mechanisms Flashcards
mechanism of denosumab
monoclonal antibody which inhibits RANKL receptors, which, when activated, inhibits the maturation of osteoclasts
acts as a competetive inhibitor which prevents activation of osteoclasts from resorbing bone
what is denosumab used to treat
osteoporosis - second line
tumours or other diseases which result in bone loss
side effects of denosumab
fever
chills
muscle and joint pains
dysuria
skin conditions - dermatitis, eczema
couhging and SoB
UTIs
hypocalcaemia
osteonecrosis of jaw or fractures
administration of denosumab
injection under skin every 6 months by HCP
subcutaneous
contraindications of denosumab
not given orally, IV, IM, or intradermally
not given to pregnant women
correct pre-existing hypocalcaemia before administrating denosumab
not given with immunosuppressants
mechanism of methotrextate
inhibits the enzyme dihydrofolate reductase
essential for the synthesis of purines and pyrimides
mechanism of leflunomide
inhibits the enzyme dihydroorotate dehydrogenase
stops pyrimidine synthesis
pyrimidine important component of RNA and DNA
mechanism of sulfasalazine
not completely known
thought to be suppression of IL1 and TNF alpha
mechanism of hydroxychloroquine
induces apoptosis of inflammatory cells
decreases chemotaxis
targets TNF alpha
interferes with toll like receptors, disrupting antien presentation and increasing pH of lysosomes
mechanism of adalimumab
inhibits TNF alpha and inhibits its reaction with p55 and p75 cell surface receptors
mechanism of rituximab
acts against CD20 protein on B-cell surface, triggering cell death
it is an IgG
side effects of methotrexate
pulmonary fibrosis
mouth ulcers and mucositis
liver toxicity
bone marrow suppression
leukopenia
harmful to pregnancy
atrial fibrilation when paired with etanercept (anti TNF biologic)
side effects of leflunomide
mouth ulcers and mucositis
liver toxicity
bone marrow suppression
leukopenia
rashes
peripheral neuropathy
harmful to pregnancy
side effects of sulfasalazine
temporary male infertility - reduced sperm count
bone marrow suppression
side effects of hydroxychloroquine
nightmares
reduces visual activity
liver toxicity
skin pigmentation
side effects of Anti TNF drugs
vulnerable to severe infections and sepsis
reactivation of TB and Hep B
side effects of rituximab
vulnerable to severe infections and sepsis
night sweats
thrombocytopenia
peripheral neuropathy
liver and lung toxicity
mechanism of colchicine
not fully established
likely to be inhibition of tubulins
- antimitotic, stops metaphase
stops production of IL-1
mechanism of allopurinol
xanthine oxidase inhibitor
- stops conversion of xanthine to uric acid (de novo synthesis)
mechanism of febuxostat
non-purine xanthine oxidase inhibitor
mechanism of prednisolone and dexamethasone (glucocorticoids)
inhibits neutrophil apoptosis
inhibit phospholipase A2
promotes IL-10
mechanism of ibuprofen
non selective COX inhibitor
- COX 1 inhibition causes GI problems(?)
mechanism of aspirin
non selective COX inhibitor
mechanism of naproxen
non selective COX inhibitor
mechanism of diclofenac
non selective COX inhibitor
mechanism of aciclovir (herpes, chickenpox, shingles)
nucleoside analog that inhibits action of viral DNA polymerase and DNA replication of different herpesviruses
mechanism of alendronic acid
binds to bone hydroxyapetite
bone resorption releases alendronic acid which is taken into osteoclasts by endocytosis
causes apoptosis of osteoclasts
mechanism of amitryptiline (tricyclic antidepressant)
suggested
inhibits membrane pump mechanism responsible for re-uptake of transmitter amines (norepinephrine and serotonin)
mechanism of amlodipine
dihydropyridine calcium antagonist
causes influx of calcium ions to smooth and cardiac muscle
mechanism of amoxicillin (gram +ve - strep)
inhibits penicillin binding protein-1 leading to upregulation of autolytic enzymes and inhibition of cell wall synthesis
mechanism of buprenorphine
partial agonist against Mu-receptor
antagonist at kappa receptor
mechanism of carbimazole (hyperthyroidism)
decreases uptake of iodine by thyroid
reduces formation of di-iodotyrosine and thyroxine
prevents coupling of peroxidase and iodinating the tyrosine residues on thyroglobulin - stop production of T3 and T4 thyroid hormones
mechanism of codeine
selective agonist for Mu-receptor
mechanism of doxycycline (tetracyclines)
inhibits bacterial protein synthesis by allosterically binding to 30S (ribosomes)
mechanism of flucloxacillin (gram positive except for staph A)
inhibits 3rd and last stage of bacterial cell wall synthesis by binding to penicillin binding proteins
mechanism of furosemide (diuretic)
blocks tubular resorption of sodium and chloride through competitive inhibition of NKCC2
decreases excretion of uric acid
mechanism of gabapentin
unclear
inhibits calcium ion channels?
mechanism of methadone
full agonist against u-receptors, k-recetpros, and o-receptors
strong inhibition of seritonin and norepinephrine uptake - likely contributes to anti-nociceptive pain
mechanism of morphine
agonist of mu and kappa receptors
mechanism of naloxone
opioid receptor antaognist
competitive inhibitor of u-receptor
mechanism of omeprazole (eradication of h-pylori!)
proton pump inhibitor
inhibits ATPase
mechanism of pregabalin
suggested
binding to voltage gated calcium channels
anticonvulsant
mechanism of tramadol
agonist for u-receptor
