08.25 - Drugs for Restrictive Lung Disease (Sweatman) - Questions Flashcards Preview

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Flashcards in 08.25 - Drugs for Restrictive Lung Disease (Sweatman) - Questions Deck (50):
1

Drugs with clinical benefit in iPF

None yet

1

Advantage of Endothelin-1 Receptor Antagonists over Prostacyclins

Orally active

2

Proportion of patienst that respond to vasodilator challenge

15%

3

2 notable toxicities of Azathioprine

Neoplasia, Pancytopenia

3

Metabolism of PDE5 inhibitors

CYP

3

Metabolism of CCB's

CYP3A4 substrates

3

End points of Vasodilator Challenge

Decr PAP and CO

4

CCB's used in PAH

Diltiazem, Nifedipine, Amodipine

5

Where does Wegener's typically occur

URT, Lungs, Kidneys

5

Plexiform lesions result in

proliferation of monoclonal endothelial cells, SM cells, and an accumulation of circulating cells --> Obstruction of flow

7

Pro-fibrogenic factors released by activated epithelium in iPF

TGF-B, PDGF

7

3 Notable Toxicities of Rituximab

HTN, Allergic -it is, Asthenia

8

PDE5 inhibitors are Not to be used in pateints taking

Organic Nitrates

9

Effect of Prostacyclin on vascular SM

Vasodilation and Anti-Proliferation

10

3 notable Glucocorticoid toxicities

Pancreatitis, Osteoporosis, DM

12

Most common cause of death in premature infants

IRDS

13

Drug class with efficacy in PAH and Systemic HTN

CCB's

13

Route and toxicity of Epoprostenol

IV, Monitor Bleeding

13

Agents used for vasodilator challenge of pulmonary circulation

Epoprostenol, Adenosine, Inhaled NO

14

Route and 2 toxicities of Treprostinil

SC or IV; Bleeding, CYP

14

Route of Endothelin-1 Receptor Antagonists

Oral

15

Adverse effects of CCB's

Hypotension, CYP3A4 Substrate

17

Goodpasture Syndrome

Type 2 hypersensitivity against alpha-3 chain of type 4 collagen

18

Route and toxicity of Iloprost

Inhaled, Hemoptysis

20

MOA of Azathioprine

DNA, RNA synthesis inhibitor --> Apoptosis of T Cells

21

Histologic sine qua non of patients with iPAH or heritable PAH

Plexiform Lesions

21

Disadvantage of Endothelin-1 Receptor Antagonists

Expensive, Teratogenic, Bosentan (liver, blood toxicities)

21

How to determine if CCB's will work

Vasodilator Challenge

23

Glucocorticoids inhibitor production of __ and promote apopotosis of ___

IL-1, TNF; Mac's, Dendritic Cells, T Cells

24

Not all patients respond to CCBs, some develop

potentially fatal hemodynamic decompensation

26

Most potent anti-inflammatory agents

Gluoccorticoids

28

Size of vessels affected in Granulomatosis w/ Polyangiitis

Small-medium

30

Effect of Endothelin on vascular SM

Vasconstriction and SM proliferation

32

2 notable toxicites of MTX

Pulmonary Fibrosis/Pneumonitis; Malignant Lymphoma

32

Most common adverse events with Ambrisentan

Edema and Headache

33

4 treatments for Wegeners

Labeled: Rituximab; Off-Labed: Azathioprine, Cyclophosphamide, Corticosteroids

34

Role of MTX in Sarcoidosis

Increase in Adenosine-Mediated Immunosuppression

36

2 notable toxicities of Cyclophosphamide

Bladder Cancer; Myelo- and Lympho-proliferative malignancies

37

General MOA of Prostanoids

Pulmonary Artery Vasodilation, Retard SM growth, Disrupt platelet aggregation

38

Most common adverse event in Sildenafil and Tadalafil?

Headache

40

Tx of Goodpastures

Plasmapharesis

41

Metabolism, Interactions of Bosentan and Ambrisentan

Liver, CYP - Don't use in liver dysfunction

42

Goal of CCB therapy

Achieve NYHA 1 or 2 after 3-4 months; Only 50% of 15% achieve this

43

Responsivenss of Idiopathic Pulmonary Fibrosis to anti-inflammatory drugs

Little to none

44

Goodpasture is type __ hypersenstivity

2

46

Bottom Line for Prostanoids

Expensive and difficult to administer

47

MOA of Cyclophosphamide

Alkylating Agent; Suppression of B lymphocyte activity and Ig Secretion

48

Length of effect of Rituximab

6-9 months

49

Route of PDE5 inhibitors

Oral

50

Treatment of Sarcoidosis

Glucocorticoids, Methotrexate