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MBChB 3 Drug Database > Immuno-modulator Drugs > Flashcards

Immuno-modulator Drugs Flashcards

1
Q

what are some examples of oral corticosteroids (glucocorticoids)?

A

Prednisolone
Hydrocortisone
Dexamethasone

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2
Q

what are some examples of topical corticosteroids (glucocorticoids)?

A

Hydrocortisone
Betamethasone
Clobetasone

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3
Q

what are some examples of parenteral corticosteroids (glucocorticoids)?

A

Methyprednisolone
Hydrocortisone
Triamcinolone

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4
Q

What is the mechanism of action for Glucocorticoids?

A

Bind to glucocorticoid receptors causing up-regulation of a variety of anti-inflammatory mediators and down regulation of pro-inflammatory mediators.
This provides immunosupression

also have metabolic effects e.g. increased gluconeogenesis. and some have mineralocorticoid activity

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5
Q

what are the indications for Glucocorticoids?

A

Replacement therapy in adrenal insufficiency
Post-transplantion immunosupression
Treatment of exacerbations of a variety of inflammatory conditions (including eczema, rheumatoid arthritis, inflammatory bowel disease and multiple sclerosis).
Treatment of acute asthma

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6
Q

list some side effects of Glucocorticoids:

A 
Sleep disturbance
Mood disturbance / psychosis
Hyperglycemia
Immunodeficiency
Easy bruising
Moon-faced
Increased abdominal fat
Glaucoma
Striae
Hypertension
Gastric irritation
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7
Q

What is important clinically regarding pharmacokinetics/dynamics for glucocorticoids?

A

Drugs have differing degrees of glucocorticoid and mineralocorticoid activity.

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8
Q

What info needs to be given to patient before commencing on a glucocorticoid?

A

Avoid alcohol and caffeine
Take with food to avoid gastric irritation
Don’t stop abruptly
Always tell doctors they are on prenisolone
Carry steroid card
Take higher dose when ill

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9
Q

what are the functions of mineralocorticoids?

A

Increased resorption of water
Increased resorption of sodium
Increased renal excretion of potassium

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10
Q

Give an example of a glucocorticoid with:

Predominant glucocorticoid activity. Low mineralocorticoid activity

A

Prednisolone

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11
Q

Give an example of a glucocorticoid with:

Potent glucocorticoid activity. No mineralocorticoid activity

A

Betamethasone

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12
Q

Give an example of a glucocorticoid with:

Good glucocorticoid and mineralocorticoid activity

A

Hydrocortisone

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13
Q

Give an example of a glucocorticoid with:

Potent glucocorticoid activity. Minimal or no mineralocorticoid activity

A

Dexamethasone

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14
Q

Give an example of a glucocorticoid with:

Mild to moderate glucocorticoid activity. Potent mineralocorticoid activity

A

Fludrocortisone

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15
Q

what are 3 examples of anti-TNG agents?

A

Etanercept – receptor fusion protein
Infliximab – monoclonal antibody
Adalimumab – monoclonal antibody

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16
Q

What is the mechanism of action for an anti-TNF agent?

A

Anti-TNF-α and anti-TNF-β
Blocks its interactions with TNF cell receptors
TNF α and β produced from macrophages and T cells
Stimulates cytokine – IL1, IL8, IL6
Reduces inflammation

17
Q

What are the indications for anti-TNF agents?

A

Rheumatoid arthritis
Psoriatic arthritis
Ankylosing spondylitis
Juvenile arthritis

18
Q

what are some side effects of anti-TNF agents?

A

Injection site reactions
Flu-like symptoms (fever, headache, runny nose)
Immune deficiency – in particular risk of legionella and listeria infection and reactivation of tuberculosis

19
Q

What is important clinically regarding pharmaco-kinetics/dynamics for anti-TNF agents?

A

Given parenterally (subcut)

20
Q

what info should be given to patient before starting an anti-TNF agent?

A

maintain good hygiene and report symptoms of infection early.

21
Q

What are 3 examples of immunosuppressant drugs?

A

Methotrexate
Azathioprine
Mercaptopurine

22
Q

What is the MoA for azathioprine?

A

Disrupt DNA synthesis

blocks purine synthesis mainly in lymphocytes

23
Q

What is the MoA for methotrexate?

A

Disrupt DNA synthesis

stops the action of the enzyme dihydrofolate needed for production of DNA

24
Q

What are the indications for immunosuppressant drugs?

A

Post transplantation immunosuppression
Inflammatory bowel disease
Renal vasculitis
Paediatric leukaemia (methotrexate is used)

25
Q

list some side effects of immunosuppressant drugs?

A 
Bone marrow suppression (leucopenia)
Risk of infection
Nephrotoxicity
Hepatotoxicity
Seizures
GI upset
Mucosal ulceration
Alopecia
26
Q

What is important clinically regarding pharmaco-kinetics/dynamics for immunosuppressant drugs?

A

Do not cross the blood brain barrier
Undergo hepatic metabolism
Oral absorption is dose dependent
Patients with low levels of thiopurine methyltransferase activity are more prone to azathioprine and mercaptopurine related marrow suppression

27
Q

what info should be given to patient before starting an immunosuppressant drugs?

A

Limit caffeine intake

Take without regard to meals

MBChB 3 Drug Database (10 decks)

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