AUTOIMMUNE DISEASES

Sulfasalazine

Broken down by colonic bacteria → Sulfapyrine + 5-aminosalacylic acid 5-aminosalacylic acid scavenges ROS from neutrophils

Hydroxychloroquine

Lipophilic weak base → accumulates in acidic vesicles to stop macrophage antigen presentation + neutrophil ROS production

Leflunomide

Dihydroorate dehydrogenase inhbitor → inhibits pyrimidine synthesis

Teriflunomide

Leflunomide active drug

Etanercept

Anti-TNFα → fusion protein of IgG1 + TNFα receptor

Anakinra

IL-1ra recombinant → antagonises IL-1

Azathioprine

Prodrug for 6-MP | 6-MP → TIMP | TIMP → 6-methyl-TIMP or 6-thioguanosine 6-methyl TIMP inhibits de nove purine synthesis 6-thioguanosine incorporated into nucleic acids to inhibit nucleotide and protein synthesis

Mycophenolic acid

Inhibits inosine monophosphate dehydrogenase → inhibits guanosine synthesis

Tacrolimus

Binds FKBP → FKBP-Tacrolimus complex inhibits calcineurin to inhibit NFAT and IL-2 transcription

Basiliximab

Belatacept

Same as abatacept → fusion of CTLA-4 and IgG to bind B7 to block costimulation

Alemtuzumab

Binds B52 on mature lymphocytes but not those on stem cells

Cantumaxomab

Bispecific mAb → binds epithelial adhesion molecule on tumour cells and CD3 on T cells → localises tissue destruction of cancer

Metformin

Activates AMPK → type 2 diabetes drug

Glipizide

Sulphonylurea

Exenatide

Synthetic exendin-4 → mimics GLP-1 but more stable and longer acting

Gliptin

→ Inhibits dipeptidyl peptidase 4 to inhibit incretin breakdown

Acarbose

α glucosidase inhibitor → slow breakdown of starch into glucose in GI tract = less uptake of glucose