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Flashcards in autoimmune disease Deck (19)
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1
Q

name some aminosalicylates

A

mesalazine

sulfasalazine

2
Q

Indications of aminosalicylates

A
  • 1st line in UC

- Can be used in RA

3
Q

MOA Aminosalicylates

A
  • release 5-ASA. antinflammatory and immunosuppressive. acts topically on gutl delay delivery of active ingredients to the colon.
4
Q

which aminosalicylates do you give in RA

A
  • Sulfasalzine
5
Q

SE aminosalicylates

A
  • mes has less than sulf.
  • GI upset - nausea, hyspepsia
  • headache
  • leucopenia
  • thrombocytopenia
  • renal impairment

men - sulfasaline; recersible oligospermia.
sulfasalzine - hypersensitivity reaction - fever, rash and liver issues

6
Q

who to not give the aminosalicyaltes too

A

those with aspirin hyeprsensitivity as this is also a salicyalte

7
Q

interactions of aminosaslicyaltes

A
  • drugs that alter tummy pH e.g PPI - increase pH = coating of salicylates breaks down prematurely,
  • lacutlose - lowers stool ph - stopping release in colon.
8
Q

methotrexate indications

A
  • DMD for RA
  • Chemo for cancers including leukaemia, lymphoma and some solid tumours
  • severe psoriasis that is resistant to other therapies
9
Q

MOA methotrexate

A
  • inhibits dihydrofolate reductase - which is needed for protein synthesis and cellular replication
  • is also antinflammatory and immunosupressive
10
Q

SE methotrexate

A

dose related =

  • mucosal damage e.g. sore mouth/GI upset
  • BM supression - neutropenia and infection
  • hypersensitivity reactions inc cutaenous, hepatitis and pneumonitis
ltm  =
- hepatic cirrhosis 
- pulmonary fibrosis 
- accidental overdose if pt takes daily as normally should be once a week; severe toxicity if renal impairment and hepatotoxicity 
\+ seizures, headache, coma
11
Q

reversal agent for methotrexate overdose

A

folinic acid + hydration and urinary alkalization

12
Q

CI to methotrexate

A

pregnancy, severe renal impairment

13
Q

Relative CI to methotrexate

A

-liver function abnormalities

14
Q

what should patients be told (men and women) regarding pregnancy if on methotrexate

A

must take contraception during and for 3 months after stopping treatment as is teratogenic

15
Q

interactions of methotrxate

A

drugs that inhibit its renal excretio

  • NSAIDs
  • penicillins

other folate antagonists
- trimethoprim and phenytoin = haematological abnormalities

  • clozapine - increased risk of neutropenia
16
Q

what can you prescribe alongside methotrexate to reduce SE

A
  • Folic acid
17
Q

what supplementary materials will you give a patient with methotrexate

A
  • treatment booklet

- warning card

18
Q

how to monitor methotrexate

A
  • FBC, LFT and renal profile before startin then 1-2 x / week until established rx. then 2-3x monthly
19
Q

can fy1s initiate a methotrexate prescription

A

no