ILD Pharm

Question 1

Prednisone (glucocorticoid/corticosteroid)

Answer 1

anti-inflammatory and immunosuppressive

caution for Cushing’s syndrome and hyperglycemia with chronic use (HPA suppression)

Question 2

Mycophenolate

Answer 2

immunosuppressive

embryotoxicity

opportunistic infection and leukopenia

MALIGNANCY

efficacy reduced with antacids (mess with enterohepatic recirculation)

Question 3

Methotrexate

Answer 3

Neoplasms, Psoriasis, RA

Toxic reactions, should only be used in life-threatening neoplastic diseases or others that are unresponsive

embryotoxicity

MALIGNANCY with tumor lysis syndrome

opportunistic infection (p. carinii pneumonia)

fatal skin reactions

reduced elimination in impaired renal fxn, ascites and pleural effusion

don’t give with NSAIDS–>bone marrow suppression and GI toxicity

prolonged use–> hepatotoxicity, fibrosis, cirrhosis
….so don’t give to alcoholics with psoriasis

given with oral abx decrease absorption

penicillin concominant–> GI and hem toxicity

Question 4

Nintedanib

Answer 4

kinase inhibitor to treat IPF (idiopathic pulmonary fibrosis)

elevates liver enzymes, GI sx and perforation

embryotoxicity

thromboembolic events and bleeding have occurred

increased concentration when given with P-gp and CYP3A4 inhibitors