Pulm: Drugs for Interstitial Lung Disease

Question 1

MOA of Prednisone

Answer 1

Steroid used as anti-inflammatory or immunosuppressive agent

Question 2

Warning when using prednisone?

Answer 2

May suppress the HPA axis

-monitor for Cushings and hyperglycemia, and taper patients off

Question 3

What are some common adverse rxns of prednisone?

Answer 3

fluid retention, alteration in glucose tolerance, elevation in BP, behavior and mood change, weight gain

Question 4

MOA of mycophenolate

Answer 4

Inhibits IMP dehydrogenase for immunosupression

Question 5

Indications for mycophenolate?

Answer 5

Rheumatoid arthritis, when pts can’t take methotrexate

Used in prophylaxis of organ transplantation

Question 6

Would mycophenolate be safe during pregnancy?

Answer 6

Nope

-fetal harm and miscarriage has been shown

Question 7

Most common adverse reactions with mycophenolate

Answer 7

GI Upset

-nausea, vomiting, diarrhea

Question 8

What drugs can reduce the efficacy of mycophenolate?

Answer 8

Antacids (Mg or Al Hydroxide)

PPIs

Question 9

If pt is on oral contraceptives and needs to start taking mycophenolate, what should you advise?

Answer 9

Use additional protection/barriers (condoms?)

Question 10

BB warning of methotrexate?

Answer 10

Serious toxic rxns, can be fatal

Embryotoxic

Question 11

Adverese effects of methotrexate?

Answer 11

Bone marrow suppression
Hepatotoxicity and fibrosis/cirrhosis
GI Upset

plus many more.. not safe, only use if you HAVE to

Question 12

Indications for methotrexate?

Answer 12

Severe disease:

• Neoplasms
• psoriasis
• Rheumatoid Arthritis

Question 13

Is methotrexate safe during pregnancy?

Answer 13

No, actually used as an abortifactant

Question 14

MOA of azathioprine

Answer 14

Inhibits production of purines

-Prodrug of 6MP

Question 15

Indications for azathioprine?

Answer 15

Adjunct to prevent renal transplant rejection

-also for rheumatoid arthritis

Question 16

Is azathioprine safe in pregnancy?

Answer 16

No, should not be used to treat RA during pregnancy

Question 17

BB warning for azithioprine?

Answer 17

Malignancy

Question 18

MOA of nintendanib?

Answer 18

A kinase inhibitor used to treat IPF

Question 19

Warnings of nintendanib? (5)

Answer 19

Elevated liver enzymes (monitor)
GI upset
Embryotoxic
Thrombosis/Bleeding
GI perf

Question 20

Adverse rxns of nintendanib?

Answer 20

GI Upset and liver damage

Headache, HTN, and weight loss

Question 21

What drugs do nintendanib interact with?

Answer 21

P-gp and CYP3A4 inhibitors increase concentration

-monitor closely