Pulm: Drugs for Interstitial Lung Disease Flashcards
MOA of Prednisone
Steroid used as anti-inflammatory or immunosuppressive agent
Warning when using prednisone?
May suppress the HPA axis
-monitor for Cushings and hyperglycemia, and taper patients off
What are some common adverse rxns of prednisone?
fluid retention, alteration in glucose tolerance, elevation in BP, behavior and mood change, weight gain
MOA of mycophenolate
Inhibits IMP dehydrogenase for immunosupression
Indications for mycophenolate?
Rheumatoid arthritis, when pts can’t take methotrexate
Used in prophylaxis of organ transplantation
Would mycophenolate be safe during pregnancy?
Nope
-fetal harm and miscarriage has been shown
Most common adverse reactions with mycophenolate
GI Upset
-nausea, vomiting, diarrhea
What drugs can reduce the efficacy of mycophenolate?
Antacids (Mg or Al Hydroxide)
PPIs
If pt is on oral contraceptives and needs to start taking mycophenolate, what should you advise?
Use additional protection/barriers (condoms?)
BB warning of methotrexate?
Serious toxic rxns, can be fatal
Embryotoxic
Adverese effects of methotrexate?
Bone marrow suppression
Hepatotoxicity and fibrosis/cirrhosis
GI Upset
plus many more.. not safe, only use if you HAVE to
Indications for methotrexate?
Severe disease:
- Neoplasms
- psoriasis
- Rheumatoid Arthritis
Is methotrexate safe during pregnancy?
No, actually used as an abortifactant
MOA of azathioprine
Inhibits production of purines
-Prodrug of 6MP
Indications for azathioprine?
Adjunct to prevent renal transplant rejection
-also for rheumatoid arthritis
Is azathioprine safe in pregnancy?
No, should not be used to treat RA during pregnancy
BB warning for azithioprine?
Malignancy
MOA of nintendanib?
A kinase inhibitor used to treat IPF
Warnings of nintendanib? (5)
Elevated liver enzymes (monitor) GI upset Embryotoxic Thrombosis/Bleeding GI perf
Adverse rxns of nintendanib?
GI Upset and liver damage
Headache, HTN, and weight loss
What drugs do nintendanib interact with?
P-gp and CYP3A4 inhibitors increase concentration
-monitor closely
