Drugs

Question 1

what do steroids suppress the action of?

Answer 1

B and T cells by decreasing transcription of cytokines

Question 2

what cells do steroids make apoptose?

Answer 2

T cells

Question 3

what three endocrine issues can steroids cause?

Answer 3

cushing syndrome
osteoporosis
hyperglycemia
diabetes adrenocortical atrophy

Question 4

what female repro issue can steroids cause?

Answer 4

amenorrhea for female

Question 5

what can happen in GI with steroids?

Answer 5

peptic ulcers

Question 6

what can happen to bone with steroids?

Answer 6

avascular necrosis and osteoporosis

Question 7

what can happen with eyes in steroid use?

Answer 7

cataracts

Question 8

what is the anti malarial used in SLE?

Answer 8

hydroxychloroquine

Question 9

what is a secondary effect that HCQ has that helps with antiphospholipid syndrome?

Answer 9

slightly anti coagulant

Question 10

what two situations mean you should not give HCQ?

Answer 10

retinopathy and G6PD deficiency

Question 11

what should patients on HCQ have yearly?

Answer 11

eye exam for retinopathy

Question 12

what are the two main side effects of hCQ?

Answer 12

rash and N/V

Question 13

what is MoA of methotrexate

Answer 13

dihydrofolate reductase inhibitor…so decrease DNA synthesis

Question 14

what four inflammatory conditions is methotrexate used in?

Answer 14

RA, IBD, psoriasis, vasculitis

Question 15

what are the three main side effects of methotrexate?

Answer 15

nausea
fatigue
mucosal ulceration

Question 16

what is biggest toxicity associated with methotrexate use?

Answer 16

hepatotoxicity

Question 17

what pregnancy class is methotrextae?

Answer 17

class X

Question 18

what is MoA of leflunomide?

Answer 18

enzyme inhibitor of dihydroorate dehydrogenase…leads to low levels of pyrimidine synthesis

Question 19

what cell does leflunomide really inhibit production of?

Answer 19

T cells

Question 20

what is leflunomide often used for?

Answer 20

SLE RA and psoriatic arthritis

Question 21

what pregnancy category is leflunomide?

Answer 21

category X

Question 22

what is the MoA of azathioprine?

Answer 22

purine analog that inhibits the purine synthesis

Question 23

what molecule activated azathioprine?

Answer 23

HGPRT..turns it into 6-mercaptopurine

Question 24

what inflammatory disorders is azathioprine used for?

Answer 24

SLE, systemic vasculitis and myopathies

Question 25

what vasculitidies is azathioprine the maintenance therapy for?

Answer 25

ANCAs

Question 26

what are the main SEs of azathioprine?

Answer 26

GI, liver tox, myelosuppression!!!

Question 27

what three drugs can azathioprine interact with?

Answer 27

allopurinal, trimehtoprim, ACE inhibitors

Question 28

what pregnancy class is azathioprine?

Answer 28

not teratogenic

Question 29

what is MoA of mycophenolate mofetil?

Answer 29

reversibly inhibits IMP dehydrogenase to slow purine synthesis in B and T cells

Question 30

what is number one indication for mycophenolate mofetil?

Answer 30

lupus nephritis

Question 31

what are some indications for mycophenolate mofetil other than lupus nephritis?

Answer 31

SLE, scleroderma lung disease, vasculitis

Question 32

what is most common SE of mycophenolate mofetil?

Answer 32

dyspepsia...GI upset

Question 33

what can happen to bone marrow on mycophenolate mofetil?

Answer 33

myelosuppression

Question 34

what is the MoA of cyclophosphamide?

Answer 34

alkylates DNA...crosslinks at the guanine residues

Question 35

what is indication for cyclophosphamide in auto immine disorders?

Answer 35

SLE, vasculitis, systemic sclerosis

Question 36

name the three main SEs of cyclophosphamide

Answer 36

nausea alopecia myelosuppression

Question 37

what is risk with cyclophosphamide in GU?

Answer 37

hemorrhagic cystitis and bladder cancer

Question 38

how can you prevent bladder cancer and hemorrhagic cystitis when taking cyclophosphamide?

Answer 38

give MESNA

Question 39

what can happen to repro tract on cyclophosphamide?

Answer 39

infertility

Question 40

name the three most used TNF-a inhibitors

Answer 40

atanercept infliximab adalimumab

Question 41

what is big black box warning with TNF-a inhibitors?

Answer 41

TB re activation and Hpe B reactivation

Question 42

what is the MoA of rituximab?

Answer 42

MAB at CD20

Question 43

when is rituximab used

Answer 43

RA, ANCA vasculitis,

Question 44

name three adverse effects of rituximab

Answer 44

arthralgias serum sickness infections

Question 45

what is a major infection concern with rituximab?

Answer 45

reactivation of Hep B and PML

Question 46

what autoimmune conditions are indications for IVIG?

Answer 46

kawasakis immune thrombocytopenia SLE inflammatory myopathy