Immunosuppressants Flashcards
How do systemic steroids work?
Up-regulate anti-inflammatory and down regulate pro-inflammatory genes
What are some important ADRs of systemic steroids?
Immunosuppression and adrenal insufficiency
What are some important DDIs of systemic steroids?
They are affected by CYP inducers and there is an increased bleeding risk with NSAIDs
What type of drug is methotrexate?
Disease modifying anti-rheumatic drug (DMARD)
What are some important ADRs of methotrexate?
Mucositis, liver disease, tetrogenic, abortifactant
Which of methotrexate and sulfasalazine is safe to use in pregnancy?
Sulfasalazine
What are some important DDIs of methotrexate?
NSAIDs, drugs reducing renal excretion or those displacing bound drug
How does azathioprine work?
Inhibits synthesis of purines needed for DNA replication
What are some ADRs associated itch azathioprine?
Immunosupression, risk of malignancy, hepatitis, infection
How do the drugs ciclosporin and tacrolismus work?
They inhibit calcineurin which helps reduce helper T cell activity
What is an important ADR associated with calcineurin blockers?
Renal toxicity
Caution should be taken when giving what types of drugs with azathioprine?
Other immunosuppressants- caution
How do cyclophosphamide and mycophenolate mofetil work?
They prevent the proliferation of B and T cells
Why are patients on cyclophosphamide advices to have at least 2 lites of fluids a day?
Has a toxic metabolite (acrolein) to bladder epithelium and ca lead to haemorrhagic cystitis
What are some important ADRs associated with sulfasalazine?
Myelosupression, hypersensitivity, rash
