Immunosuppressants Flashcards
What side effects are trusty and you can pretty much always assume for immunosuppressants in an exam?
Increased cancer risk and risk of infection.
Cyclosporin is one of those standy-outy ones for side effects. What are the five?
NEPHROTOXICITY, hepatotoxicity, GUM HYPERPLASIA, hirsuitism, hypertension
List in order of invention the IL-2 transcription inhibitors
Cyclosporin, tacrolimus
Tacrolimus is more potent and effective than cyclosporin. Why isn’t it used more often?
Lower patient compliance because side effects are amplified.
Think “better check the P450 interactions”, no more grapefruit, think…
… cyclosporin.
Cyclosporin is often used with G, tacrolimus is often used alongside H.
Corticosteroids (cyclosporin-corticosteroids = c-c)
Glucocorticoids
Among others, glucocorticoids decrease the expression of these four biggies. Oh and COX-2 (reducing prostaglandin).
Two are easily recognisable immune molecules, and I like that one too.
IFNg TNFa IL-1 IL-2 -----(I) (L)like that (one) (too) -----I.e. IL's 1 and 2
What are some yucky effects of GCs that aren’t just a predicted consequence of it’s function?
There are four headings.
Metabolic
Electrolytic
Bones
Protein fuckery
What are some problems with fat redistribution (GC side effect)
trigylceridaemia
vanity - moon face, buffalo hump
atherosclerosis
What are some problems with bones? (GC side effect)
Avascular necrosis
Osteoporosis
What are the electrolytic problems of GC side effects?
Sodium retention inc. hypertension
Hypokalaemic alkalosis
How does protein fuckery adversely effect patients taking GCs?
Growth retardation
Cataracts
What’s the bDMARD?
Etanercept
Just in case, azathioprine and leflunomide block DNA synthesis.
azathioprineIMMUNOSUPRESSION and
IMMUNOSUPRESSIONleflunomide
Just in case, adalimumab are infliximab are anti TNFa antibodies.
And anakinra is IL-1.
