Immunopharmacology Flashcards
Which of the following drug is used for patients with SLE and RA?
A. Tacrolimus
B. Cyclosporine
C. Hydroxychloroquine
D. Sirolimus
C. Hydroxychloroquine
Which drug suppresses intracellular antigen processing and loading of peptides into MHC class II by increasing the pH of lysosomal and endosomal compartments?
Hydroxychloroquine
Recombinant humanized IgG1 that binds to soluble and membrane-associated IL-6 receptors to inhibit signaling
Tocilizumab
Anti-IgE recombinant humanized monoclonal antibody for allergic asthma in adult and adolescent patients whose symptoms are REFRACTORY TO INHALED CORTICOSTEROIDS
Omalizumab
Total serum IgE levels may remain elevated in patients for up to how long after omalizumab administration?
1 year
Which of the 2 anticytokine-antibodies below is used for Crohn’s disease and RA?
A. Etanercept
B. Infliximab
B. Infliximab
Which of the 2 anticytokine-antibodies can cause reactivation of latent TB?
A. Etanercept
B. Infliximab
B. Infliximab
Which of the 2 anticytokine-antibodies below is used for Psoriatic arthritis and RA?
A. Etanercept
B. Infliximab
A. Etanercept
Which of the 2 anticytokine-antibodies is a genetically engineered fusion protein that prevent TNF-α from binding to TNFR1 and TNFR2?
A. Etanercept
B. Infliximab
A. Etanercept
Which of the 2 anticytokine-antibodies inhibit T-cell and macrophage function?
A. Etanercept
B. Infliximab
B. Infliximab
Which of the 2 anticytokine-antibodies is a chimeric monoclonal antibody that cross links with membrane bound TNF-α receptors on cell surface?
A. Etanercept
B. Infliximab
B. Infliximab
Which antimetabolite inhibits lymphocyte folate metabolism?
Methotrexate
This antimetabolite suppresses BOTH B and T lymphocytes, including mitogen and mixed lymphocyte responses, probably by DE NOVO SYNTHESIS OF PURINES. The active product inhibits inosine monophosphate dehydrogenase, leading to suppression of T- and B-lymphocyte proliferation.
Mycophenolate mofetil
What to do if a patient using allopurinol must take azathioprine?
Reduce azathioprine dose to 1/4-1/3 to prevent toxicity
since both are inactivated by xanthine oxidase
Cellcept is a selective noncompetitive inhibitor of which enzyme in the de novo pathway of guanine nucleotide synthesis?
Cellcept (Mycophenolate mofetil) inhibits Inosine Monophosphate Dehydrogenase or IMPDH
Cellcept is an alternative to cyclosporine or tacrolimus for intolerant patients when it is combined with:
Prednisone
Cellcept is Mycophenolate mofetil
This is the first line drug for preventing or reducing chronic allograft vasculopathy in cardiac transplant recipients due to antiproliferative properties
Mycophenolate mofetil (Cellcept)
Which drug, isolated from the mold Penicillum glaucus, inhibits lymphocyte guanosine synthesis to counter refractory rejection in solid organ transplant patients?
Mycophenolate mofetil
mTOR inhibitors are associated with an increased risk for developing which vascular pathology?
Hepatic Artery thrombosis
This is a Proliferation Signal Inhibitor that inhibits JAK enzymes that stimulate hematopoiesis and immune cell function in response to cytokine or growth factor signaling. It is a targeted synthetic small molecule (tsDMARD) that selectively inhibits all members of the Janus kinase family to varying degrees. At therapeutic doses, it exerts its effect mainly by inhibiting JAK3, and to a lesser extent JAK1, hence interrupting the JAK-STAT signaling pathway.
Tofacitinib (Xeljanz)
This oral sedative drug, though banned due to teratogenic effects, is now currently used for treatment of Multiple Myeloma at initial diagnosis and for relapsed-refractory disease. Despite its toxicity, it is also now approved by the FDA for limited use as a potent immunoregulatory agent and to treat certain forms of leprosy (erythema nodosum leprosum).
Thalidomide
This is the immunomodulatory derivative of Thalidomide (IMiD) that is less toxic, less teratogenic, and effective for myelodysplastic syndrome with chromosome 5q31 deletion
Lenalidomide
Which group of immunosuppressants can cause profound myelosuppression, specifically thrombocytopenia?
Proliferation Signal Inhibitors (PSIs):
- Sirolimus
- Everolimus
Cell source (cells that release) IFN-γ
CD4 Th1, CD8 and NK cells
Which Mabs bind and neutralize TNF-α and are important for ankylosing spondylitis?
TNF-α inhibitors particularly Infliximab and Adalimumab
Which fully human, high-affinity, recombinant anti-tumor necrosis factor (TNF) alpha monoclonal antibody blocks the binding of B. anthracis “protective” antigen to its cellular receptor?
Adalimumab
Which alkylating cytotoxic agent can cause hemorrhagic cystitis?
Cyclophosphamide
Which alkylating cytotoxic agent can cause pancytopenia when given in large doses?
Cyclophosphamide
Cytokine that suppresses HIV replication and stimulates T-cell chemotaxis
IL-16
Which fully human IgG2 kappa light chain monoclonal antibody binds to EGFR and is used in metastatic colorectal cancer?
Panitumumab
Cell source (cells that release) IFN-α
Leukocytes
Human-mouse chimeric Mab that targets EGRF and is used in head and neck squamous cell carcinoma and KRAS-negative, EGFR-positive metastatic colorectal cancer
Cetuximab
Cytokine that stimulates eosinophil proliferation
IL-5
Interleukin that in produced by hematopoietic stem cells
IL-3
Mab that binds to CD38, which is over-expressed in myeloma cells
Daratumumab
A ganglioside D2-binding Mab approved for pediatric patients with high-risk neuroblastoma in combination with GM-CSF, IL-2 and 13-cis-retinoic acid
Dinutuximab
Which of the following is an acute phase protein that activates complement pathway for the opsonization of microbes?
A. Macrophage
B. Pentraxin
C. Collectin
B. Pentraxin (CRP)
Cytokine that is also known as the T-cell growth factor
IL-2
Cytokine that stimulates neutrophil chemotaxis
IL-8
Mab targeting EGFR used for Squamous non-small cell lung CA in combination with gemcitabine and cisplatin
Necitumumab
Treatment of relapsed multiple myeloma via antibody-dependent cell-mediated cytotoxicity (ADCC) after binding to SLAMF7 on myeloma cells
Elotuzumab
Cell source (cells that releases) IFN-β
Fibroblasts
Regulatory cytokine of Th2
IFN-γ
Regulatory cytokine of Th1
IL-10
Mab that blocks the cleavage of the complement protein C5
Eculizumab
A prodrug of an inhibitor of pyrimidine synthesis that is approved only for RA
Leflunomide
An active metabolite pyrimidine synthesis inhibitor that is approved for relapsing-remitting multiple sclerosis
Teriflumide
Adenosine deaminase inhibitor that is used mainly as antineoplastic agent for lymphoid malignancies
Pentostatin
Humanized IgG1 with a kappa chain that binds CD52 and is used for CLL that have failed with fludarabine therapy, and approved in the EU for RR-MS
Alemtuzumab
Recombinant bi-specific trifunctional rat-mouse IgG hybrid mab that targets EpCAM and CD3
Catumaxomab
Mab indicated for Glioblastoma multiform
Bevacizumab
Cytotoxic agent that is useful in idiopathic thrombocytopenic purpura refractory to prednisone
Vincristine
Profound AE of Pentostatin
lymphopenia
Cytotoxic agent effectively used against acquired factor XIII antibodies and bleeding syndromes
Cyclophosphamide
SEs of Muromonab-CD3 that resulted in its withdrawal from the market
Cytokine release syndrome and severe pulmonary edema
Percent concentration of Rho (D) Ig solution of human IgG
15%
After miscarriage, Rho (D) IgG treatment is recommended at ___ weeks of gestation
26-28 weeks
Orphan drug for treating abdominal ascites in ovarian and gastric CA
Catumaxomab
Human anti-mouse antibodies (HAMA) is generated in 4% of patients treated with:
Cetuximab
Important SEs of Rituximab
Neutropenia and anemia
The main adverse effect of Rituximab is countered by giving:
G-CSF for anemia and neutropenia
This is a recombinant humanized monoclonal anti-body that targets all forms of VEGF-A. This antibody binds to and prevents VEGF-A from interacting with the target VEGF receptors. It is FDA approved as a first-line treatment for metastatic colorectal cancer in combination with any intravenous fluoropyrimidine-containing regimen and is now also approved in combination with chemotherapy for metastatic NSCLC and breast cancer.
Bevacizumab
This is a monoclonal antibody directed against interleukin-13 which is used in the treatment of moderate-to-severe atopic dermatitis in patients requiring systemic therapy.
Tralokinumab
