Iszard Interstitial lung disease Flashcards
What drugs are considered for initial therapy of interstitial lung disease?
G M MAN
Glucocorticoids - prednisolone
Mycophenalate
Methotrexate
Azathioprine
Nintedanib
What drugs are considered for initial therapy of interstitial lung disease?
What drug is used as an anti inflammatory/ immunosuppressive for allergic, dermatologic, GI, hematologic, opthalmic, other conditions that is also used for interstitial pneumonia?
Prednisolone (glucocorticoids)
What interstitial lung disease tx can cause hypothalamic-pituitary-adrenal axis suppression and will require patients be monitored for cushings and hyperglycemia?
Prednisone
What drug can cause adverse rxn of fluid retention, alteration in glucose tolerance, elevation in blood pressure, behavioral and mood changes, increased appetite and weight gain?
Corticosteroids - Prednisone
What is an immunosuppressive drug used to treat interstitial lung disease that is also used to treat rheumatoid arthritis, including patients resistant to methotrexate.
Mycophenolate
What drug used to treat interstitial lung disease is an antimetabolite immunosuppressant indicated for the prophylaxis of organ rejection in recipients of allogeneic kidney, heart or liver transplants, and should be used in combination with other immunosuppressants
Mycophenolate
What is the black box warning for mycophenolate?
- Embryofetal toxicity, malignancies, and serious infections
- increased risk of lymphoma/skin malignancies
- increased susceptibility to infections including opportunistic infections
This drug’s efficacy may be reduced by:
- antacids with magnesium or aluminum hydroxide
- proton pump inhibitors
- drugs that interfere with enterohepatic recirculation
Mycophenolate
What are the black box warnings of methotrexate?
- Only physicians with experience and knowledge of antimetabolite therapy should prescribe — can have serious toxic reactions
- only used in life threatening neoplastic disorders, psoriasis, or RA if disease is debilatating
- Death have been reported - monitor for bone marrow, liver, lung and kidney toxicities
- inform patients of the risk
What drug is used as an anti inflammatory/ immunosuppressive for allergic, dermatologic, GI, hematologic, opthalmic, other conditions that is also used for interstitial pneumonia?
Prednisolone (glucocorticoids)
What interstitial lung disease tx can cause hypothalamic-pituitary-adrenal axis suppression and will require patients be monitored for cushings and hyperglycemia?
Prednisone
What drug can cause adverse rxn of fluid retention, alteration in glucose tolerance, elevation in blood pressure, behavioral and mood changes, increased appetite and weight gain?
Corticosteroids - Prednisone
What is an immunosuppressive drug used to treat interstitial lung disease that is also used to treat rheumatoid arthritis, including patients resistant to methotrexate.
Mycophenolate
What drug is an antimetabolite immunosuppressant indicated for the prophylaxis of organ rejection in recipients of allogeneic kidney, heart or liver transplants, and should be used in combination with other immunosuppressants
Mycophenolate
What is the black box warning for mycophenolate?
- Embryofetal toxicity, malignancies, and serious infections
- increased risk of lymphoma/skin malignancies
- increased susceptibility to infections including opportunistic infections
This drug’s efficacy may be reduced by:
- antacids with magnesium or aluminum hydroxide
- proton pump inhibitors
- drugs that interfere with enterohepatic recirculation
Mycophenolate
What drug used to treat interstitial lung disease may reduce the effectiveness of oral contraceptives?
Mycophenolate
How can methotrexate affect a pregnancy?
fetal death and/or congenital anomalies
What can reduce methotrexate elimination?
- impaired renal function
- ascites
- pleural effusions
- penicillin
Methotrexate + NSAID can cause what?
- severe (sometimes fatal) bone marrow suppression
- aplastic anemia
- gastrointestinal toxicity`
Prolonged methotrexate use can cause
- Hepatotoxicity
- Fibrosis
- Cirrhosis
What opportunistic infection may occur with methotrexate therapy?
Pneumocystis carinii pneumonia
What drug that is used to treat interstitial Lung disease is used in neoplastic disorders, Psoriasis, RA including poly articular course juvenile RA
methotrexate
Who should NOT take methotrexate?
- Pregnant patients
- Patients of childbearing potential
- patients with alcoholism, alcoholic liver disease, or chronic liver disease
What could decrease the intestinal absorption of methotrexate?
Oral ABX:
- tetracycline
- chloramphenicol
- nonabsorbable broad spectrum abx
What can reduce the clearance of methotrexate?
penicillins
What is an immunosuppressive antimetabolite available po?
Azathioprine
What treat interstitial lung disease drug is used:
- in rejection prevention for renal homotransplantation
- indicated for the management of active rheumatoid arthritis to reduce signs and symptoms.
Azathioprine
What drug can have serious toxic hematologic and GI effects?
Azathioprine
What drug can cause chronic immunosupression and increase risk of malignancy in humans?
Azathioprine
What drug is a kinase inhibitor used to treat idiopathic pulmonary fibrosis?
Nitedanib
What are the drug interactions of Nintedanib?
Co-administration of P-gp and CYP3A4 inhibitors may increase Nintedanib exposure»>Monitor patients closely for tolerability.
