PBL Pharmacology Flashcards

1
Q

How should you treat uncomplicated HSP?

A

Supportive care

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2
Q

When should you treat HSP with drugs (ex: steroids)?

A

When crescents are found on renal biopsy –> indicates crescentic glomerulonephritis

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3
Q

What is the top treatment for crescenteric HSP?

A

High dose steroids + cyclophosphamide or daily mycophenolate mofetil

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4
Q

What corticosteroid is usually used for HSP?

A

Prednisone

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5
Q

What drug is Azathioprine similar to?

A

6-Mercaptopurine

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6
Q

What is the MOA for Azathioprine?

A

Active metabolite (methyl-thioinosine monophosphate - MeTIMP) is a purine synthesis inhibitor that works by blocking the enzyme amidophosphoribosyl transferase –> functions as immunosuppressive agent

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7
Q

What is the MOA for Cyclophosphamide?

A
  • Immunosuppressive agent
  • Alkylating agent, may cross-link DNA –> interfering with DNA replication and transcription of RNA –> disrupts nucleic acid function
  • Active metabolites interfere with rapidly proliferating malignant cells
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8
Q

What is the mechanism of acetaminophen?

A
  • Weak, reversible, non-specific COX inhibitor
  • Doesn’t inhibit platelets
  • Antipyritic, Analgesic
  • CNS inhibition of prostaglandin synthetase –> dec. PGE2
  • Possible inhibition of COX-3
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9
Q

What is the MOA of Mycophenolate Mofetil?

A

Reversibly inhibits inosine monophosphate dehydrogenase (enzyme that controls rate of synthesis of guanine monophosphate in the de novo pathway of purine synthesis –> used in proliferation of B and T lymphocytes)
-Inhibits T and B cells –> also inhibits antibody formation by B cells

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10
Q

How does Mycophenolate Mofetil specifically target T and B cells?

A

Other cells use the salvage pathways to make purines and are thus more able to escape the effect

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11
Q

What is the MOA for steroids?

A
  • Stabilizes neutrophil lysozymes
  • Lipocortin inhibits phospholipase A2 which inhibits prostaglandins and lipoxygenases
  • Glucocorticoid receptors (in membrane) –> GRE (nucleus) –> Inc. transcription of anti-inflammatory genes
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12
Q

What two OTC drugs can lead to renal damage?

A
  • Aspirin

- Ibuprofen

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13
Q

How does Prednisone work?

A

Corticosteroid

  • Blocks glucocorticoid receptor
  • Interacts with SRE –> inhibits many cytokines and proteins (including phospholipase A2 and COX)
  • Immune suppression (may raise WBC though)
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