Interstitial Lung Dz

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Author:
mpgcuenca
ID:
119915
Filename:
Interstitial Lung Dz
Updated:
2011-11-30 20:14:40
Tags:
Asthma COPD
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Description:
Interstitial Lung Dz
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  1. Chemotherapy drugs
    • Cyclophosphamide (Cytoxan)
    • Azothioprine (Imuran)
    • Methotrexate (Trexall, Rheumatrex)
  2. MoA (Chemotherapy drugs)
    • Cyclophosphamide
    • Metabolically cytochrome P450 activated to phosphoramide mustard - inactive otherwise
    • Forms DNA crosslinks both between and within DNA strands leads to cell death

    • Methotrexate
    • Inhibits dihydrofolate reductase (DHFR)
    • Inhibits thymidine synthase (TS)
    • Inhibits de novo purine nucleotide synthesis

    • Azothioprine
    • Metabolized into the active 6-mercaptopurine, itself a purine synthesis inhibitor.
    • 6-Mercaptopurine impedes DNA synthesis and thus inhibits the proliferation of cells, especially the fast-growing lymphocytes.
    • T-cells and B-cells are particularly affected by the inhibition of purine synthesis.
  3. SEs (Chemotherapy drugs)
    • Cyclophosphamide
    • Acrolein is one prominent metabolite responsible for major toxicities
    • Hemorrhagic cystitis,
    • Cardiac toxicity
    • Alopecia
    • SIADH

    • Methotrexate
    • Mucositis
    • Diarrhea
    • Myelosuppression with neutropenia and thrombocytopenia

    • Azothioprine
    • Uncommon but include nausea
    • Fatigue
    • Hair loss
    • Rash
    • BM supression- susceptible to infection
  4. Anti-inflammatory Drugs
    • Steroids
    • Colchicine
  5. MoA (Anti-inflammatory drugs)
    • Colchicine
    • Arrests mitosis in metaphase by binding to tubulin & prevents mitotic spindle formation in granulocytes & other motile cells.
    • Inhibits migration of granylocytes into inflamed areas & ↓ their metabolic & phagocytic activities.
    • Prevents elaboration of urate-induced glycoprotein in joints.
  6. Indication (Anti-inflamm. drugs)
    • Colchicine
    • Prevention & treatment of gout.
    • No analgesia.
    • Give within 24 hrs.
  7. SEs (Anti-inflamm. drugs)
    • Colchicine
    • GI upset from chronic exposure to drug & its metabolites
    • Due to enterohepatic circulation (↑ turnover of jejunal mucosal cells)
    • Diarrhea
    • Long-term use:
    • Hair loss
    • Bone marrow depression
    • Peripheral neuritis
    • Myopathy (↑ CPK)

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