Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MOHD3 Exam 2 > Immunomodulatory Drugs > Flashcards

Immunomodulatory Drugs Flashcards

(84 cards)

Start Studying
1
Q

Disease-modifying antirheumatic agents (DMARDs) target _____

A

inflammatory cytokines

CAN target both innate and adaptive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Activated T cells secrete ____ and express ____

A

IL-2

IL-2 receptor protein (CD25)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

IL-2 stimulates ___

A

proliferation and clonal expansion of the antigen-specific T cell population.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

___:Generally do not promote specific immune reaction

A

Immuno-stimulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Require parenteral administration
Very short half-lives
Expensive

A

Cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

___: support prolonged exposure to developing immune reactions

A

Alum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

BCG

A

Adjuvants: live attenuated bacillus calmette-guerin
Immuno-stimulants
Cancer therapy (bladder cancer)
Surface antigens interact directly with pattern recognition receptors on antigen presenting cells and increase their APC activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Interleukin-2 (Aldesleukin, Prokeukin) action:

A

increased proliferation of activated T cells, production of IFN-gamma, cytotoxic killer cell activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Interleukin-2 treats: (2)

A

metastatic melanoma

renal cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Interleukin-2 adverse effects:

A

Serious capillary leak syndrome
Hypotension
Reduced organ perfusion
Can be fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

IFN-gamma (Actimmune) action:

A

stimulates cell mediated cytotoxic immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

IFN-gamma treats:

A

recurrent infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

IFN-alpha, IFN-beta produced by:

A

most cells in response to a variety of stimuli including viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

IFN-alpha, IFN-beta treats: (3)

A
  1. Chronic viral infection (hepatitis)
  2. Anti-proliferative activities used to treat some cancers: cell leukemia, melanoma, lymphomas
  3. Reduce episodes in multiple sclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Immuno-stimulants (4)

A

BCG
Interluekin-2
IFN-gamma
IFN-alpha, beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Adverse effects of ALL general immunosuppressants (5)

A
  1. Risk of infection
  2. Risk of cancer
  3. Loss of immune surveillance
  4. Susceptibility to tumor-promoting pathogens
  5. Posttransplant lymphoproliferative disorder (PTLD) = infection of B cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cyclophosphamide action:

A

Immunosuppressant

Cross-link DNA and kill proliferating cells –> prevent expansion of antigen-specific lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cyclophosphamide uses: (2)

A

Autoimmune disease

Bone marrow transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cyclophosphamide adverse effects (4)

A

Myelosuppression
Nausea, vomiting
infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Azathioprine action:

Inactivated by:

A

Immunosuppressant: prodrug –> 6-mercaptopurine, 6-thioguanine
Inhibit purine synthesis

Xanthine oxidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Azathioprine uses (2)

Adverse effects (3)

A

Renal and other transplantation
Auto-immune disease (lupus, rheumatoid arthritis)

Myelosuppression, nausea, vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Mycophenolate Mofetil action

A

Immunosuppressant

Inhibits inosine monophosphate dehydrogenase –> prevents purine synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mycophenolate Mofetil uses (2)

Adverse effects (3)

A

Solid organ transplant
Auto-immune disease

Myelosuppression, nausea, vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Methotrexate action

A

Immunosuppressant

Inhibit dihydrofolate reductase –> prevent synthesis of thymidine and purine nucleotides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Methotrexate uses Adverse effects (3)
rheumatoid arthritis Diarrhea, myelosuppression, modest hepatotoxicity
26
Have combined immuno-suppressive AND anti-inflammatory effects
glucocorticosteroids (Prednisone)
27
Glucocorticosteroids (Prednisone) immuno-suppressive action
Inhibit cytokine (IL-2, IFN-gamma) gene expression from antigen-activated T cells
28
First-line immunosuppressant for solid organ and hematopoietic stem cell transplantation
Glucocorticosteroids (Prednisone)
29
Glucocorticosteroids (Prednisone) uses:
Management of immune-based disorders: | autoimmune diseases, asthma, allergic reactions, systemic inflammation ...etc.
30
``` Adverse effects of ____: Like Cushing's Syndrome Glucose intolerance Hypertension, fluid retention Osteoporosis GI disturbances Ocular disturbances Psychiatric disturbances ```
Glucocorticosteroids (Prednisone)
31
Calcineurin
Calcium dependent phosphatase that de-phosphorylates transcription factor, NF-AT --> cytokine gene expression in antigen activated T cells
32
Cyclosporine action Uses: (3) Adverse effects:
Calcineurin inhibitor Kidney, liver, cardiac transplants Autoimmune disorders Some inflammatory diseases (asthma) Nephrotoxicity, HTN, hyperglycemia, liver dysfunction, increased cancer incidence
33
Tacrolimus (FK506) action
Calcineurin inhibitor | 10-100x more potent to cyclosporine
34
Serine/threonine kinase | Regulate translation of proteins required for cell proliferation induced by cytokines (IL-2)
mTOR (mammalian target of rapamycin
35
Sirolimus action Uses: (2) Adverse effects: (5)
mTOR inhibitor Preserve solid organ transplants hematopoietic stem cell transplants myelopsuppression, hyperlipidemia, hypertension, edema, hepatotoxicity
36
Sirolimus antagonizes ____, synergizes with ____
tacrolimus cyclosporine
37
Variable domain of animal derived antibody with non-variable backbone of fully human antibody
Humanized antibodies
38
Constant domain of human antibodies and selected ligand binding proteins
Fusion proteins
39
Antibodies used in immunosuppression by:
1. Depleting cell mediators of adaptive immune response | 2. Blockade of critical receptor-ligand interactions
40
____ uses antibodies used to suppress unwanted immune responses in Rh negative mothers against Rh-positive fetus
Rh(D) immune globulin
41
Rh(D) immune globulin mechanism:
Opsonization and clearance of D antigens | Inhibit activation of maternal naive Rh(D) reactive B cells
42
Drug (antibody) that blocks co-stimulatory receptors for immunosupression
Belatacept
43
Belatocept =
fusion protein of high affinity B7 ligand with IgG Fc domain
44
Belatocept uses: Mechanism:
Kidney transplantation Prevent interaction b/w B7 (on APC) and CD28 (on T cell)
45
Comparable to calcineurin inhibitors in preventing transplant rejection
Belatocept
46
Drugs (antibodies) used as immune-depleting agents (3)
Anti-T cell globulin (ATG) Alemtuzumab Basiliximab
47
Anti-T cell globulin (ATG) = Mechanism: Effect: Adverse effects:
Purified serum IgG Blocks T cell surface receptors and opsonizes T cells Prolonged T cell depletion Cytokine release syndrome, serum sickness
48
Cytokine release syndrome can be pretreated with
acetaminophen and antihistamine to prevent: | fever, chills, headache, nausea, malase
49
Alemtuzumab = Mechanism: Effect:
humanized anti-CD52 antibody Depletes broad variety of cells involved in adaptive and innate immune reactions Prolonged depletion of T cells and other immune cells
50
CD52
surface protein expressed on T and B cells, monocytes, macrophages and NK cells
51
Basiliximab = Mechanism: Effect:
humanized anti-IL-2 receptor (anti-CD25) antibody Blocks and opsonizes the alpha-chain of IL-2 receptor (CD25) that is present on ACTIVE T cells Depletes only antigen-activated T cells
52
___ and ___ activate macrophages, causing macrophages to ____
TNF-alpha, IL-1 Produce more inflammatory mediators
53
____ activate neutrophils, causing them to produce ___
IL-6 Proteases that increase tissue destruction
54
Anti-TNF-alpha agents (3)
Infliximab Adalimumab Etanercept
55
Infliximab = Mechanism: Uses (2): Complications:
Humanized antibody to TNF-alpha Binds to TNF-alpha --> prevents interaction with its receptor Rheumatoid arthritis, Crohn's disease Increased frequency of infection
56
Adalimumab =
Human antibody to TNF alpha
57
Etanercept =
Fusion protein = ligand binding domain of TNF alpha receptor + Fc domain of human IgG
58
Anakinra = Uses: Characteristics: Complications:
Anti-IL 1 agent Competitive IL-1 receptor antagonist RA Short half-life, daily injection required Increased susceptibility to infection
59
Tofacitinib = Uses: Mechanism: Complications: (2)
General Jak kinase inhibitor Comparable to anti-TNFalpha agents in treating RA Rheumatoid arthritis Inhibits all activity of cytokines required for adaptive immunity and some inflammatory cytokines Myelosuppression, risk of infection (herpes zoster)
60
Arachidonic acid is converted to ____ by ____ (2)
prostaglandin H2 Cyclooxygenase-1 (COX-1) Cyclooxygenase-2 (COX-2)
61
Prostaglandin E (PGE2) produced in ___
most tissues
62
Thromboxane (TXAs) produced in ____
platelets, macrophages
63
Prostacyclin (PGI2) produced in ____
Endothelial cell, vascular smooth muscles
64
PGE2 and PGI1 (dilates/constricts) blood vessels
Dilates
65
TXA2 (dilates/constricts) blood vessels
Constricts
66
PGI2 (inhibits/stimulates) aggregation of platelets
inhibits
67
TXA2 (inhibits/stimulates) aggregation of platelets
stimulates
68
____ is responsible for production of most prostanoids contributing to inflammatory reactions
COX-2
69
COX-2 in induced by ____
pro-inflammatory cytokines (IL-1, TNF-alpha)
70
COX-2 is inhibited by _____
glucocorticosteroids, cytokines associated w/ anti-inflammatory effects (IL-10)
71
NSAIDs inhibit platelet ____
COX-1
72
COX-1 effect in GI
decrease acid production | increase mucus formation
73
Drugs that prevent GI ulcers from NSAID toxicity
Proton pump inhibitors H2-receptor antagonists Misoprostol (only NSAID induced)
74
___ contracts uterine smooth muscle
PGE2
75
___ relaxes uterine smooth muscle
PGI2
76
Acetaminophen = Uses: Contraindications:
Non-selective COX-1/COX-2 inhibitor NO anti-inflammatory activity Used for analgesic and antipyretic ONLY Alcohol --> hepatotoxicity
77
Celecoxib = Uses: Effects:
COX-2 selective NSAID Osteoarthritis, rheumatoid arthritis Anti-inflammatory, antipyretic, analgesic
78
Leukotrienes metabolized to ___ and ___ by ___ Effect:
LTB4, LTD4 5-lipoxygenase Pro-inflammatory
79
LTD4 (increases/decreases) capillary permeability
Increases Promote localized edema
80
LTD4's effect on bronchial smooth muscle
Potent constrictor of bronchial smooth muscle --> difficulty breathing
81
LTB4 attracts ____ LTD4 attracts ____
Neutrophils Eosinophils
82
Asthma's major mediators
leukotrienes
83
Zieuton = Uses: Adverse effect:
Leukotriene synthesis inhibitor Inhibition of 5-lipoxygenase Long term maintenance therapy for asthma (oral) Liver toxicity, decrease metabolism of other drugs
84
Zafirlukast, Montelukast = Uses:
Leukotriene receptor antagonists Maintenance therapy for asthma Reduced bronchoconstriction and edema associated with inflammatory responses

MOHD3 Exam 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions