Renal: Drugs to Treat ANCA Vasculitis and Goodpasture Syndrome Flashcards
MOA of Glucocorticoids (prednisone)
Inhibit NF-kB
-decreases B and T cell response which decreases cytokine production and increases cell apoptosis
Indications for glucocorticoids (prednisone)
Many autoimmune and inflammatory conditions
-asthma, vasculitis, non-Hodgkins lymphoma etc
Adverse reactions of Glucocorticoids (prednisone)
Cushing syndrome**
hyperglycemia
decreased immune response**
Osteoporosis
Which patient populations can glucocorticoids cause issues in?
Immunocompromised
Diabetics (hyperglycemia)
Psychiatrics
Osteoporosis
MOA of Cyclophosphamide
Alkylating agent that cross-links DNA
Indications for Cyclophosphamide
Minimal Change Disease
-in those who do not respond to steroids!
More commonly used in solid and hematologic malignancies
- Hematologic: lymphomas, leukemias
- Solid: neuroblastoma, breast cancer
When is cyclophosphamide contraindicated?
urinary outflow obstruction
What are some toxicities of cyclophosphamide?
Myelosuppression and immunosuppression
Urinary Tract Toxicity (hemorrhagic cystitis)
Cardiopulmonary Toxicity
Is cyclophosphamide safe during pregnancy?
No
MOA of Ritxumab
Chimeric monoclonal antibody directed at CD20
Main indications of Rituximab
Non-Hodgkins Lymphoma
Chronic Lymphocytic Leukemia
Rheumatoid Arthritis
Can also be used to decrease B-cell response in vasculitis
Black box warnings with rituximab?
Fatal Infusion Reactions
Tumor Lysis syndrome
Severe Mucocutaneous Rxns
Progressive Multifocal Leukoencephalopathy
What drug-drug interactions does rituximab have?
Renal toxicity when combined with Cisplatin
MOA of Azithioprine
Inhibits production of purines
-Prodrug of 6MP
Indications for azathioprine?
Adjunct to prevent renal transplant rejection
-also for rheumatoid arthritis
