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MOS > Pharmacology of MOS > Flashcards

Pharmacology of MOS Flashcards

1
Q

What are the doses of low, medium and high dose Glucocorticoids

A

Low: 5-10 mg/d
Medium: 20-40 mg/d
High: 60 mg/d

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2
Q

MOA for Glucocorticoids

A

Regulation of transcription of certain genes; suppress macrophage activation, WBC trafficking and cytokine production

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3
Q

Side Effects of Glucocorticoids

A 
Insomnia/Psychosis/Irritability
Weight gain
Hyperglycemia
Cushing's Syndrome
HTN
Infection
Osteoporosis
Cataracts
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4
Q

What MUST you consider before placing a patient on Glucocorticoids

A

PPD testing
Review/Update immunizations
Calcium/Vitamin D supplementation

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5
Q

Antimalarial agent that can also be used as an anti-inflammatory; Inhibits TLR signaling, and thus cytokine production and WBC activity; used for SLE, RA and Sjogren syndrome; CONTRAINDICATED with retinopathy and G6PD deficiency

A

Hydroxychloroquine

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6
Q

Indications for Hydroxychloroquine

A

Malaria prophylaxis
SLE
RA
Sjogren Syndrome

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7
Q

Contraindications for Hydroxychloroquine

A

G6PD deficiency

Retinopathy

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8
Q

How does Hydroxychloroquine have anti-inflammatory effects?

A

Inhibit TLR signaling–> dec. cytokines and WBC activity

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9
Q

Dihydrofolate Reductase inhibitor used for inflammatory and autoimmune diseases; CONTRAINDICATED in Pregnancy or with Sulfamethoxazole

A

Methotrexate

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10
Q

MOA of Methotrexate

A

Dihydrofolate Reductase inhibitor -> interferes with DNA synthesis

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11
Q

Contraindications for Methotrexate

A

PREGNANCY

Sulfamethoxazole

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12
Q

____________ ___________ is administered prophylactically along with Methotrexate to prevent megaloblastic anemia and glossitis

A

Folic Acid

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13
Q

Side Effects of Methotrexate

A 
Fatigue/Nausea
Mucosal ulcerations
Hepatotoxicity
Bone Marrow toxicity
Pneumonitis

*note that most involve rapidly dividing cells

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14
Q

Dihydroorate Dehydrogenase Inhibitor (no Orotate–> no de novo pyrimidine synthesis); used for arthritis and SLE; TERATOGEN

A

Leflunomide

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15
Q

MOA of Leflunomide

A

Dihydroorate Dehydrogenase inhibitor (no Orotate–> no de novo pyrimidine synthesis)

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16
Q

Side Effects of Leflunomide

A 
Rash
Alopecia
Diarrhea
Liver toxicity
Bone marrow toxicity

*note most have rapidly dividing cells

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17
Q

Contraindications for Leflunomide

18
Q

Immunosuppressant precursor of 6-mercaptopurine (inhibits Purine synthesis); used for SLE, Systemic Vasculitis and Inflammatory Myopathy; SAFE in pregnancy

A

Azathioprine

19
Q

MOA of Azathioprine

A

Precursor to 6-mercaptopurine, which prevents conversion of PRPP to IMP/AMP/GMP

20
Q

Side Effects of Azathioprine

A 
Fever
Rash
Anaphylaxis
Infection
Bone marrow toxicity
Hepatotoxicity
Malignancy
21
Q

Azathioprine is (safe/dangerous) in pregnancy

22
Q

Immunosuppressant that inhibits the conversion of IMP to GMP (Purine synthesis); indicated for SLE, Scleroderma, Vasculitis and Inflammatory Myopathy

A

Mycophenolate

23
Q

MOA of Mycophenolate

A

Inhibit conversion of IMP to GMP (Purine synthesis)

24
Q

Side Effects of Mycophenolate

A 
Dyspepsia
Diarrhea
Abdominal pain
Rash
Infection
Bone Marrow suppression
Malignancy
25
Q

Alkylating agent used for immunosuppression; used for Organ THREATENING complications, like SLE, Vasculitis, Lung Sclerosis, etc; can cause infection, bone marrow toxicity, infertility, hemorrhagic cystitis and bladder malignancy

A

Cyclophosphamide

26
Q

Indications for Cyclophosphamide

A

ORGAN THREATENING complications (SLE, Vasculitis, Lung Sclerosis, etc.)

27
Q

Side Effects of Cyclophosphamide

A 
Infection
Bone marrow toxicity
Infertility
Hemorrhagic cystitis
Bladder malignancy
28
Q

Examples of TNF-a inhibitors (5 total)

A 
Etanercept
Infliximab
Adalimumab
Certolizumab
Golimumab
29
Q

Indications for TNF-a inhibitors (Etanercept, Adalimumab, Infliximab, etc.)

A

RA
Psoriasis
IBD

30
Q

TNF-a inhibitors can be used for SLE (True or False)

A

False; associated with worsening disease

31
Q

Side Effects of TNF-a inhibitors (Etanercept, Adalimumab, Infliximab, etc.)

A

TB and Hepatitis B reactivation

NO LIVE VACCINES

32
Q

_______ is involved with the inflammatory response and granuloma formation around Tuberculosis

33
Q

Monoclonal antibody against B-cell CD20; causes B-cell depletion; indicated for RA, ANCA vasculitis (GPA and MPA) and other autoimmune diseases

34
Q

MOA of Rituximab

A

Antibody against CD20–> depletes B cells

35
Q

Side Effects of Rituximab

A 
Infusion reactions
HTN
Arthralgias
Serum Sickness
PML
Hepatitis B reactivation
36
Q

Anti-IL-6 receptor antibody; indicated for Giant Cell (Temporal) Arteritis and RA

A

Tocilizumab

37
Q

MOA for Tocilizumab

A

IL-6 receptor antibody

38
Q

Side Effects of Tocilizumab

A

Infusion reaction
Cytopenias
Dyslipidemia

39
Q

Antibody that blocks the activation of B cells (via B Lymphocyte Stimulator); used for SLE refractory to treatment

40
Q

Purpose of Intravenous Ig for treating autoimmune diseases

A

Occupies and blocks Fc receptors, preventing immune-mediated phagocytosis and production of cytokines

41
Q

Indications for IVIg

A

Kawasaki’s disease
ITP
SLE

MOS (7 decks)

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