Immunomodulatory Drugs Flashcards by Serinna Singh

Which immunomodulatory drugs decrease T cell activation?

BEST BCD

Belatacept
Everolimus
Sirolimus
Tacrolimus

Basiliximab
Cyclosporine
Daclizumab

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Which immunosuppressants target cytokines?

I TEAA

Infliximab
Adalimumab
Etanercept
Anakinra
Tocilizumab

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Which drugs target oncogenic growth factors?

Cetuximab
Trastuzumab
Erlotinib

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What are the MOA of Cyclosporine and Tacrolimus?

Inhibit calcineurin, a phosphatase required for activation of NFAT

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What are the indications for cyclosporine and tacrolimus?

Transplant rejection prophylaxis

Autoimmune diseases: RA (cyclosporine)

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What AEs are associated with cyclosporine and tacrolimus?

⬛️⬛️⬛️

⬛️ inc. risk of infections
⬛️ nephrotoxicity (cyclosporine)
⬛️ HTN (tacrolimus)

Inc. risk of malignancies

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What is the MOA of belatacept?

Fusion protein between CTLA-4 and Fc; binds B7 and prevents activation by CD28

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What are indications for belatacept?

Transplant rejection prophylaxis

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What AEs are associated with belatacept?

Inc. risk of infections

Inc. risk of malignancies

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What is the MOA of muromonab?

An anti-CD3 antibody

Binding of CD3 antibody to CD3 initiates activation of T cell = strong signal 1

(Causes cytokine secretion first, and since there is only 1 signal, cell undergoes apoptosis)

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What is Muromonab indicated for?

Transplant rejection

Type 1 DM

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What AEs are associated with Muromonab?

“Cytokine Storm”

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What is the MOA of rituximab?

depletes B cells

Anti-CD20 antibody activates ADCC for killing of B cells by NK cells

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What is rituximab indicated for?

Autoimmune diseases: RA, SLE, MS

Certain B cell lymphomas

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What AEs are associated with Rituximab?

⬛️⬛️⬛️

Inc. risk of infections
(⬛️= HBV exacerbation)

⬛️Inc. risk of PML
(Progressive multifocal leukoencephalopathy)

⬛️serious rash

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What is the MOA of glucocorticoids?

Binds to glucocorticoid receptor and regulates gene transcription, resulting in

Inc. apoptosis
Dec. inflamm. Cytokines from macrophages and Tecells
Dec. T cell activation

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What are indications for glucocorticoids?

Transplant rejection
Chronic inflammatory disease (IBD)
Autoimmune diseases (MS, RA)

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What AEs are associated with glucocorticoids?

Diabetes

Weight gain

Osteoporosis

Fluid retention

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What are the MOA of infliximab and adalimumab?

TNF antibodies

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What is the MOA of Etanercept?

TNF receptor fusion protein

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What is the MOA of anakinra?

IL-1 receptor antagonist

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What is the MOA of tocilizumab?

IL-6 receptor antibody

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What is the MOA of natalizumab?

VLA-4 antibody

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What are indications and CI for infliximab and adalimumab?

Indications:
inflammatory diseases
RA, IBD, psoriatic arthritis

CI: heart failure

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What AEs are associated with infliximab and adalimumab? ⬛️⬛️

⬛️inc. risk of infections ⬛️inc. risk of malignancies Inc. liver enzymes Injection site reactions GI adverse effects

What are the indications for etanercept?

inflammatory diseases | RA, IBD, psoriatic arthritis

What are the AEs of etanercept? (Like TNF antibodies - infliximab, adalimumab) ⬛️⬛️

⬛️inc. risk of infections ⬛️inc. risk of malignancies Inc. liver enzymes Injection site reactions GI adverse effects

What are indications for anakinra?

Inflammatory diseases RA Hereditary fever syndromes

What AEs are associated with anakinra?

Inc. risk of infections Inc. risk of malignancies Injection site reactions

What are indications and CIs for tocilizumab?

Indications: Inflammatory diseases, RA CI: Hepatic disease Hyperlipidemia

What AEs are associated with tocilizumab? ⬛️

⬛️inc. risk of infections Inc. risk of malignancies Inc. liver enzymes HYPERLIPIDEMIA

What is natalizumab indicated for?

Inflammatory diseases | RA, MS, IBD

What AEs are associated with natalizumab? ⬛️

Inc. risk of infections Inc. risk of malignancies Inc. liver enzymes ⬛️PML (Progressive multifocal leukoencephalopathy)

What is the MOA of cetuximab?

(1) blocks EGFR signaling in order to dec. tumor cell growth and survival (2) initiates ADCC to kill tumor cells by NK cells

What are indications for cetuximab?

Tumor's overexpressing EGFR

What AEs are associated with cetuximab?

Rash | GI effects

What is the MOA of trastuzumab?

(1) blocks HER2 signaling in order to dec. tumor cell growth and survival (2) initiates ADCC to kill tumor cells

What are indications for trastuzumab?

Tumor's overexpressing HER2

What AEs are associated with trastuzumab?

Cardiotoxic

What is the MOA of erlotinib?

Blocks EGFR tyrosine kinase

What is the indication for erlotinib?

Tumor's expressing mutant EGFR

What AEs are associated with erlotinib?

Rash Diarrhea SJ syndrome

What is the MOA of bevacizumab?

Monoclonal antibody that binds to and neutralizes VEGF

What is bevacizumab indicated for?

Tumor's secreting VEGF

What AEs are associated with bevacizumab?

Dec. wound healing HTN Thromboembolism

What is the MOA of allergen-specific immunotherapy (SIT)?

SQ injections of gradually increasing amounts of specific allergen to activating allergen-specific Tregs to secrete IL-10 and inhibit Th2 response **only therapy that can change underlying TH2 response**

What AEs are associated with allergen specific immunotherapy?

Risk of anaphylaxis

What is the MOA of omalizumab?

Anti-IgE antibody | Prevents IgE loading onto mast cells

What is the indication for omalizumab?

Allergic asthma (moderate to severe)

What AEs are associated with omalizumab?

Injection site reactions | Anaphylaxis (rare)

What is the MOA of mepolizumab?

Anti-IL-5 antibody | Dec. recruitment of eosinophils

What is mepolizumab indicated for?

Severe asthma in patients with eosinophilia phenotype

What AEs are associated with mepolizumab?

Injection site reactions | Hypersensitivity reactions

What is the MOA of montelukast?

Leukotriene receptor antagonist

What are the indications for montelukast?

Asthma | AR

What AE are associated with montelukast?

Neuropsychiatric AEs

What are the MOA and indications for albuterol?

Beta2 agonist Asthma

What AEs are associated with albuterol?

Tremor CNS effects Cardiac stimulation

What is the MOA, indication, and AE of epinephrine?

alpha1, beta1, beta2 agonist Indicated for anaphylaxis AE: arrhythmias

⬛️Which drugs have BBW for inc. risk of infections?⬛️ C? I TREAT

``` Cyclosporine Infliximab Tacrolimus Rituximab Etanercept Adalimumab Tocilizumab ```

What drugs have AE of inc. liver enzymes? I NATE

``` Infliximab Natalizumab Adalimumab Tocilizumab Etanercept ```

Immunomodulatory Drugs Flashcards

(61 cards)