Immunosuppressant Drugs Flashcards
Examples of corticosteroids
Prednisone, Hydrocortisone
Mechanism of action of corticosteroids (Immunosuppressants)
Reduce production of interleukin 1 and 6, inhibit the action of T cells
ADRs of corticosteroids
Weight gain, Glucose intolerance, Insomnia, Hypertension, Psychosis, Gastritis, Pancreatitis, Osteoporosis
Monitoring of corticosteroids
Monitor inflammatory markers
Mechanism of action of Azathioprine
Forms 6-MP which inhibit purine synthesis, reduces DNA synthesis, reduces lymphocyte number
ADRs of Azathioprine
Myelosuppression, Lymphoma, Infection, Hepatitis
Monitoring of Azathioprine treatment
LFTs and FBCs
Test before Azathioprine treatment
Test for TPMT levels
Mechanism of action of methotrexate (Immunosuppressant)
Increased adenosine levels reducing T cell activity
ADRs of methotrexate
Mucositis, Myelosuppression, Hepatitis, Cirrhosis, Infection, Pneumonitis, Teratogenesis
Monitoring during methotrexate treatment
FBCs, LFTs, U+Es, CXR
Mechanism of action of Sulphasalazine
Salicylate in colon reducing cytokines, Sulphpyridine in circulation reduces interleukin 2 production in T cells
ADRs of Sulphsalazine
Myelosuppression, Hepatitis, Nausea, Vomiting, Abdo pain
Mechanism of action of Cyclophosphamide
Metabolites act as alkylating agents inhibiting DNA synthesis, reduces lymphocyte number
ADRs of Cyclophosphamide
Bladder cancer, Leukaemia, Infertility
DDIs of Cyclophosphamide
Effected by inducers and inhibitors
Mechanism of action of Mycophenolate Mofetil
Inhibits guanine synthesis, reducing lymphocyte number
ADRs of Mycophenolate Mofetil
Nausea, Vomiting, Leukopenia, Neutropenia, Myelosuppression, Infection
Examples of Calcineurin inhibitors
Ciclosporin, Tacrolimus
Mechanism of action of Calcineurin inhibitors
Inhibit calcineurin preventing the transcription of interleukin 2
ADRs of Calcineurin inhibitors
Nephrotoxicity, Hypertension
DDIs of Calcineurin inhibitors
Effected by inducers and inhibitors
Monitoring of Calcineurin inhibitor treatment
BP, eGFR
