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pre-reg exam 2021 > Immunosuppressants > Flashcards

Immunosuppressants Flashcards

1
Q

What are immunosuppressants?

A

Suppresses or prevents the immune response

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2
Q

What are immunosuppressants used for?

A

Transplant rejection

Inflammatory disease

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3
Q

What are the antiproloferative immunosuppressants?

A

Azathioprine
Mercaptopurine
Mycophenolate mofetil

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4
Q

What are the other immunosuppressants?

A

Ciclosporin
Tacrolimus
Corticosteroids

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5
Q

Can you have vaccines when on immunosuppressants?

A

Yes, but not live vaccines

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6
Q

What is the mechanism of action of azathioprine and mercaptopurine?

A

Mercaptopurine inhibits purine metabolism therefore DNA, RNA and protein synthesis

Azathioprine is metabolised to mercaptopurine

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7
Q

What are the side effects of azathioprine and mercaptopurine?

A

Hypersensitivity reactions - stop immediately

Bone marrow suppression - pre treatment screening for thiopurine methyl transferase

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8
Q

What are the interactions for azathioprine/mercaptopurine?

A

Allopurinol - toxicity, inhibits metabolism of purines

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9
Q

What is the mechanism of action of mycophenolate mofetil?

A

Metabolised to mycophenolic acid

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10
Q

What are the side effects of mycophenolate mofetil?

A

Hypogammaglobinaemia - recurrent infections
Bronchiectasis - respiratory symptoms
Bone marrow suppression

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11
Q

Can mycophenolate mofetil be used in pregnancy?

A

NO - genotoxic and teratogenic

Women - 2 methods of effective contraception until 6 weeks after discontinuing

Men - use condoms until 90 days after discontinuing

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12
Q

What is the mechanism of action of tacrolimus?

A

Calcineurin inhibitor

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13
Q

What are the side effects of tacrolimus?

A 
Heart - cardiomyopathy 
Kidney - nephropathy
Liver - hepatotoxicity 
Bone marrow - blood dyscrasias 
Blood - hypertension, hyperglycaemia, hyperkalaemia, hyperuricaemia
Neurotoxicity - headaches and tremors
Eye disorders - blurred vision, photophobia
Skin - rashes
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14
Q

What are the counselling points for tacrolimus?

A

Avoid sunlight
Avoid high potassium and grapefruit juice
Driving may be affected

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15
Q

What is the MHRA warning for tacrolimus?

A

Maintain on same brand of oral tacrolimus

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16
Q

What is the mechanism of action of ciclosporin?

A

Lowers activity of T cells and their immune response

17
Q

What are the side effects of ciclosporin?

A

Nephrotoxicity
Hepatotoxicity
Blood dyscrasias
Hyperlipidaemia, hypertension, hyperkalaemia, hypomagnesaemia

Visual disturbances
Gingival hyperplasia
Neurotoxicity

18
Q

What are the counselling points for ciclosporin?

A

Avoid sunlight

Avoid high potassium and grapefruit juice

19
Q

What is the MHRA advice on ciclosporin?

A

Maintain on same brand

pre-reg exam 2021 (79 decks)

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