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AII Week 2 > Pharmacotherapeutics > Flashcards

Pharmacotherapeutics Flashcards

1
Q

Induction regimens

A

Intense, early post-op immune suppression

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2
Q

Maintenance regimens

A

Used throughout the patients life to prevent acute and chronic rejection

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3
Q

How does prednisone work

A

Prevents production of cytokines and vasoactive substances. T cells are primarily affected

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4
Q

What is the main adrenocorticoid used in immunosuppression

A

prednisone

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5
Q

What is prednisone used for

A

Induction and maintenance of immunosuppression.

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6
Q

Types of conditions prednisone is used in

A

Lupus, RA, asthma

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7
Q

AE of prednisone

A
  1. CATARACTS
  2. Osteoporosis
  3. Weight gain
  4. Hypertension
  5. Hypercholesterolemia
    (do not give with anti-inflammatory, will cause peptic ulcer disease)
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8
Q

How does cyclosporine work

A

Inhibits production/function of cytokines (IL, IFN, TNM). Comes from a soil fungus

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9
Q

What are cyclosporines used for

A

Induction and maintenance of allografts to prevent rejection. May be used in psoriasis

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10
Q

AE of cyclosporines

A
  1. Nephrotoxicity
  2. HTN
  3. Hyperkalemia
  4. Hemolytic-uremic
  5. Hyperlipidemia
  6. Glucose intolerance
    Require trough testing
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11
Q

MOA of tacrolimus

A

Similar pathway of cyclosporine, but slightly different.

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12
Q

Use of tacrolimus

A

Used orally or IV for preventing solid organ rejection. Can also be used for atopic dermatitis

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13
Q

AE of tacrolimus

A

Same as cyclosporine but more severe nephrotoxicity and neurotoxicity

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14
Q

Name the selective inhibitors of cytokines

A
  1. cyclosporine
  2. Tacrolimus
    Aka - calcineurin inhibitors
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15
Q

Name the adrenocorticoids used in immunosuppression

A

Prednisone (methylprednisolone, prednisolone also used)

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16
Q

Name the 3 Antimetabolites

A
  1. Azathioprine
  2. Mycophenolate mofetil
    Generally used in combo with corticosteroids and cytokine inhibitors. Helps reduce adverse affects of some of the other drugs when used in combo)
  3. Methotrexate
17
Q

What is the MOA of azathioprine

A

Impairs DNA synthesis and may also function as apoptotic signal

18
Q

What is azathioprine used for

A

2nd line drug for maintenance of immunosuppression

19
Q

AE of azathioprine

A
  1. Leukopenia
  2. Thrombocytopenia (due to bone marrow suppression)
  3. Hepatotoxicity
20
Q

MOA of mycophenolate mofetil

A

Impairs B and T cell proliferation while sparing other rapidly dividing cells

21
Q

What is mycophenolate mofetil used for

A

Used in heart, kidney, liver transplants (pretty much replaced azathioprine). Improved safety and efficacy in prolonged graft survival

22
Q

AE of mycophenolate

A
  1. NVD - prominent GI!
  2. Anemia
  3. Leukopenia
  4. Thrombocytopenia
23
Q

Name the 2 antibodies (biologic agents/biologic immune modulators)

A
  1. Adalimumab
  2. Daclizumab
    Used in induction or tx of rejection.
    Created by immunization of rabbits/horses with human lymphoid cells.
    More targeted or focused effect
24
Q

MOA of Adalimumab

A

Inhibits TNF, helps prolong graft and induce immunosuppression.

25
Q

What is adalimumab used for

A
  1. ankylosing spondylitis
  2. crohns
  3. psoriasis
  4. RA
26
Q

AE of adalimumab

A

Reactivation of latent infections and solid organ cancers (as a combo drug)

27
Q

MOA of daclizumab

A

Monoclonal activity to IL 2 which suppresses T cell activation

28
Q

Use of daclizumab

A

Prevent graft rejection and GVHD following bone marrow transplant (discontinued in US - mostly used for MS patients)

29
Q

AE of daclizumab

A
  1. Tremor
  2. HTN
  3. GI upset
  4. Infections
  5. Hepatotoxicity
30
Q

What 2 drugs should not be given together (causes peptic ulcer disease)

A

Antiinflammatory and steroid

31
Q

MOA of methotrexate

A

Anitfolate agent that interferes with folate metabolism and DNA synthesis. Stops cells from proliferating

32
Q

Use of methotrexate

A
  1. In Cancer with combo drugs

2. Inflammatory disorders like RA and crohns

33
Q

AE of methotrexate

A
  1. NVD
  2. Stomatitis - inflammation around openings
  3. Myelosuppression
  4. Nephrotoxicity

AII Week 2 (4 decks)

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