Immunopharmacology Drugs

Question 1

Glucocorticoids

Answer 1

Action: Inhibits leukotriene and prostaglandin synthesis; inhibits leukocyte function and traffic control; inhibits NF-kB transcription induction.

Uses: Acute anti-inflammatory; chronic use in transplant rejection and autoimmune diseases.

Toxicity: Many toxicities if used chronically.

Question 2

Cyclosporine

Answer 2

Action: Blocks early T-cell maturation by binding cylophilin and inhibiting calcineurin (prevents activation of the transcription factor NFAT and cytokine gene induction).

Uses: Human organ transplants; GVHD; autoimmune diseases.

Toxicity: Nephrotoxicity.

Question 3

Tacrolimus

Answer 3

Action: Blocks early T-cell maturation by binding FKBP and inhibiting calcineurin (prevents activation of the transcription factor NFAT and cytokine gene induction).

Uses: Human organ transplants; GVHD; autoimmune diseases.

Toxicity: Nephrotoxicity.

Question 4

Sirolimus

Answer 4

Action: mTOR inhibitor (inhibition of interleukin- driven T-cell proliferation); binds FKBP-12.

Uses: Organ transplant; GVHD.

Toxicity: Increases cholesterol and triglycerides; BM suppression.

Question 5

Mycophenolate mofetil (MMF)

Answer 5

Action: Inhibits B cell and T cell response via inhibition of inosine monophosphate dehydrogenase and GTP synthesis.

Uses: Organ transplant; GVHD.

Toxicity: BM suppression.

Question 6

Azathioprine

Answer 6

Action: Prodrug for mercaptopurine; inhibits purine synthesis.

Uses: Organ transplant; autoimmune diseases.

Toxicity: BM suppression.

Question 7

Infliximab

Answer 7

Action: Anti-TNF-alpha antibody.

Uses: Autoimmune diseases.

Toxicity: Infusion reactions.

Other drugs in class: Adalimumab; etanercept.