (ciclosporin)

A

Monitor FBC weekly for first month , then monthly for first 3 months, then every 3 months for next year, use oral if IV is irritant

28
Q

Drugs that causes bone marrow suppression

A

Azathioprine, ciclosporin methotrexate
MAC

29
Q

Vincristine and bleomycin causes Bone marrow suppression true or false

A

False

30
Q

Side effect of ciclosporin

A

Eye inflammation

31
Q

Food interaction with ciclosporin

A

Pomelo juice is predicted to increase ciclosporin exposure and purple grape fruit is predicted to decrease exposure

32
Q

Tacrolimus must be prescribed by brand . T/F

A

T

33
Q

Tacrolimus causes greater neurotoxicity. True/false

A

True

34
Q

Facts about Tacrolimus

A

Similar mode of action and ADR to ciclosporin
Cardiomyopathy reported
Bone marrow suppression
Disturbance of glucose metabolism (signs of hyperglycemia)
Causes hyperkalaemia

35
Q

Monitoring requirements with Tacrolimus

A

Monitor liver and kidney function

36
Q

Patient and carer advice for Tacrolimus

A

Avoid excess exposure to UV light including sunlight ( use wide spectrum SPF)
May affect performance of skilled task( eg driving)

37
Q

Indication of Sirolimus

A

Licensed for renal transplantation
Prophylaxis of organ transplant rejection in kidney recipients

38
Q

Which ethnicity may require higher doses of Sirolimus

A

Afro carribean

39
Q

Monitoring with Sirolimus

A

Blood- sirolimus trough concentration

40
Q

Patient and carer advice on sirolimus

A

Avoid excessive exposure to UV light

cardiovascular system 1 (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions