Prednisone, an anti-inflammatory and immunosuppressive may lead to suppresion of what pathway?
What should be monitored for?
Suppression of the HPA
Monitor for Cushing's Syndrome and Hyperglycemia
What type of drug is Mycophenolate?
What is the Black Box Warning?
What are the side effects of mycophenolate?
What are the drug interactions of mycophenolate?
efficacy is reduced by antacids, PPIs, or drugs that enter enterohepatic circulation
May diminish efficacy of OCPs
what is the black box warning for methotrexate?
Careful use as indicated by physicians with knowledge and experience using the drug
Deaths have been reported in using MTX
Used to treat malignancy, psoriasis and RA
What are some main concerns of MTX outside of the black box warning?
reduced elimination in renal pt's
bone marrow suppression and aplastic anemia
hepatotoxicity with prolonged use
diarrhea and hemorrhagic enteritis
Should women of childbearing potential use MTX?
No, not until pregnancy is excluded and they're counseled on risks
The incidence and severity of acute side effects of MTX is related to what two things?
Frequency of administration
What are the contraindications for the immunosuppressive antimetabolite, Azathioprine?
HSN to the drug itself
Pregnant women with RA
What are the two adverse reactions of Azathioprine?
Hematologic and GI issues
What is the black box warning for Azathioprine?
increased risk of malignancy
Which drug is a kinase inhibitor used for IPF?
What are the main contraindications?
No significant CI
What are some GI sx to watch for on Nintedanib?
elevated liver enzymes
GI perforation during surgery
What are some hematologic concerns to watch for on Nintedanib?
arterial thromboembolic events
Should Nintedanib be given to pregnant women?
What are the common side effects of Nintedanib?
elevated liver enzymes
Co-administration of P-gp and CYP3A4 inhibitors may increase what drug levels?
Monitor pt's closely for tolerability
What are the two main indications for Azathioprine?
(and ILD obviously)
What are some drugs to avoid mixing with MTX?
NSAIDs (causes MTX toxicity)
Oral Abx (interferes with enterohepatic circulation)
Hepatotoxic drugs (accelerates hepatoxicity)
Theophylline (decreases clearance)
MTX is especially toxic to which two major organs?
Which drug is very successful in treating RA?