Drugs for ILD Flashcards

1
Q

Prednisone, an anti-inflammatory and immunosuppressive may lead to suppresion of what pathway?

What should be monitored for?

A

Suppression of the HPA

Monitor for Cushing’s Syndrome and Hyperglycemia

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2
Q

What type of drug is Mycophenolate?

What is the Black Box Warning?

A

Immunosupressive Drug

Embryotoxic

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3
Q

What are the side effects of mycophenolate?

A

Diarrhea

leukopenia

infections

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4
Q

What are the drug interactions of mycophenolate?

A

efficacy is reduced by antacids, PPIs, or drugs that enter enterohepatic circulation

May diminish efficacy of OCPs

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5
Q

what is the black box warning for methotrexate?

A

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

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6
Q

What are some main concerns of MTX outside of the black box warning?

A

fetal death

reduced elimination in renal pt’s

bone marrow suppression and aplastic anemia

hepatotoxicity with prolonged use

lung disease

diarrhea and hemorrhagic enteritis

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7
Q

Should women of childbearing potential use MTX?

A

No, not until pregnancy is excluded and they’re counseled on risks

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8
Q

The incidence and severity of acute side effects of MTX is related to what two things?

A

Dose

Frequency of administration

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9
Q

What are the contraindications for the immunosuppressive antimetabolite, Azathioprine?

A

HSN to the drug itself

Pregnant women with RA

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10
Q

What are the two adverse reactions of Azathioprine?

A

Hematologic and GI issues

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11
Q

What is the black box warning for Azathioprine?

A

Chronic immunosuppression

increased risk of malignancy

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12
Q

Which drug is a kinase inhibitor used for IPF?

What are the main contraindications?

A

Nintedanib

No significant CI

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13
Q

What are some GI sx to watch for on Nintedanib?

A

elevated liver enzymes

N/V/D

GI perforation during surgery

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14
Q

What are some hematologic concerns to watch for on Nintedanib?

A

arterial thromboembolic events

bleeding

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15
Q

Should Nintedanib be given to pregnant women?

A

No

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16
Q

What are the common side effects of Nintedanib?

A

N/V/D

elevated liver enzymes

HA

HTN

17
Q

Co-administration of P-gp and CYP3A4 inhibitors may increase what drug levels?

A

Nintedanib

Monitor pt’s closely for tolerability

18
Q

What are the two main indications for Azathioprine?

(besides ILD)

A

Renal Homotransplantation

RA

(and ILD obviously)

19
Q

What are some drugs to avoid mixing with MTX?

A

NSAIDs (causes MTX toxicity)

Oral Abx (interferes with enterohepatic circulation)

Hepatotoxic drugs (accelerates hepatoxicity)

Theophylline (decreases clearance)

20
Q

MTX is especially toxic to which two major organs?

A

Liver

Kidneys

21
Q

Which drug is very successful in treating RA?

A

Mycophenolate