PDA Flashcards
(23 cards)
Methotrexate Brand name
Trexall
MOA of methotrexate
folate antagonist
Inhibits DHFR, TYMS, AICART
Increase adenosine
Decrease purine and pyrimidine pools
Methotrexate DDI
Glucocorticoid decreases effectiveness
NSAIDs, PPIs, hydroxychloroquine increases toxicity
Contraindications Methotrexate
pregnancy, breastfeeding, hepatic toxicity and renal impairment
Antidote for methotrexate
Leucororin - folate
ADR for methotrexate
GI
Cytopenia
Pulmonary toxicity
Lymphomas
Increased liver enzymes
Leflunomide brand name
Arava
MOA of leflunomide
immunomodulator
Inhibits dihydrooradate dehydrogenase (DHODH) to inhibit pyrimidine synthesis
B and T cell inhibition
Why does leflunomide last so long in the serum?
prodrug (isoxazole ring broken by CYPs in liver to teriflunomide) and enterohepatic recirculation
ADR of leflunomide
SJS/TEN
Increased liver enzymes (do not start if ALT over 2 times normal limit)
HTN
BBW for leflunomide
Embryo fetal toxicity (cholestyramine washout)
Hepatotoxicity ( discontinue if ALT over 3 times the upper limit of normal)
Brand name of sulfasalazine
Azulfidine
MOA of sulfazalazine
Prodrug that breaks down in the colon into 5ASA (NSAID) and sulfapyridine (abx)
Anti inflammatory actions
Contraindications for sulfazalazine
crystalluria
hypersensitivity to sulfa and or aspirin
Cautions for sulfazalazine
G6PD deficient patients are more likely to experience hemolytic anemia
SJS/TEN
DDI of sulfazalazine
decreases the absorption of folate and digoxin
ADR of sulfazalazine
GI
Oligospermia
Photosensitivity
Alopecia
Orange yellow discoloration of the urine and skin
brand name of hydroxychloroquine
Plaquenil
MOA of hydroxychloroquine
Anti malarial, anti inflammatory, and immunomodulatory effects
Blocks activation of antigen presenting cells by preventing acidification of lysosome
DDI of hydroxychloroquine
digoxin and antacids
ADR of hydroxychloroquine
ocular toxicity
cardiac effects
GI effects
Vertigo and tinnitus
Indications of hydroxychloroquine
SLE
RA
