Purine inhibitors , Azathioprine, 6-Mercaptopurine , mycophenolate mofetil

Question 1

6 Mercaptopurine MOA

(“CAPTured gypsy”)

Answer 1

Azathioprine is prodrug
(“AZmeralda”)
——————————————————————————–
-cytotoxic purine analog

• need HGPRT (enzyme) to activate 6-MP

(“HiGh Priest”)

​-block synthesis of IMP
(“captive toppling imp”)

-inhibits DNA synthesis, blocks S phase
(“broken stair way”)

Question 2

6-Mercaptopurine can treat …

Answer 2

hematogenous malignancies

• ALL
  (“stained glass window with crabs, antibody archers and T knights”)

​​-used for immunosuppressive therapies

• SLE
• ​grafts
• ​ inflammations

(“torn lanterns with antibodies and bone”)

-rheumatoid arthritis, DMARD
(“bone lantern”)

-Inflammatory Bowel Disease
(“inflamed colonic lanterns”)

Question 3

6-Mercaptopurine Side Effects

Answer 3

-bone marrow suppression
(“nun with bone tray feeding bird”)

-immunosuppression and increased risk for infection monitor pt with CBCs
(“statue with cane”)

-pancreatitis
(“pancreas sponge”)

-hepatotoxicity or hepatitis
(“liver stain on apron”)

-allopurinol inhibits breakdown of 6 mercaptopurine and azathioprine increasing risk of toxicity

• may cause a mild rash
  (“purine bead necklace”)

Question 4

Mycophenolate Mofetil MOA

(“quasimoto”)

Answer 4

-IMP dehydrogenase inhibitor

• decrease GMP synthesis, decreased lymphocyte production
  (“knocking over GruMPy statue”)

Question 5

Mycophenolate Mofetil is used to treat …

(“Quasimoto”)

Answer 5

-for immunosuppressive therapy

• grafts
• SLE
• MG
• rheumatoid arthritis (DMARD)

(“swinging on lanterns”)

Question 6

Mycophenolate Mofetil Side Effects

(“Quasimoto”)

Answer 6

-GI effects
(“nauseated quasi-mofetil”)

-immunosuppressive side effects
(“nuns”)

-increased infection in immunosuppressed
(“cane”)