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Pharmacology > Immuno-modulators > Flashcards

Immuno-modulators Flashcards

1
Q

Oral corticosteroids

A

Prednisolone
Hydrocortisone
Dexamethasone

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2
Q

Topical corticosteroids

A

Hydrocortisone
Betamethasone
Clobetasone

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3
Q

Parenteral corticosteroids

A

Methyprednisolone
Hydrocortisone
Triamcinolone

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4
Q

Mechanism of action of corticosteroids

A

Glucocorticoid activity:
Bind to G. receptor
This causes upregulation of a variety of anti-inflammatory mediators and down regulation of pro-inflammatory mediators
Provides immunosuppression
Also metabolic effects (increased gluconeogenesis)

Some corticosteroids have mineralocorticoid activity:
Bind to M. receptor
Increased resorption of water/sodium
Increased renal excretion of K

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5
Q

Indications for corticosteroids

A

Replacement therapy in adrenal insufficiency
Post-transplantation immunosuppression
Treatment of exacerbations of a variety of inflammatory conditions (eczema, RA, IBD, MS)
Acute asthma

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6
Q

Side effects of corticosteroids

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

What is important to tell patients on corticosteroids?

A

CARRY STEROID CARD & DON’T STOP ABRUPTLY - this can cause adrenal crisis
SICK DAY RULES

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8
Q

Glucocorticoid vs Mineralocorticoid activity of different preparations

A
  1. Prednisolone (G>M)
  2. Betamethasone (G)
  3. Hydrocortisone (G/M)
  4. Dexamethasone (G)
  5. Fludrocortisone (M>G)
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9
Q

Etanercept, Infliximab, Adalimumab: mechanism of action

A

Anti-TNF
TNF produced from macrophages and t-cells
Stimulates cytokines IL1, IL8, IL6
Reduces inflammation
Etanercept = receptor fusion protein
Infliximab, Adalimumab = monoclonal antibodies

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10
Q

Etanercept, Infliximab, Adalimumab: indications

A

RA
Psoriatic arthritis
Ankylosing spondylitis
Juvenile arthritis

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11
Q

Methotrexate: mechanism of action

A

Prevents folate synthesis by inhibiting dihydrofolate reductase - disrupts DNA
Folic acid co-prescribed

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12
Q

Methotrexate: indications

A

RA

Psoriasis / psoriatic arthropathy

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13
Q

Azathioprine: mechanism of action

A

Inserts into DNA / RNA chains to prevent purine synthesis in lymphocytes
TPMT enzyme vital in reducing active drug in cells - check patient has this first!

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14
Q

Cyclosporin: mechanism of action

A

Targets lymphocyte signalling - inhibits calcineurin to inhibit t-cell activation
Tacrolimus is similar drug

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15
Q

Rituximab: mechanism of action

A

Anti-CD20 biologic

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Pharmacology (10 decks)

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