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Phamacology > Immunosuppression- Rheumatoid Arthritis and Transplants > Flashcards

Immunosuppression- Rheumatoid Arthritis and Transplants Flashcards

1
Q 
BIOLOGICS?
Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept
Adalimumab
Infliximab

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2
Q

TRADITIONAL

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Hydroxychloroquine
Sulfasalazine
Minocycline (a tetracycline)
Azathioprine/ Mercaptopurine

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3
Q

Has two receptors which target and bind to TNF (Tumor Necrosis Factor) and neutralizes it

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS

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4
Q

Treats
Rheumatoid Arthritis

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS

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5
Q

Has two receptors which target and bind to TNF (Tumor Necrosis Factor) and neutralizes it

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS

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6
Q

NURSING CONSIDERATION:
Monitor the site for redness, pain and swelling after administration
Report if doesn’t improve after a few days

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS

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7
Q

Serious Infections (this drug suppresses the immune system

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS

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8
Q

NURSING CONSIDERATION:
Monitor the site for redness, pain and swelling after administration
Report if doesn’t improve after a few days

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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9
Q

Serious Infections (this drug suppresses the immune system

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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10
Q

Higher risk for TB!

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS

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11
Q

Higher risk for Fungal infections, Atypical bacteria (such as TB!)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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12
Q

Higher risk for TB!

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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13
Q

Risk for
Legionella pneumophila, Mycobacterium tuberculosis

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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14
Q

RISK FOR SERIOUS INFECTIONS

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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15
Q

RISK FOR SERIOUS INFECTIONS◦Mostly seen when combined with other suppressing drugs
Etanercept + Steroids, or Etanercept+ Methotrexate

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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16
Q

Higher risk for infection with TB, HBV, bacterial, fungal, viral,

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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17
Q

Nursing should assess patient for infection prior to giving medication (CBC as well)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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18
Q

No live vaccines (just like no live vaccines with steroids!)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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19
Q

One of the requirements when using this medication is to check for latent TB and HBV

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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20
Q

MALIGNANCIES◦We have seen lymphomas and other malignancies develop during use of this medication

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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21
Q

NURSING CONSIDERATIONS:◦Assess for s/s of malignancy (splenomegaly, hepatomegaly, night sweats, weight loss, persistent fever)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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22
Q

Periodic monitoring
◦Heart (Heart Failure)
◦Liver (Hepatotoxicity)
◦CBC (pancytopenia)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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23
Q

Don’t forget the infection risk
◦Watch out with additive effects of immunosuppressant’s
◦No LIVE vaccines
◦Baseline screening for TB and HBV

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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24
Q

Do NOT give in malignancies!

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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25
Q 
BIOLOGICS: BICYCLE
Blood Dyscrasias
Infection
Cardiac (heart failure)
Yucky (injection site)
CancerLiver
Educate about SJS/TEN
Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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26
Q

Etanercept-BIOLOGICSAdalimumab- BIOLOGICS
Infliximab- BIOLOGICS

BIOLOGICS: BICYCLE
B-
I-
C-
Y-
C-
E-
A

Etanercept-BIOLOGICS Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

BIOLOGICS: BICYCLE
Blood Dyscrasias
Infection
Cardiac (heart failure)
Yucky (injection site)
CancerLiver
Educate about SJS/TEN
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27
Q

◦Watch out with additive effects of immunosuppressant’s

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Etanercept-BIOLOGICS
Adalimumab- BIOLOGICS
Infliximab- BIOLOGICS

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28
Q

Treat
Rheumatoid Arthritis
Crohn’s
Ulcerative Colitis

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Adalimumab- BIOLOGICS

Infliximab- BIOLOGICS

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29
Q

Which is the correct MAB

? = Human mab that works Immunomodulatory (RA, IBD= Crohn’s, Ulcerative Colitis)

Inf-li-xi-mab, Ada-lim-u-mab

A

Ada-lim-u-mab= Human mab that works Immunomodulatory (RA, IBD= Crohn’s, Ulcerative Colitis)

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30
Q

?= Chimeric mab that works Immunomodulatory (RA, IBD)

Inf-li-xi-mab, Ada-lim-u-mab

A

Inf-li-xi-mab= Chimeric mab that works Immunomodulatory (RA, IBD)

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31
Q

MECHANISM OF ACTION:◦Monoclonal Antibody that targets TNF of the immune system

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Adalimumab- BIOLOGICS

Infliximab- BIOLOGICS

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32
Q

? is given intravenously (IVPB), can see infusion reactions (flu-like, chills, headache, fever), rarely anaphylaxis

Adalimumab, Infliximab

A

Infliximab- BIOLOGICS

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33
Q

? is also given subcutaneously (like Etanercept), so watch out for local reactions (20% of patients)

Adalimumab, Infliximab

A

Adalimumab- BIOLOGICS

34
Q 
USED TO TREAT
Malaria
Systemic Lupus erythematosus
Sjorgen Syndrome
Rheumatoid Arthritis
Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Hydroxychloroquine - Traditional

35
Q

ALWAYS FINISH THE ENTIRE COURSE OF THERAPY (EVEN IF SYMPTOMS IMPROVE EARLY!)

A

Hydroxychloroquine - Traditional

36
Q

Retinal damage

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Hydroxychloroquine - Traditional

37
Q

QT Prolongation

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Hydroxychloroquine - Traditional

38
Q

ALWAYS FINISH THE ENTIRE COURSE OF THERAPY (EVEN IF SYMPTOMS IMPROVE EARLY!)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Hydroxychloroquine - Traditional

39
Q

Retinal damage

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Hydroxychloroquine - Traditional

40
Q

QT Prolongation

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Hydroxychloroquine - Traditional

41
Q

Reports of Hypoglycemia

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Hydroxychloroquine - Traditional

42
Q

Contra-indicated in G6PD Deficiency

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Hydroxychloroquine - Traditional

43
Q

Acne- topical and oral preparations

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

44
Q

Lyme Disease

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

45
Q

Chlamydia

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

46
Q

Anthrax

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline)- Traditional

47
Q

Binds to calcium- bones, teeth, drugs (AVOID CHILDREN, PREGNANT PATIENTS)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

48
Q

Photosensitivity\

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

49
Q

GI irritation

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

50
Q

Risk for suprainfection (C.diff, candida albicans)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

51
Q

Hepatotoxicity

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline)- Traditional

52
Q

Alternative Contraception needed

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

53
Q

Intended OutcomesResolve the infection (decreased WBC, decreased temperature/fever)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

54
Q

ALWAYS FINISH THE ENTIRE COURSE OF THERAPY (EVEN IF SYMPTOMS IMPROVE EARLY!)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

55
Q

Take with FULL GLASS OF WATER, AVOID BEDTIME, AVOID CALCIUM!

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Minocycline ( a tetracycline) - Traditional

56
Q

LIFE
Lifelong therapy
Immunosuppressed (infection and malignancy risk)
Frequent monitoring of liver, kidneys , blood pressure and drug levels
Electrolyte abnormalities

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Mycophenolate
Tacrolimus
Cyclosporine

57
Q 
Transplant Med Mycophenolate, Tacrolimus, Cyclosporine
L
I
F
E
A

Lifelong therapy
Immunosuppressed (infection and malignancy risk)
Frequent monitoring of liver, kidneys , blood pressure and drug levels
Electrolyte abnormalities

58
Q

Treats
Rheumatoid Arthritis
Transplants
Ulcerative Colitis

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant

59
Q

Inhibition of production and release of interleukin II and inhibits interleukin II-induced activation of resting T-lymphocytes.

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant

60
Q

PROVIDER MUST BE EXPERIENCED IN IMMUNOSUPPRESSION AND TRANSPLANTS

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant
Tacrolimus - Transplant
Mycophenolate Transplant

61
Q

IMMUNOSUPPRESSION/ MALIGNANCY RISK

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant
Tacrolimus - Transplant
Mycophenolate Transplant

62
Q

BIOAVAILABILITY (DO NOT SWITCH BRANDS)

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant

63
Q

HYPERTENSION/ NEPHROTOXICITY

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant
Tacrolimus - Transplant
Mycophenolate Transplant

64
Q

ADVERSE EFFECTS:◦Hirsutism◦Gingival Hyperplasia

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant

65
Q

NARROW THERAPEUTIC DRUG
We check trough levels

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant

Tacrolimus - Transplant

66
Q

NO GRAPEFRUIT JUICE!

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant

Tacrolimus - Transplant

67
Q

Just like with phenytoin, good oral hygiene

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant

68
Q

Monitor Blood Pressure
Assess Renal and Hepatic Function

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant
Tacrolimus - Transplant
Mycophenolate Transplant

69
Q

Monitor and Report Infection/Malignancy
No LIVE vaccines, do not use in active/recent Herpes/Chickenpox infection

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant
Tacrolimus - Transplant
Mycophenolate Transplant

70
Q

Treats
Transplants
◦Lots of off label auto-immune uses

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Tacrolimus - Transplant

Mycophenolate Transplant

71
Q

Suppresses cellular immunity (inhibits T-lymphocyte activation), by binding to an intracellular protein, FKBP-12 and complexes with calcineurin dependent proteins to inhibit calcineurin phosphatase activity

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Tacrolimus - Transplant

72
Q

2 BOXED WARNINGS FROM THE FDA
◦ IMMUNOSUPPRESSION- INFECTION RISK
◦ MALIGNANCY RISK

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Tacrolimus - Transplant

73
Q

Main= Hypertention

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Tacrolimus - Transplant

74
Q

MPA exhibits a cytostatic effect on T and B lymphocytes. It is an inhibitor of inosine monophosphate dehydrogenase (IMPDH) which inhibits de novo guanosine nucleotide synthesis. T and B lymphocytes are dependent on this pathway for proliferation.

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Mycophenolate Transplant

75
Q 
4 BOXED WARNINGS FROM THE FDA
◦PROVIDER MUST BE EXPERIENCED IN IMMUNOSUPPRESSION AND TRANSPLANTS
◦SERIOUS INFECTIONS/IMMUNOSUPPRESSION
◦MALIGNANCY RISK
◦FETAL TOXICITY
Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Mycophenolate Transplant

76
Q

Box Warning
◦FETAL TOXICITY

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Mycophenolate Transplant

77
Q 
4 BOXED WARNINGS FROM THE FDA
◦PROVIDER MUST BE EXPERIENCED IN IMMUNOSUPPRESSION AND TRANSPLANTS
◦IMMUNOSUPPRESSION/ MALIGNANCY RISK
◦BIOAVAILABILITY (DO NOT SWITCH BRANDS)
◦HYPERTENSION/ NEPHROTOXICITY
Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant

78
Q

Administertion
CONSISTENCY- SAME TIME DAILY-

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Mycophenolate Transplant

79
Q

Administertion
CONSISTENCY- SAME TIME DAILY- CHECK TROUGH LEVELS! ( DON’T CHANGE BETWEEN MANUFACTURERS!)- NO GRAPEFRUIT JUICE.

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Cyclosporine - Transplant

Tacrolimus - Transplant

80
Q

Transplant

Etanercept
Tacrolimus
Methotrexate
Cyclosporine
Infliximab
Sulfasalazine
Hydroxychloroquine
Azathioprine/ Mercaptupurine
Mycophenolate
Cyclosporine
Minocycline ( a tetracycline)
Adalimumab
A

Tacrolimus
Cyclosporine
Mycophenolate

Phamacology (13 decks)

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