Immunopharm

Question 1

glucocorticoids AE: short/long term

Answer 1

short term: HTN, hyperglycemia, psychosis, cognitive impairment

long term: myopathy, Cushing syndrome, osteoporosis

Question 2

cyclosporine

Answer 2

calcineurin inhibitor

Question 3

tacrolimus

Answer 3

calcineurin inhibitor

Question 4

cyclosporine AE

Answer 4

*nephrotoxicity
tremor
hyperglycemia/hyperlipidemia
osteoporosis
*hirsutism
*gum hyperplasia

Question 5

Cyclosporine interactions

Answer 5

CYP3A4 metabolizer

Question 6

cyclosporine uses

Answer 6

organ transplant, uveitis, RA, psoriasis

Question 7

tacrolimus AE

Answer 7

same as cyclosporine: nephrotoxicity, hyperglycemia/lipidema, hyperkalemia AND neuro sxs!!

Question 8

tacrolimus use

Answer 8

prevent rejection of transplanted kidneys, liver, heart

topical for atopic dermatitis and psoriasis

Question 9

sirolimus AE

Answer 9

myelosuppresion
hepatotoxicity
hyper TG
pneumonitis

Question 10

sirolimus

Answer 10

proliferation signal inhibitors
binds FKBP - inhibits mTOr kianse = block T cell proliferation

mTOR blocks IL-2 driven T cell proliferation: Th1

Question 11

thalidomide

Answer 11

angiogenesis inhibitor and TNF-alpha inhibitor

Question 12

thalidomide use

Answer 12

erythema nodosum leprosum and MM

Question 13

lefluonomide

Answer 13

anti-metabolite - cytotoxic agent

Question 14

mycophenolate mofetil

Answer 14

anti-metabolite - cytotoxic agent

inhibits inosine monophoshpate dehydrogenase

Question 15

methotrexate

Answer 15

anti-metabolite - cytotoxic agent

Question 16

azathioprine

Answer 16

anti-metabolite - cytotoxic agent

Question 17

azathioprine AE

Answer 17

BM suppression, GI disturbances, inc in infections

Question 18

azathioprine warning

Answer 18

if taken with allopurinol, dec dose of azathioprine

Question 19

azathioprine use

Answer 19

prevent organ transplant rejection

severe RA

Question 20

MTX AE

Answer 20

mucosal ulcers
luekopenia
anemia
hepatotoxicity

can be reduced with leucovorin or folic acid
contraindic in pregnancy

Question 21

MTX uses

Answer 21

RA
psoriasis
ankylosing spondylitis
SLE

Question 22

mycophenolate mofetil AE

Answer 22

n/v/d
HA
HTN
reversible myelosuppresion

Question 23

mycophenolate mofetil uses

Answer 23

prophylaxis of transplant rejection

SLE

Question 24

leflunamide AE

Answer 24

reversible alopecia
myelosuppresion
INC aminotransferase activity
monitor CBC and LFTs
carcinogenic and teratogenic in animals
diarrhea

contraindicated in pregnancy

Question 25

leflunomide use

Answer 25

RA, SLE, MG

Question 26

cyclophosphamide

Answer 26

alkylating agent

Question 27

cyclophosphamide AE

Answer 27

``` BM suppression hemorrhagic cystitis bladder carcinoma acrolein = urine toxin infertility ```

Question 28

hydroxychloroquine AE

Answer 28

hemolysis in G6PD def | retinal damage

Question 29

sulfasalazine AE

Answer 29

``` neutropenia thrombocytopenia drug induced Lupus hemolysis in G6PD n/v ```

Question 30

sulfasalazine use

Answer 30

UC RA CD ankylosing spondylitis

Question 31

rituximab

Answer 31

anti-CD20 - depletes B cells nonhodgkins lymphoma, CLL, RA

Question 32

basiliximab

Answer 32

IL-2 antagonist

Question 33

omalizumab

Answer 33

anti-IgE antibody

Question 34

etanercept

Answer 34

TNF-alpha binding

Question 35

adalimumab

Answer 35

anti-TNF alpha | human IgG1

Question 36

infliximab

Answer 36

anti-TNF alpha | chimeric monoclonal antibody

Question 37

anakinra

Answer 37

IL-1 blocker

Question 38

leflunoamide MOA

Answer 38

inhibits dihydroorate dehydrogenase

Question 39

MTX MOA

Answer 39

inhibit AICAR transformylase (aminoimidazolecarboxamide ribonucleotide transformylase) responsible for catalyzing final steps of purine synthesis and IMP synthesis

Question 40

aldesleukin

Answer 40

recombinant IL-2 | promotes production of cytotoxic T cells and activation NK

Question 41

aldesleukin use

Answer 41

adjuvant for renal cell CA and malignant melanoma

Question 42

IFN-alpha use

Answer 42

``` hairy cell leukemia MCL malignant melanoma Kaposi sarcoma HBV, HCV ```

Question 43

IFN-beta use

Answer 43

relapsing MS

Question 44

IFN-gamma use

Answer 44

treat CGD

Question 45

bacillus calmette geurin

Answer 45

tx and prophylaxis bladder ca

Question 46

BCG AE

Answer 46

hypersensitivity shock immune complex disease

Question 47

glucorticoids on PLA-2 and COX-2

Answer 47

Inhibit PLA-2 | Reduce transcription of COX-2

Question 48

calcineurin mechanism

Answer 48

phosphatase necessary for activation of T cell specific transcription factor: NFAT

Question 49

cyclosporine MOA

Answer 49

complexes with cyclophilin - immunophillin = this complex inhibits calcineurin

Question 50

tacrolimus MOA

Answer 50

binds FK binding protein = immunophilin - inhibits calcineurin

Question 51

tx for erythema nodosum leprosum

Answer 51

thalidomide

Question 52

tx for multiple myeloma

Answer 52

thalidomide

Question 53

azathioprine MOA

Answer 53

converts to 6-MP: inhibit de novo purine synthesis | suppresses B and T cell function, dec IL-2 secretion

Question 54

what accumulates with use of MTX

Answer 54

AMP | converted extracellularly to adenosine - potent inflam inhibitor

Question 55

mycophenolate mofetil MOA

Answer 55

converted to mycophenolic acid: inhibits IMP dehydrogenase in de novo pathway of GTP synthesis suppresses B and T activation

Question 56

leflunomide

Answer 56

prodrug - terfluonmide inhibits Dihydroorotate dehydrogenase Increases UMP - needed for pyrimidine synthesis

Question 57

what lab values should be checked in people leflunomide

Answer 57

CBC | LFTs

Question 58

cyclophosphamide MOA

Answer 58

alkylates DNA = destroys proliferating lymphoid cells

Question 59

tx of UC

Answer 59

sulfasalazine -- the 5-ASA moiety

Question 60

abatacept

Answer 60

fusion protein - interferes with T cell activation