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Drugs Lists > Immunosuppressants > Flashcards

Immunosuppressants Flashcards

1
Q

What are the 3 main DMARD’s used?

A
  1. Methotrexate
  2. Sulfalazine
  3. Hydroxychloroquine
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2
Q

What is methotrexates mechanism of action?

A
  • Binds competitively to DHFR
  • Inhibits the synthesis of DNA, RNA and proteins
  • Not a clear mechanism in non malignant diseases
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3
Q

What are the most important side effects of methotrexate?

A
  1. Mucositis - Pneumonitis, oral ulcers
  2. Hepatotoxic - Hepatitis, cirrhosis
  3. Bone marrow suppression
  4. Teratogenic, abortifacient
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4
Q

What investigations must you do before starting a patient on methotrexate?

A

CXR - causes ILD

FBC, U+E, LFT

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5
Q

How is methotrexate excreted?

A

Renally

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6
Q

What supplement can you give to reduce side effects of methotrexate?

A

Folic acid

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7
Q

What class of drug is sulphasalazine?

A

Aminosalicylate

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8
Q

How do aminosalicylates work?

A

They inhibit T cells and neutrophils

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9
Q

What are the main side effects of sulfasalazine?

A
  1. Rash
  2. Reduced sperm count
  3. Oral ulcers
  4. Myelosuppression
  5. Hepatitis
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10
Q

What are some side effects of hydroxychloroquine?

A
  1. Retinopathy
  2. Alopecia
  3. Sensitivity to sunlight
  4. NVD
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11
Q

What are side effects of all immunosuppressive drugs?

A
  1. Immunosuppression
  2. Bone marrow supression
  3. Increased risk of malignancy
  4. Hepatitis
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12
Q

What should you monitor in a patient taking hydroxychloroquine?

A
  • Pre treatment eye screening

- Annual eye screening

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13
Q

What pre treatment screening is required for biologicals?

A
  • HIV
  • HEP B/C
  • TB
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14
Q

Name a TNF-a inhibitor?

A

Infliximab

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15
Q

Name a B cell depleter?

A

Rituximab

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16
Q

What are some side effects of biologicals?

A
  • Serious infections
  • Reactivation of TB or hep B
  • Worsening heart failure
  • Injection site reactions
  • Blood disorders
17
Q

Which drugs are absolutely contraindicated in pregnancy and breastfeeding?

A
  • Methotrexate, leflunomide, cyclophosphamide
18
Q

What are the main side effects of mycophenolate motefil?

A 
Nausea 
Vomiting 
Diarrhoea 
Myelosupression
Mouth ulcers 
Risk of skin malignancy
19
Q

What class of drug is mycophenolate motefil?

A

Anti proliferative drugs

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