Azathioprine
This is a brand name of Azathioprine.
What is any of: Imuran, Azasan, AzamunTM?
This is the brand name of Apremilast.
What is Otezla?
IVIg is composed primarily of this type of antibody.
What is IgG?
These 3 systemic immunomodulators are processed via the CYP3A4 enzyme (limited to those discussed in this session).
What are: corticosteroids, cyclosporine, apremilast
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Who is Kurt Cobain? Half points: Nirvana.
This is the active metabolite of Azathioprine.
What is 6-mercaptopurine?
This is the typical dosing for Apremilast.
What is 30mg bid?
Patients must be screened for this before initiating IVIg therapy.
What is IgA deficiency? Bonus points: hepatitis, HIV, RF, cryoglobulins.
These 2 discussed systemic immunomodulators are absolutely contraindicated in pregnancy.
What are methotrexate and mycophenylates?
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What is Anthropic?
Azathioprine dosing can be based on the level of this enzyme.
What is TMPT?
This is the mechanism of action of Apremilast.
What is phosphodiesterase 4-inhibition?
Patients should be monitored for development of these potential adverse events during and after IVIg infusion.
What are volume overload, hemolysis, anaphylaxis?
These discussed medications can be used for psoriasis?
•Systemic corticosteroids
•Methotrexate
•Cyclosporine
•Antimalarials
•Mycophenylates
•Azathioprine
•Apremilast
•IVIg
What are:
• Methotrexate
• Cyclosporine
• Antimalarials (cautiously, can also exacerbate or induce psoriasis)
• Mycophenylates
• Azathioprine
• Apremilast
ie, NOT IVIg or systemic corticosteroids (high risk of severe rebound flares upon withdrawal)
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Who is Abdel Fattah el-Sisi?
Clinical benefits from Azathioprine can be seen after this amount of time.
What is 4-6 weeks?
(full therapeutic effect can take up to 3-6 months to become apparent)
This is the most common side effect of Apremilast.
What is GI intolerance (nausea, vomiting)?
This is the typical dose of IVIg.
What is 2 g/kg divided over 3-5 days?
The mechanism of action of these 2 discussed medications involves disruption of DNA and RNA synthesis.
What are Methotrexate and Azathioprine?
This longest-running top album in the Billboard 200 (spending over 1000 weeks in the top 10) can be curiously coordinated with the original Wizard of Oz movie.
What is the Dark Side of the Moon?
Caution should be taken when prescribing Azathioprine in a patient who takes either of these two xanthine oxidase-inhibiting medications.
What is allopurinol and febuxostat?
When screening patients for whom Apremilast may be initiated, it is important to ask about a history of these conditions (unique to Apremilast among the discussed medications).
What is depression and suicidal ideation?
These are 3 potential serious adverse events that can develop after IVIg.
What are:
•Thromboembolic events
•Renal dysfunction (increased risk in patients with increased rheumatoid factor and/or cryoglobulins)
•Aseptic meningitis
This is the only medication of those discussed that does not require routine blood test monitoring.
What is Apremilast?
Still requires clinical monitoring for potential side effects (depression, suicidal ideation, unexplained weight loss)
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What is Clair Obscur: Expedition 33?
Random trivia:
- writer found via Reddit (originally brought on as a voice actor)
- lead composer found on SoundCloud, never composed a soundtrack before
- art director scouted directly from his ArtStation portfolio
- animator also found on ArtStation, enlisted his friends to help in their free time