Iszard ILD drugs Flashcards
What is prednisone used for with an ILD? Warnings for it?
- anti inflammatory or immunosuppressive
- May lead to HPA axis suppression
- monitor for cushing’s syndrome and hyperglycemia
Mycophenolate use?
- Immunosuppressive drug used in patients with RA and those resistant to methotrexate
- Used for prophylaxis of organ rejection
Mycophenolate contraindication and bbw?
- hsn to mycophenolate mofetil or any ingredient
- Embryofetal toxicity, malignancy, and infections are BBW
Mycophenolate AE?
- diarrhea
- leukopenia
- infection
- vomiting
- opportunistic infections
Mycophenolate drug interactions?
- antacids with Mg or Aluminum hydroxide
- PPI
- drugs that interfere with enterohepatic circulation
- reduces OC effectiveness
Methotrexate BBW?
- Monitor for bone marrow liver lung and kidney toxicities
- only used in life threatening neoplastic diseases or those with psoriasis RA, recalcitrant, disabling disease that is un responsive to other therapies
AE’s of Methortrexate? (so many)
- fetal death/abnormalities
- methotrexate elimination decreased in those with impaired renal function
- bone marrow suppression
- aplastic anemia
- hepatotoxicity
- fibrosis/cirrhosis
- can induce lung disease
- Diarrhea and ulcerative stomatitis require interruption of the therapy
- Hemorrhagic enteritis and death from intestinal perforation
- severe skin reactions
- opportunistic infections
- given with radiotherapy increases risk of necrosis and osteonecrosis
- tumor lysis syndrome
Indications for methotrexate?
- Neoplastic disease
- Psoriasis
- RA
Contraindications for methotrexate?
- Pregnancy or potential to become pregnant
- Psoriasis or RA patient with alcohol abuse, alcoholic liver disease or other chronic liver disease
What antibiotics may reduce renal clearance of methotrexate?
Penicillins
Administration of _____ with high dose methotrexate has been reported to elevate and prolong serum methotrexate levels resulting in deaths from severe hematologic and GI toxicity.
Administration of NSAID’S with high dose methotrexate has been reported to elevate and prolong serum methotrexate levels resulting in deaths from severe hematologic and GI toxicity.
Oral abx such as ___, ___, ___, may decrease intestinal absorption of methotrexate or interefere with enterohepatic circulation.
Oral abx such as tetracycline, chloramphenicol & nonabsorbable broad spectrum abx, may decrease intestinal absorption of methotrexate or interefere with enterohepatic circulation.
How does methotrexate impact theophylline levels?
may decrease clearance- needs monitoring
Azathioprine indication?
- adjunct for prevention of rejection in renal homotransplantation
- management of active RA to reduce signs and sx
Azathioprine contraindications?
- pregnancy
- previous tx with alkylating agents may increase risk of malignancy if treated with azathioprine
