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FINALS - RHEUM > Drugs + physiology > Flashcards

Drugs + physiology Flashcards

1
Q

mechanism of azathioprine/ mercaptopurine

A

azathioprine is metabolised to mercaptopurine // purine analogue (inhibits purine synthesis)

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2
Q

what blood marker is used for azathioprine toxicity

A

TPMT

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3
Q

SE of azathioprine

A

bone marrow depression // N+V // pancreatitis

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4
Q

drug interactions of azathioprine / mercaptopurine

A

allopurinol

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5
Q

which DMARDs are safe in pregnancy

A

azathioprine + sulfalazine + hydroxychloroquine

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6
Q

contraindications for sulfalazine (2)

A

GPD6 deficiency // allergy to aspirin or sulphonamides

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7
Q

SE sulfalazine

A

oligospremia // ling fibrosis // myelosuppresion + anaemia // colourful tears

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8
Q

SE hydroxychloroquine

A

bulls eye retonipathy

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9
Q

what screening is required when on hydroxychloroquine

A

annual eye screening

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10
Q

indications for methotrexate

A

RA // psoriasis // chemo in ALL

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11
Q

SE methotrexate (5)

A

mucositis // myelosuppression // pneomonitis, pulmonary fibrosis // liver fibrosis

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12
Q

advise for methotrexate when getting pregnant

A

men + women should not get pregnant until 6 months stopping treatment

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13
Q

presribing methotrexate: how often do you take it, what monitoring, what should be prescribed with it

A

take weekly // FBC, LFT, U+E monitred every 2-3 months // folic acid 5mg with it

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14
Q

interactions methotrexate (2)

A

trimethoprim or co-trimoxazole // high dose aspirin

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15
Q

mx methotrexate toxicity

A

folinic acid

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16
Q

mechanism for bisphosphonates

A

inhibit osteoclats

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17
Q

indication bisphosphonates

A

osteoporosis // hypercalcaemia // pagets // bone mets

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18
Q

SE bisphosphonates

A

oesophagitis // necrosis of the jaw // atypical stress fractures // hypocalcaemia

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19
Q

advice on how to take bisphosphonates

A

take on an empty stomach, sitting or standing at least 30 mins before breakfast (or other medications)

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20
Q

prescribing advice on hypocalcaemia and Vit D prior to bisphosphonates

A

correct before starting

21
Q

supplements when on bisphosphonates

A

Vit D // Ca only if dietary intake inadequate

22
Q

who should take vit D supplements (4)

A

pregnant + breastfeeding // kids aged 6months - 5 years // adults >65 // housebound

23
Q

aside from osteoporosis, when may denosumab be used

A

prevent pathological fractures esp in bone mets - dose every 4 weeks

24
Q

what type of drug is denosumab

A

monoclonal antibody

25
Q

when are interferons released in the body

A

viral infections / cancer

26
Q

when is interferon alpha used (3)

A

hep B/C // kaposi’s // renal cancer

27
Q

when is interferon beta used

A

relapse-remitting MS

28
Q

most abundant Ig in the blood

A

IgG

29
Q

which Ig is found in breast milk

A

IgA

30
Q

what is the first Ig in infection

A

IgM

31
Q

what Ig is a pentamer

A

igM

32
Q

what is the role of IgD

A

involved activation of B cells

33
Q

what immune protection does IgG provide

A

phagocytoses bacteria and viruses

34
Q

what immune protection does IgE provide

A

immunity to parasites

35
Q

what cells are involved in type I hypersensitivity

A

IgE + mast cells

36
Q

examples type I hypersensitivity

A

anaphylaxis (+ atopy)

37
Q

what cells are involved in type I hypersensitivity

A

antibodies eg IgG or IgM

38
Q

examples type II hypersensitivity

A

autoimmune haemolytic anaemia // pernicious anaemia // rhematic fever // acute haemolytic reactions // pemphigus or pemphigoid

39
Q

what cells are involved in type III hypersensitivity

A

immune complex

40
Q

examples of type III hypersensitivity

A

SLE // post-strep glomerulonephritis

41
Q

what cells are involved in type IV hypersensitivity

A

T cell

42
Q

examples type IV hypersensitivity

A

TB // allergic dermatitis // MS // GBS

43
Q

diseases assoc with HLA-B27

A

Ank spondy // reactive arthritis // anterior uveitits

44
Q

starting allopurinol

A

start once inflammation settles + patient not in pain // start WITH colchine cover

45
Q

when is allopurinol indicated

A

first gout attack

46
Q

SE Allopurinol

A

severe cutaneous reaction (HLAB 5801) // DRESS // stevens Johnson

47
Q

interaction Allopurinol

A

azathioprine (reduce dose) // cyclophosphamide // theophylline

48
Q

mechanism Allopurinol

A

xanthine oxidase inhibitor

FINALS - RHEUM (8 decks)

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