Immunosuppressants

Question 1

SE of cyclophosphamide

Answer 1

Acute hemorrhagic cystitis, bladder CA, sterility, and myelosuppression. Hemorrhagic cystitis and bladder cancer are caused by acrolein, a bladder-toxic metabolite of cyclophosphamide. Drinking plenty of fluids, voiding frequently and taking MESNA are all helpful in preventing these complications.

Question 2

SE of cisplatin and carboplatin

Answer 2

Cochlear dysfunction. Amino glycosides can also cause this

Question 3

Ethambutol and hydroxychloroquine have both been implicated in causing what SE?

Answer 3

Optic neuritis

Question 4

Digital vasospasm may be caused by what 2 classes of drugs?

Answer 4

Beta blockers and ergotamine

Question 5

MOA of methotrexate

Answer 5

DMARD which works by inhibiting dihydrofolate reductase. It acts by interfering with the cellular utilization of folic acid, and folate depletion is considered to be the cause of most SE.

Question 6

Side effects of methotrexate

Answer 6

Hematologic toxicity with microcytic red blood cells may occur with its usage and one of the more serious abnormalities is dev of pancytopenia. American College of Rheum recommends routine peripheral blood counts every 3 months. Other side effects include, nausea, STOMATITIS, rash, HEPATOtoxicity, INTERSTITIAL LUNG DISEASE, ALOPECIA, and fever.