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Pharm 2 > Immuner modulating drugs > Flashcards

Immuner modulating drugs Flashcards

1
Q

Cyclosporin/ Sandimmune

Class
MOA
SE

A

Immunosupp ressant drug derived from a soil fungus

  • Target Calcineurin, Inhibit production of interleukinn 1,2,3,4 and IF-y, thus stoping activated T- Lymphocytes from reproducing

N/V, diarrhea, loss of appetite, High blood pressure, kidney damage, tremors, HA, seizures, excessive hair grown, excessive gum growth, confusion, coma, and gout……. Cleared by P450- 3A4

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2
Q

Cyclosporin/ Sandimmune

Indication

A

Prevent rejection of Kidney, liver and heart transplants as well as for treatment of RA and other autoimmune diseases. Also used in Severe dermatitis

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3
Q

Cyclosporin/ Sandimmune

Interactions

A

Phenobarbit one, Phenytoin and Rifampin enhance clearance.

Erythromycin or Ketoconazol e, grapefruit juice decrease clearance

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4
Q

Methotrexate

MOa

A

Prevent clonal expansion of both B and T lymphocytes - Methotrexate - Is a purine analog of Folate B-9 that gets polyglutamat ed and will slow/alter growth of cells using B-9. Slows formation of GMP and AMP, making DNA unstable.
- As Abortifacient , Low hCG, Low progesteron e, are used to ascertain if Methotrexate is working

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5
Q

Methotrexate dosege considerations

A

Polyglutamat e can be measured in the blood to gauge doseage, Polyglutamat ed Methotrexate is the active form. Taken Weekly, not daily

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6
Q

Methotrexate SE

A

Hepatic Toxicity, Nephro Toxicity,Gen etic malformation s in the MHTFR, N/ V, oral ulcerations, Hepatitis, blood dycrasias and immunosupp ression. -Causes Pulmonary Fibrosis and is treatment for pulmonary Fibrosis

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7
Q

Methotrexate class

A

Anti- metabolite, anti-folate immunosupp ressant and chemotherap eutic

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8
Q

Methotrexate indications

A

Cancer, AI, Abortifacient

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9
Q

Azathioprine/ Imuran

MOA

A

Metabolic breakdown products of Azathiprine act to inhibit purine synthesis which will block protein synthesis, particularly in cells that experience rapid turn over—— gets conve

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10
Q

Azathioprine/ Imuran

Dose
SE
Class
INd

A

3-5 mg/kg/ day

Bone marrow depression - Takes 12 months or longer to take effect

Purine anti- metabolite immunosupp ressant

Prevention of transplant rejection, inflammatory bowel disease, SLE and rheumatoid arthritis

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11
Q

Tacrolimus/ Program

MOA

A

T-Cell inhibition similar to that of Cyclosporine .Tacrolimus is approximatel y 100x more potent in its immunosupp ressive effects then an equal volume of cyclosporine

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12
Q

Tacrolimus/ Program SE

A

N/V diarrhea, loss of appetite, high blood pressure, kidney damage and increased risk for infection

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13
Q

Tacrolimus/ Program

Class

A

Immunosupp rressant drug related to the macrolide class of antibiotics extracted from soil microorganis m.

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14
Q

Tacrolimus/ Program

Char

A

Protection against rejection of organ transplantati on. Topical treatment for severe eczema

Metabolized by the P450… avoid grape juice

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15
Q

Etanercept/ Enbrel

MOA

A

Mimics the inhibitory effects of naturally occurring soluble anti- TNF receptors, however it has double the half life of biologic form

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16
Q

Etanercept/ Enbrel

Dose

A

1-2 weekly 50mg/ml injections at home

17
Q

Etanercept/ Enbrel

SE

A

Notable decreased resistance to infection. Increased risk for leukemia, lymphoma and solid tumors, Liver injury, CHF and Demyelinatin g CNS. Reemergenc eof URT infection and UT infection

18
Q

Etanercept/ Enbrel

Class

A

DMARD, Recombinan t-DNA drug

19
Q

Etanercept/ Enbrel

Ind
Char

A

RA, Juvenile arthritis, psoriatic arthritis, ankylosing spondylitis and psoriasis
IL-1 and TNF-alpha both mediate inflammation and bone resorption in RA
-Cost 12k-16k/year -Not approved to treat Crohn’s and UC
- worse than placebo for Crohn’s

20
Q

Infliximab/ Remicade

MOA

A

Binds with High affinity to soluble TNF-alpha, preventing effective binding of TNF-alpha with its receptors. Causes programmed cell death of TNF-alpha expressing activated T cells. ENBREL don’t do this

21
Q

Infliximab/ Remicade

Dose

A

Intravenous infusion, 6-8 week intervals. PO form is not available, because stomach would destroy AB

22
Q

Infliximab/ Remicade

Se

A

Fatal blood disorders, infections, lymphoma and solid tissue cancers, Liver injury, demyelinatin g CNS, CHF

23
Q

Infliximab/ Remicade Class

A

DMARD, Recombinan t-DNA drug

24
Q

Infliximab/ Remicade

INd
Char

A

RA, Crohn’s Disease, U.C

  • Most widely used
  • can treat UC and Crohns
25
Q

Hydroxychlor oquine/ Plaquenil

MOA

A

Block activation of toll-like receptors on plasmacytoid dendritic cells.. Mainly TLR-9 that recognizes DNA containing immune complexes

26
Q

Hydroxychlor oquine/ Plaquenil

Dose

A

Malaria 400mg/day prophylacticl y 2 weeks before exposure. 8 weeks after leaving area
Lupus 400mg 2x/ day for weeks- months
RA- 400-600 flare, 200-400 daily, May take up to 12 weeks to kick in

27
Q

Hydroxychlor oquine/ Plaquenil

Se

A

HA, Ataxia, Abdominal pain, N/V, Pruritus, Photosensitivity, Retinopathy, Visual Changes

28
Q

Hydroxychlor oquine/ Plaquenil

Ind
Char

A 
Anti-malerial, RA, Lupus, Sjogren’s, Post lyme arthritis
Not approved for Juvenile Arthritis
- G6PD its
can develop severe anemia
- Children are more sensitive
than adults
29
Q

Gold Salts (gold chloride) -Auranofin (Ridaura) is cap form

MOA

A

unknown -taken up by macrophage s and suppresses phagocytosis and lysosomal enzyme activity resulting in slower progression of bone and auricular destruction

30
Q

Gold Salts (gold chloride) -Auranofin (Ridaura) is cap form

dose

A

DO or IM weekly for 3-5 months before effec

31
Q

Gold Salts (gold chloride) -Auranofin (Ridaura) is cap form

SE

A

Dermatiis, Thrombocyto penia, leukopenia, pancytopeni a, Aplasitic anema, N, Hair thinning, Renal Tox

32
Q

Gold Salts (gold chloride) -Auranofin (Ridaura) is cap form

Indications

A

RA, IBD, psoriatic arthritis, membranous nephritis, lupus, juvenile RA

33
Q

Gold Salts (gold chloride) -Auranofin (Ridaura) is cap form

Char

A

-used in children
when NSAIDS, Methotrex ate and DMARDS does not work

-600a month,
need to check ruin for nephapthy

Pharm 2 (16 decks)

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