Therapeutics 2

Question 1

aetiology of autoimmunity

1. ?
   ○ Failure of the ? to get rid of ?? that have a high affinity for ?? - autoimmune conditions have a defect in the ? and ? of ??? which has a ? basis
2. ? ‘trigger’
   Trigger signals ?? to activate ??? which triggers an immune response and causes ??. Trigger is often a ? that mimics a ?.

Answer 1

genetic
thymus
T cells
self antigens
number
function
regulatory T cells
genetic

environmental
dentritic cells
t helper cells
tissue damage
pathogen
self-antigen

Question 2

what drugs are used to manage autoimmune diseases? 4

Answer 2

analgesics/NSAIDs

corticosteroid

DMARDs

biologics

Question 3

If a pt is taking corticosteroid and NSAID will also be prescribed what? why?

Answer 3

proton pump inhibitor
to prevent GI problems

Question 4

corticosteroid is used to treat autoimmune diseases

? the immune system - reduces ?? and ? by binding to ? which blocks ??

Answer 4

suppresses
autoimmune response
inflammation
glucocorticoid
cytokine transcription

Question 5

how is corticosteroid given to pt with autoimmune diseases? 2

Answer 5

Can have hydrocortisone/triamcinolone intra-articular injection

Can have oral prednisolone

Question 6

when is oral prednisolone used to treat autoimmune disease?

Answer 6

Used during acute flares or at the start of diagnosis when disease is uncontrolled

Start high then taper of

Question 7

why is it important to review tapering off of oral prednisolone?

Answer 7

in case of relapse

Question 8

why is it important to reduce the dose of oral prednisolone slowly?

Answer 8

to prevent acute adrenal deficiency leading to severe low blood pressure

Question 9

side effects of corticosteroid 6

Answer 9

Hypertension

impaired diabetic control

hyperglycaemia (high glucose)

osteoporosis

increased weight

GI affects (peptic ulcers and Cushing syndrome)

Question 10

what is important to prescribe for long term use of corticosteroid, why?

Answer 10

○ Proton pump inhibitor important for long term use to prevent GI problems (peptic ulcers)

Question 11

dental affects of corticosteroids 4

Answer 11

Increased susceptibility to infection

Candidosis

MRONJ

Steroid prophylaxis on days of procedure when traumatic

Question 12

what do DMARDs do? 2

Answer 12

Suppress the immune system and prevent progression

Question 13

compare biologics to DMARDS

Answer 13

biologics are proteins that target specific sites so no systemic involvement like traditional DMARDs