Sketchy Pharm: Azathioprine, 6-Mercaptopurine, Mycophenolate Mofetil Flashcards

1
Q

How is purine synthesis distinct from pyrimidine synthesis?

A

Purine starts with the ribose, while pyrimidine starts with the nitrogenous base.

This is why purine synthesis starts with the enzyme phosphoRIBOSYL pyrophosphate (PRPP) amidotransferase.

(Think of the guys starting to carve near the five-pointed block with the two P-shaped hammers.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Purine synthesis begins with ____________.

A

IMP (like the imp standing watch over the two golden purine derivative statues)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Azathioprine is converted to __________ inside cells.

A

6-mercaptopurine

Think of Ezmerelda –azomerelda –being CAPTured.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What enzyme converts 6MP to its active metabolite?

A

HGPRT (like the HiGh PRiesT prodding CAPTured Ezmerelda)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

6MP and azathioprine ultimately inhibit _______________.

A

IMP synthesis (like the CAPTured woman kicking over the IMP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Like the pyrimidine synthesis inhibitors, azathioprine is ___________-specific.

A

S phase

This makes sense because it disrupts DNA synthesis.

(Think of the Stairs that are broken.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

6MP and azathioprine are mainly used to treat what diseases?

A
  • Hematologic malignancies (represented by the cracked stained glass window with the archers and knights)
  • Rheumatoid arthritis (like the red, inflammed lanterns lining the street)
  • IBD (like the haustra-shaped lanterns to the left of the image)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the side effects of 6MP and azathioprine?

A
  • Myelosuppression (like the nun sprinkling seed from her bone pan)
  • Immunosuppression (like the canes held by the statues)
  • Pancreatitis (like the nun polishing the statue with the pancreas sponge)
  • Hepatotoxicity (liver stain on nun’s shirt)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

6MP and azathioprine should be dosed carefully in those taking ________________.

A

allopurinol, because xanthine oxidase degrades 6MP and azathioprine and inhibiting it with allopurinol can raise the serum levels of these drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does mycophenolate mofetil work?

A

It inhibits IMP dehydrogenase and thus prevents it from converting IMP to GMP (like Quasi-Mofetil kicking over the GruMP statue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The most common side effect of mycophenolate mofetil is __________________.

A

GI upset (like the hunchback about to vomit) and immunosupression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly