GPhC Pre-Reg Exam Preparation Specialists
This section falls into the medium-weighted category for the GPhC exam, and you should identify that a large proportion of the topics are related to oncology. You will need to focus on the following topics: cytotoxic drugs (i.e. alkylating drugs, antimetabolites), drugs that affect the immune response (i.e. corticosteroids, immunosuppressants, immunomodulating drugs), and sex hormones/hormone antagonists (drugs that are used in cancer).
Some of the key diseases that appear in this section include inflammatory bowel disease, organ transplantation/bone marrow, rheumatoid arthritis, ulcerative colitis, severe psoriasis, leukaemia, lymphomas, and autoimmune conditions.
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ANTIMETABOLITE: METHOTREXATE | |||
Drug action | What is it used for? | Cautions | (Very) common side effects |
· Inhibits the enzyme dihydrofolate reductase (DHFR) thus, prevents the synthesis of purines and pyrimidines (which are essential in DNA synthesis) | · Severe Crohn’s disease; maintenance of remission of severe Crohn’s disease · Moderate to severe active rheumatoid arthritis · Neoplastic diseases (malignant or benign tumour development) | · Blood count – bone marrow suppression, reduced white cell count, reduced platelet count · GI toxicity – stomatitis, diarrhoea · Liver toxicity – increased liver transaminases, liver cirrhosis · Pulmonary toxicity – dyspnoea, cough, fever, pneumonitis | · Anaemia · Reduced appetite · Nausea, vomiting, diarrhoea, GI discomfort, throat ulcer · Drowsiness, fatigue, headache · Higher risk of infections · Leucopenia, thrombocytopenia · Skin reactions |
CALCINEURIN INHIBITOR: CICLOSPORIN | ||||
Drug action | What is it used for? | Cautions | (Very) common side effects | |
· Inhibits the production and release of lymphokines thus, suppresses cell-mediated immune responses | · Severe acute ulcerative colitis refractory to corticosteroid treatment · Severe active rheumatoid arthritis · Short-term treatment of (very) severe atopic dermatitis · Severe psoriasis · Organ/bone marrow transplant · Nephrotic syndrome (protein leaks into urine) | · Following functions/parameters need to be monitored: hepatic, renal, serum potassium & magnesium, blood lipids, serum creatinine (when used in psoriasis/atopic dermatitis), blood pressure | · Reduced appetite · Nausea, vomiting, diarrhoea, GI discomfort · Electrolyte imbalance · Fatigue · Leucopenia, fever · Headaches, seizures · Hyperglycaemia · Hyperlipidaemia · Hypertension · Hyperuricaemia | |
1 stone = 6.35kg
Written by Fatima Sazzad, GPhC Reg No. 2212805
