Immunosupression And Rheumatology Drugs Flashcards
Treatment for rheumatoid arthritis?
Methotrexate and acathioprine
MoA of corticosteroids?
Bind to glucocorticoid receptor inside cell -> prevents IL-1 and Il-6 production by macrophages
Inhibits T cell activation
ADRs of corticosteroids?
Weight gain Osteoporosis Avascular necrosis Glucose intolerance Infection risk Cataracts
MoA of azathioprine?
Antagonises purine metabolism -> decreased RNA and DNA synthesis, selectively with a high mitotic rate
ADRs of azathioprine?
Myelosuppression -> neutropenia
Increased risk of malignancy and infection
MoA of calcineurin inhibitors?
Active against T helper cells, preventing IL-2 production
ADRs of calcineurin inhibitors?
Nephrotoxicity Hyperuricaemia Hepatic dysfunction Pancreatitis Psychosis Arrhythmias Pancytopenia Peripheral neuropathy (Metabolised by CYP450)
MoA of mycophenalate mofetil?
Impairs B and T cell proliferation
ADRs of mycophenalate mofetil?
Nausea
Vomiting
Diarrhoea
Myelosuppression (-> GI ulceration, leukopenia, neutropenia, increased infection risk)
Name some types of immunosuppressants?
Corticosteroids
Azathioprine
Calcineurin inhibitors
Mycophenalate mofetil
Name some disease modifying anti-rheumatic drugs?
Cyclophosphamide
Methotrexate
MoA of cyclophosphamide?
Alkylating agent
Decreases T/B cell activity
ADRs of cyclophosphamide?
Cytotoxic
Contra-indications: lymphoma, leukaemia, solid cancer, lupus nephrons, Wegner’s granulomatosis (ANCA vasculitis)
Infertility
Teratogenic
Haemorrhagic cystitis
Increased risk of bladder cancer, leukaemia and lymphoma
MoA of Methotrexate?
Decreases DNA/RNA/Protein synthesis
Increased toxicity to rapidly dividing cells
Decreases T cells
ADRs of Methotrexate?
Teratogenic Can cause miscarriage Mucositis Marrow suppression Hepatitis Infection
