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Hello in this video we’re gonna talk about lafleur de meyer the pharmacology of la fleur de meyer which is a popular disease-modifying antirheumatic drug the fluid amide is an immunosuppressant used to treat rheumatoid arthritis and psoriatic arthritis it is also used to treat neurological conditions including multiple sclerosis the fluid amide is a prodrug that
Is rapidly and almost completely metabolized following oral administration to its pharmacologically active metabolite a seven seven one seven to six or terry flute amide the mechanism of action of the flute amide has not been fully determined but appears to primarily inhibit the mitochondrial enzyme dye hydro orotate dehydrogenase t cells required nucleotides to
Proliferate especially perma dean’s resting lymphocytes use the salvage pathway for pyrimidine synthesis however activated t-cells use de novo pathway of pyrimidine synthesis de novo pathway of pyrimidine synthesis allows for dna and rna synthesis which is important for activated t cell to proliferate inhibition of dye hydro orotate dehydrogenase by terry flute
Amide essentially prevents production of pyrimidines by the de novo pathway such inhibition leads to decreased pyrimidine synthesis decreasing dna and rna synthesis because the flute imide inhibits pyrimidine synthesis it thus prevents the t cell in this case the autoimmune t cell from progressing to the s phase where dna replication occurs it doesn’t have any
Pyrimidines to make new dna the autoimmune t-cells are arrested in the g1 phase of the cell cycle it is through this action that lefleur tomate inhibits autoimmune t-cell proliferation and subsequently production of auto antibodies by b-cells patients must be monitored for side-effects of hepatic toxicity and mylo suppression peripheral neuropathy can occur with
Low fluid amide and is usually self-limited if the drug is discontinued laughs ludum i’d just like methotrexate is teratogenic and should not be used in pregnancy if severe side effects occur or a patient becomes pregnant unexpectedly while on the flu to mind stopping the drug and consideration of kali styrene washout can be done kali styrene is a non absorbed
Bile acid sequestrants it essentially helps with the elimination of the flute amide from the body because even after stopping the flute amide the flute amide has a long half-life of three weeks the flute amide is eliminated from the hepatic billary system with bile acids lefleur to mind with the bile acids in the small intestines could be readily reabsorbed thus
Increasing the prolonged effect of the fluid amide in the body cholestyramine resins absorbs and combines with the bile acids in the intestine to form an insoluble complex which is excreted in the feces this result in a partial removal of bile acids and the la flute amide from the intera hepatic circulation by preventing their absorption essentially you
Transcribed from video
Leflunomide (DMARD) pharmacology – mechanism of action, adverse effects and cholestyramine By Armando Hasudungan
