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Pha 411 > Immunomodulatory Agents > Flashcards

Immunomodulatory Agents Flashcards

1
Q

Classes of immunomodulatory agents?

A
  1. Immunosuppressant
  2. Immunostimulant
  3. Tolerogen
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2
Q

What occurs when the body cannot differentiate self from non-self?

A

Autoimmune disease

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3
Q

Examples of immunological diseases

A
  1. Rheumatoid arthritis
  2. type 1 diabetes mellitus
  3. Asthma
  4. Solid tumors
  5. Hematological malignancies
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4
Q

Classification of immunity?

A
  1. Innate/ Natural
    Broadly reactive, no priming, low affinity
  2. Adaptive/learned
    Antigen-specific, requires priming or exposure, high affinity
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5
Q

Examples of innate immunity effectors

A

Complement, Granulocytes, monocytes/macrophages, NK cells, mast cells, basophils

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6
Q

Two cells responsible for cellular response are?

A

B- lymphocytes : make antiBodies

T-lymohocytes: helper, cyToToxic, suppressor cells

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7
Q

Any foreign agent which may provoke an immune reaction when introduced into the body is?

A

Antigen

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8
Q

Characteristics of Antigens

A
  1. They are usually proteins
  2. Or Glycoproteins
  3. Or High molecular weight carbohydrates
  4. M.W of 5000 Da
  5. Processed by macrophages before presented to T-cells
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9
Q

Types of immune responses?

A
  1. Humoral immune responses
    (B lymphocytes, antibody production, plasma cells)
  2. Cellular immune responses
    T-lymohocytes
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10
Q

Humoral immunity response occurs in two stages namely?

A
  1. Primary reactions
    Occur at 1st exposure, consists largely of IgM, short-lived
  2. Secondary reaction
    Occur with subsequent exposure, consists mainly of igG, long-lived
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11
Q

Immunity that is developed in response to infection or following inoculation with a strain is?

A

Active immunity

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12
Q

Immunity that is transferred by administration of preformed antibodies either from host or recombinant techniques inVitro is?

A

Passive immunity

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13
Q

When immune response to an antigen results in tissue damage,it is called?

A

Hypersensitivity

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14
Q

Types of hypersensitivity

A

ICIC

Type I (immediate)- Anaphylactic Rx
Type II (cytotoxic) -Antibody dependent
Type III (immune complex run
Type IV (cell-mediated) -delayed hypersensitivity

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15
Q

Gell and coombs classification of hypersensitivity chart

A

IgE Mediated
Type I- within 1hr (Anaphylaxis)

IgG or IgM mediated
Type II- hours to days (hemolytic anemia)

Non-IgE mediated(others)
Type III: 7-21 days (serum sickness)
Type IV: days to weeks (contact dermatitis, maculopapular rash)

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16
Q

Major classes of immunosuppressive drugs

A

CAMS

  1. Calcinuerin inhibitors: Tacrolimus and cyclosporine
  2. Anti proliferative agents: Mofetil, azathioprine, Mycophenolate
  3. mTOR inhibitors: Sirolimus
  4. Steroids/glucocorticoid: Prednisone
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17
Q

Among the major classes of immunosuppressant, which does not fall under “immunophilin ligands”?

A

Steroids/glucocorticoids

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18
Q

Broad classification of immunosuppressant

A

Non-selective (CIA)
1. Corticosteroids
2. Anti metabolite/ Antiproliferatives
3. Immunoglobulins

Selective (CMS)
1. Calcinuerin inhibitors
2. Selective IL-2 receptor antagonists; basilicimab, daclizumab, infliximab
3. mTOR inhibitors

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19
Q

Main uses of glucocorticoids?

A

Treatment of transplant rejection and auto-immune disorders

20
Q

Most effective immunosuppressive drugs are?

A

Calcinuerin inhibitors

21
Q

Cyclosporine is produced by the fungus?

A

Beauveria nivea

22
Q

Adverse effects; CNS disorders, immunosuppression, HPA axis suppression, metabolic disorders, fall under which class of drugs?

A

Glucocorticoids

23
Q

Agents of solubilisation of cyclosporine are always?

A

Lipophylic

24
Q

Mechanism of action of Cyclosporine?

A

Binds to cytosolic protein cyclophilin and interacts with Ca2-calmodulin dependent calcinuerin complex and inhibits it’s phosphorylase

25
Q

Principle metabolism of cyclosporine is in?

A

The liver (with half life of 5-18 hours)

26
Q

How to mitigate the nephrotoxic effect of cyclosporine?

A

Concomitant use of Calcium channel blockers

27
Q

Tacrolimus is _____ times more potent than cyclosporine

A

10-100 times

28
Q

Adverse effects of cyclosporine include?

A

Relate organs that use Ca2 calmodulin

Hypertension ,tremor, hyperkalemia,hirsutism, nephrotoxicity, hepatotoxicity,etc

29
Q

What organism is responsible for production of Tacrolimus?

A

Streptomyces tsukabaensis

30
Q

What’s the first line immunosuppressive agent?

A

Calcinuerin inhibitors

31
Q

List of drugs that interact with calcinuerin inhibitors?

A

Azoles, macrolides, diltiazem

32
Q

Sirolimus (Rapamycin) is derived from?

A

Streptomyces hygroscopicus

33
Q

MOA of azathioprine (anti metabolite) is?

A

Interfere with purine metabolism at steps required for lymphoid cell proliferation

34
Q

The chief toxic effect of azathioprine and mercaptopurine is?

A

Bone marrow suppression

35
Q

Other cytotoxic agents include;

A
  1. Cyclophosphamide
  2. Hydroxychloroquine
  3. Methotrexate
36
Q

A substance that increased the ability of the immune system to fight infections is?

A

Immunostimulant

37
Q

Humanized antibodies end in?

A

-umab and -zumab

38
Q

Chimeric antibodies end in?

A

-imab or -ximab

39
Q

Classes of immunostimulants include;

A
  1. Vaccines; bacterial, viral,therapeutic, combinations
  2. Interferons
  3. Interleukins
  4. Colony stimulating factors
    Others
40
Q

what are antibody forming cells fused to plasmacytoma cells?

A

Hybridomas

41
Q

Under biologics, Monoclonal antibodies are used for?

A
  1. Anti tumors
  2. Delivery of isotopes to tumors
  3. As immunosuppressants and anti-inflammatory
  4. Antiplateles
42
Q

Hepatitis B, MMR and yellow fever are under what class of vaccines?

A

Viral vaccines

43
Q

Bacille Calmette Guérin and DPT is an example of what type of vaccine?

A

Bacterial vaccine

44
Q

Vaccines that protect against cancer are known as?

A

Therapeutic vaccines

45
Q

A foreign antigen that suppresses immune response is known as?

A

Tolerogen

Pha 411 (4 decks)

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