Unit 3/4 Drugs Flashcards
(90 cards)
NAPROXEN
NSAID - LUPUS
Non-selective inhibitor of cyclooxygenase, an enzyme invovled in prostaglandin synthesis via the arachidonic acid pathway
Decreases the synthesis of prostaglandins involved in mediating inflammation, sensitizing nociceptors involved in transmitting pain, fever and swelling
Decrease in TXA2 so lack of platelet activation, adherence, aggregation
Folic acid
Heamolytic anemia
Folic acid= biologically inactive
converted to tetrahydrofolic acid-> methytetrahydrofolate from DIHYDROFOLATE REDUCTASE.
Transpoted across cells via endocytosis + synthesixe nucleic acids and hep erythropoesis
What type of drug is ivacaftor when is it indicated
Quinolone used treat CF
Side effects ivocaftor
Abdo pain + diarrhoea
MofA ivacaftor
G551D CFTR mutation - CFTR protein reach epithelial cell surface, but doesn’t let it transport chloride through the ion channel.
Ivacaftor = potentiator of the CFTR protein.
Ivacaftor facilitates increased chloride transport by potentiating the channel-open probability (or gating) of the G551D-CFTR protein.
What are the modulator drugs in CF used in triple therapy
Ivacaftor - potentiator of CFTR ion channel
tezacaftor is a CFTR corrector that moves the mutated CFTR protein to the correct place on the epithelial cell surface membrane
Other triple therapy drugs CF
Mycophenolate - inhibts IMPDH altering DNA formation - inhibiting proliferation t/b lymphocytes + supress AB formation
Tacrolimus - binds FKBP-12 therfore inhibitng t lymphocyte activation
Predisalone mofa
Glucocorticoid R agonist. Binds GR R - translocate nucleus binding GRE in promoter region in target gene. DNA bound R interacts TF to cause up/down reg specific target gene.
Anti inflam - phosphorylates + release annexin 1 - INHIBIT LEUKOCYTE TRAFFICKING
Supression AA
Depress macro function
Th1- Th2 responce
Belimumab mofa
Binds BAFF (over expressed SLE) * BAFF cant bind B cells * no longer survival or proliferative signal. Decrease B cell survival/ B cell mediated immunity
Rituximab mofa
Human monoclonal Ab against CD20 antigen found surface normal mature + malignant b lymphocytes. AB igG1 kappa IG leads selective lysis b cells * decreased b cell survival + b mediated immunity.
Drugs used in lupus
Predisalone
Belimumab
Rituximab
Tocilizumab
anti il-6 disrupting Th17 cells
Infliximab
Anti TNF alpha
drugs used triple therapy after bilateral lung transplant
prednislone
mycophenolate mofetil
tacrolimus
Oral flucox
Staph aureus found nasal passages + skin 15-40% healthy adults. Gram positive responsible MRSA/ MSSA. Start CF diagnosis long term AB for prophylaxis against staph aureus.
Narrow spec penicillin, beta lactam. Binds + inactivates PBP on inner cell membrane of bacterial wall. Inactivated PBP interferes cross linkage of peptidoglycan chains necc bacterial cell wall strength + rigidity. Interrupts bacterial cell wall synthesis * weakening wall + lysis.
IV vancomycin
Selective resistant strains gram +ve bacteria (staph aureous). Second line treatment failed respond oral AB
Glycopeptide. Binds to NAG/ NAM of synthesizing peptidoglycan preventing transpeptidase acting on these newly formed blocks * preventing cross linking peptidoglycan layer * layer more permeable/ less rigid – osmolysis.
Nebulised colistimethate sodium
Chronic colonisation gram neg pseudomonas aeruginosa as prophylaxis CF - rare eradicate chronic p.a * give regular use nebulized AB chronic p.a reduce r deterioration.
Use inhaled drugs target conducting upper airway tobramycin, colistin + aztreonam.
Broad spec polymyxins used against gram neg (except proteus) Polymyxins = polycationic + hydrophobic/ lipophilic molecules. Interferes cell membrane synthesis via LPS synthesis pathway
Ca2+ and Mg2+ displacement from LPS. Negatively charged LPS is unstable resulting in membrane leakage= bactericidal effect.
+ polymyxins enter the cell and precipitate cytoplasmic components, primarily ribosomes.
Nebulized aztreonam
Gram neg aerobic – pseudomonas aeruginosa - targets conducting upper airway used prophylaxis
Monocyclic Beta lactam – high affinity PBP 3. Binds + inactivates PBP on inner cell membrane of bacterial wall. Inactivated PBP interferes cross linkage of peptidoglycan chains necc bacterial cell wall strength + rigidity. Interrupts bacterial cell wall synthesis * weakening wall + lysis.
Oral ciprofloxacin
Ciprofloxacin good permeation respiratory lower airway but bad upper – prophylaxis pa
Broad-spec (gram +/- AB fluoroquinolone Inhibiting DNA gyrase, and a type II topoisomerase, topoisomerase IV, necessary to separate bacterial DNA * inhibiting cell division.
Tacrolimus
Triple therapy for immunosuppression after bilateral lung transplant -tacrolimus, mycophenolate, prednisolone
Macrolide lactam
Inhibits T-lymphocyte activation by first binding to an intracellular protein, FKBP-12- prevents tranlocation NF * inhibiting t lymphocyte signlas + transcription Il-2,3,4,5.
Down regulates expression FceRI on langerhans
Mycophenate mofetil
Triple therapy bilateral lung transplant
Prednisolone
Triple therapy bilateral lung transplant
Tobramycin IV
Lower respiratory airway target pa
Broad spec Aminoglycoside against gram neg bacteria. Binds irreversibly 30s ribosome inhibiting formation 70s unit * bacterial protein synthesis.
Oral valganciclovir
Anti viral used combination therapy after lung transplant
Converted Ganciclovir after admin - phosphorylated to triphosphate form which is metabolized and taken in intracellurlarly.
Phosphorylation dependent on viral kinase + mainly occurs virus infected cells.
Ganciclovir triphosphate incorporated DNA strand replacing Adenosine * phosphodiester bridges can longer to be built, destabilizing the strand inhibiting viral DNA synthesis.
Also inhibits Viral DNA polymerase.