Immunopharmacology Drugs Flashcards
(24 cards)
1
Q
cyclosporine
- MOA (specific protein, sounds like the name)
- what does it increase?
- specificity
- uses
- toxicity
- look @ first aid picture
A
- inhibits calcineurin. binds to cyclophilin A to form a complex which binds to and inhibits calcineurin. inhibits cytokine synthesis, protooncogenes, and cytokine receptors.
- can increase TGF-beta
- T cells
- organ transplants, autoimmune disorders
- nephrotoxicity, HTN, hepatotoxicity
2
Q
tacrolimus
- MOA (different site than cyclosporine)
- uses
- toxicity
A
- calcinuerin inhbitor. binds FK506 binding protein-12 (FKBP), leading to inhibition of calcineurin and its events
- 100 x more potent than cyclosporine
- transplants, autoimmune disorders
- nephrotoxicity, neurotoxicity, diabetes
3
Q
sirolimus and everolimus
- MOA
- uses
- toxicity
A
- binds FKBP, does not inhibit like tacrolimus. inhibits mTOR, a kinase for proliferation
- blocks T cell at G1-S phase
- transplants, autoimmune disorders
- increases in serum cholesterol and TGs, delayed graft fx and wound healing, anemia, leukopenia, thrombocytopenia, increased risk for infection due to myelosuppression
- not nephrotoxic
4
Q
glucocorticoids
- MOA
- uses
A
- prednisone and prednisolone
- unclear, inhibit T cell proliferation, t cell dependent immunity, and expression of genes encoding cytokines
- transplants, AI diseases
- anti-inflammatory too
5
Q
azathioprine
- MOA
- uses
- drug interactions
- why?
- toxicity
A
- converted to 6-MP in vivo
- inhibits purine biosynthesis and T cell proliferation
- adjunct for organ transplants
- azathioprine should be reduced when given with allopurinol
- allopurinol inhibits xanthine oxidase, which catabolizes aza metabolites
- myelosuppression
6
Q
mycophenolate mofetil
- MOA
- uses
- toxicity
- what should you avoid with this drug?
A
- prodrug converted to mycophenolic acid (MPA). inhibits inosine monphosphate dehydrogenase (IMPDH), no de novo synthesis of guanine, B and T cells
- transplant Px
- GI, leukopenia
- antacids (Mg, Al) decrease absorption
7
Q
antithymocyte globulin (ATGAM)
- MOA
- uses
- toxicity
A
- polyclonal ab from horses or rabbits immunized with human thymus lymphocytes
- binds to circulating lymphocytes, causing complement mediated death (clearing agent)
- prevents allograft rejection
- serum sickness, nephritis, chills, fever, and rashes
8
Q
muromonab-CD3 (Orthoclone)
- target
- MOA
- uses
- toxicity
A
- CD3 glycoprotein (associated with TCR)
- induces internalization of the TCR, reduces circulating T cells (clearing agent)
- reverse transplant rejections
- cytokine release syndrome, anaphylactic reactions, CNS toxicity, risk for IFX and malignancy
9
Q
Daclizumab and Basiliximab
- target
- MOA
- uses
- toxicity
A
- IL-2 receptor
- inhibit T cell activation
- Px of acute rejection in renal transplants
- increased risk for IFX
10
Q
Alemtuzumab (Campath-1H)
- target
- which cells?
- MOA
- uses
A
- CD52 glycoprotein
- B cells, T cells, monocytes, macrophages, and NK cells
- induces lympholysis leads to profound T cell depletion
- used in CLL
- no longer available in the US
11
Q
Efalizumab
- target
- which cells?
- MOA
- which disease does this MOA remind you of?
- uses
- toxicity
A
- binds CD11a subunit of LFA-1
- T and B cells
- inihibts interaction between LFA-1 and ICAM, reducing adhesion and activation
- LAD
- prevent organ rejection, Tx psoriasis
12
Q
Tocilizumab
- target
- MOA
- uses
- toxicity
A
- IL-6 receptor
- inhibits IL-6 actions
- Tx juvenile RA
- increase risk for IFX
13
Q
Rituximab
- target
- which cells?
- MOA
- uses
- toxicity
A
- CD20
- B cells only
- B cell lysis
- Tx CLL, non-hodgkin’s lymphoma, and RA
- infusion rxns
14
Q
infliximab
- type
- MOA
- uses
- toxicity
A
- mouse human chimeric
- anti-TNF
- RA, psoriasis, Crohn’s disease
- IFX, lymphoma
15
Q
Adalimumab
- type
- MOA
A
- humanized monoclonal
- anti-TNF
- always PPD before anti-TNF
16
Q
Etanercept
- type
- MOA
A
- fusion protein (not an antibody) of ligand binding domain of TNF receptor and an IgG-1 fragment
- anti-TNF
17
Q
Alefacept
- name it’s fusion contents
- what does it inhibit
- therapeutic uses
A
- LFA-3-IgG1
- the interaction between LFA-3 and CD2, decreasing t cell adhesion and activation
- psoriasis
18
Q
- Abatacept/Belatacept
- name it’s fusion contents
- what does it inhibit
- therapeutic uses
- toxicity
A
- CTLA4-IgG1
- inhibits CD80/86 (B7) and CD28 (T cell) from interacting, decrease costimulation!
- juvenile idiopathic arthritis, RA (A), organ rejection (B)
- increase IFX
19
Q
Levamisole
- MOA
- use
- traditional use
A
- inhibits T-suppressor cells
- colon cancer immunostimulant
- helminths
20
Q
Isoprinosine
- MOA
- use (lol)
A
- increase NK cell cytotoxicity and activity of T cells and monocytes
- rarely used
21
Q
Thalidomyde
- MOA
- use
- contraindications
A
- decreases circulating TNF alpha
- severe, refractory RA and erythema nodusum leprosum
- pregnant women, teratogen
22
Q
IFN-alpha
- typically used by our body to defend against what?
- what does it activate?
- therapeutic uses
- toxicities
A
- viruses
- macrophages, t cells, NK cells (the virus defenders)
- Hep B and C
- flu like symptoms and development of pulmonary HTN
23
Q
IL-2
- MOA
- Indications
- toxicity (3 biggies)
A
- activates cell-mediated immunity
- metastatic melanoma, renal cell carcinoma, AIDS
- hypotension, CV toxicity, pulmonary edema
24
Q
G-CSFs
- what does that stand for?
- what’s another name for it?
- what are these typically produced by?
- physiologic fx
- therapeutic use
A
- granulocyte colony stimulating factors
- myeloid growth factors
- monocytes, fibroblasts, endothelial cells
- increases the number of granulocytes and monocytes
- neutropenia due to chemo, HIV, bone marrow transplant
