Immunosuppressive Flashcards
What drug is given to meningitis contacts?
Rifampicin
What drug is given to treat conjunctivitis?
Chloramphenicol
What are the groups of drugs used to treat rheumatoid arthritis?
DMARDs
Biologics
What is used to treat acute flares of rheumatoid arthritis?
NSAIDs
Glucocorticoids
Give examples of immunosuppressant DMARDs used in RA
Corticosteroids (avoid long-term)
Azithioprine
Calcineurin inhibitors
JAK inhibitors
Name some other DMARDs (non-immunosuppressive) used to treat RA
Methotrexate (gold standard)
Sulphasalazine
Anti-TNF angents
Rituximab
Give examples of biological response modifiers used to treat RA
Abatacept
Rituximab (very effective)
Infliximab
Anakinra
What drugs are used to treat SLE?
Corticosteroids
Immunosuppressants (if severe)
What drugs are used to treat vasculitis?
Corticosteroids
Immunosuppressants
Name the 4 classes of immunosuppressants
Steroids
Cytokines inhibitors
Biological agents
Anti-metabolites
Give examples of immunosuppressant steroids
Prednisolone
Methylprednisolone
Give examples of immunosuppressant cytokines inhibitors
Cyclosporin
Tacrolimus
Give some examples of immunosuppressive biological agents
Adalimumab
Infliximab
Give some examples of immunosuppressive antimetabolites
Methotrexate
Azathioprine
When might corticosteroids be used?
Immunosuppression (RA)
Anti-inflammatory (asthma, giant cell arteritis)
Replacement therapy (Addison’s, hypoadrenalism)
What is the action of corticosteroids?
Bind to intracellular cytoplasmic receptors
Then bind to nucleus
Promote/inhibit gene transcription
Prevent IL-1 and 6 production by macrophages
Inhibit all stages of T cell activation
ADRs of corticosteroids?
Hypertension Increased infection risk Osteoporosis GI disturbances Bruising and thinning of the skin Weight gain (central) Mood changes (psychosis and depression) Diabetes
What are the uses of methotrexate?
RA
Malignancy
Psoriasis/psoriaritic arthritis
Crohn’s disease
How does methotrexate work in malignant disease?
Inhibits DHFR enzyme
Inhibits synthesis of DNA, RNA and proteins
Greater effect on more rapidly dividing cells
What are the adverse effects of methotrexate?
Mucositis
Myelosuppression
Both respond to folic acid supplements
Hepatitis
Cirrhosis
Pneumonitis
Infection risk
Why should methotrexate not be used during pregnancy?
Highly teratogenic
Causes miscarriage