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pharm 2 > Immunosuppressant Drugs > Flashcards

Immunosuppressant Drugs Flashcards

1
Q

What drug class is methotrexate

A

Anti-metabolite and anti-folate immunosuppressant and chemotherapeutic

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2
Q

What are the indications of methotrexate

A

Cancer, autoimmune diseases, including rheumatoid arthritis, psoriasis, psoriatic arthritis, lupus and Crohn’s disease as well as an abortifacient

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3
Q

What is the MOA of methotrexate

A

Anti-metabolite and anti-folate drug

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4
Q

What are the admin routes for methotrexate

A

PO, IM, IV, SQ and IT (intra-thecal)

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5
Q

What must be monitored if you are taking methotrexate

A

CBC, LFT, creatinine

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6
Q

What are side effects of methotrexate

A

nausea, abdominal pain, fatigue, fever, dizziness, ulcerative stomatitis, low white blood cell count and thus predisposition to infection

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7
Q

What are severe side effects of methotrexate

A

developing another malignancy, pulmonary fibrosis, acute, pneumonitis

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8
Q

What category is methotraxate

A

category X, plus never should be used by pregnant women or those trying to conceive

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9
Q

What supplement decreases the efficacy of methotrexate

A

folic acid or folate

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10
Q

What drug class is azathioprine (Imuran)

A

purine anti-metabolite immuno-suppressant

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11
Q

What are the indications of azathioprine (imuran)

A

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

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12
Q

What is the MOA of azathioprine (imuran)

A

Metabolic breakdown products of Azathioprine act to inhibit purine synthesis which will block protein synthesis, particularly in cells that experience rapid turnover

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13
Q

What are side effects of azathioprine (imuran)

A

Rapidly growing cells are most readily affected, leading to hair loss, bone marrow suppression (aplastic anemia), GI toxicity, leukopenia, and thrombocytopenia. Decreased ability to fight infection

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14
Q

What drug class is Cyclosporine (Sandimmune)

A

immunosuppressant derived from a soil fungus

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15
Q

What are the indications for Cyclosporine

A

Prevent rejection of kidney, liver and heart transplants as well as for treatment of RA and other autoimmune diseases such as severe psoriasis

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16
Q

What is the MOA of Cyclosporine

A

T-cell inhibition. Blocks the signal to lymphocytes to produce IL-1, IL-2, IL-3, IL-4, and interferon gamma

17
Q

What will increase blood levels of cyclosporine

A

grapefruit, because cyclosporin is processed by CYP 450

18
Q

What drug class is Tacrolimus/ Prograf

A

An immunosuppressant drug related to the macrolide class of antibiotics extracted from soil microorganism

19
Q

What are the indication of Tacrolimus

A

Protection against rejection of organ transplantation. Topical treatment for severe eczema

20
Q

How does tacrolimus compare to cyclosporine

A

tacrolimus is like 100x more potent

21
Q

What strange location is cyclosporine used in low dose

A

in the eyes when there is reduced tear production (from inflammation) Called Restasis

22
Q

What drug class is etanercept (enbrel)

A

DMARD, recombinant-DNA drug

23
Q

How is etanercept administered

A

SQ injection 1-2x weekly

24
Q

Wat are side effects of etanercept

A

tumors, increased susceptibility to infections,

25
Q

What drug class is infliximab (remicade)

A

DMARD, recombinant-DNA drug

26
Q

What are the indications for infliximab

A

RA, Crohn’s disease, U.C (etanercept is not approved for IBD)

27
Q

What is the administration route for infliximab

A

IV, since gut would destroy the drug

28
Q

What is the MOA of infliximab

A

neutralizes the biological activity of TNFα by binding with high affinity to the soluble (free floating in the blood) TNFα and the trans-membrane (located on the outer membranes of T cells and similar immune cells) forms of TNFα, thus preventing the effective binding of TNFα with its receptors.

29
Q

Which drug is used in DMARDs is also used as an anti-malarial

A

Hydroxychloroquine (plaquenil)

30
Q

What is the MOA for hydroxychloroquine’s DMARD activity

A

blocks activation fo TLRs on plasmacytoid dendritic cells

31
Q

What are indications for hydroxychloroquine

A

AI dz, malaria, post lyme

32
Q

What are signs of hydroxychloroquine overdose

A

HA, drowsiness, convulsions, SOB, vision problems

33
Q

Which drug mandates yearly dilated eye exams

A

hydroxychloroquine (plaquenil)

34
Q

From whom is hydroxychloroquine contraindicated

A

Those with G6PD enzyme deficiency

35
Q

What are gold salts used for

A

reducing inflammation in AI disease when patient in unresponsive to other drug therapies

pharm 2 (18 decks)

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