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Pharmacology > Immunopharmacology Exam 4 > Flashcards

Immunopharmacology Exam 4 Flashcards

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1
Q

Corticosteroids/Prednisone*

A

suppress the activation and function of innate and adaptive immune cells by inhibiting cytokine gene expression. results in anti-inflammatory and immunosuppression

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2
Q

Antimetabolites (Antiproliferatives)

A

suppresives, inhibit proliferation of immune cells and induce apoptosis

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3
Q

Azathioprine*

A
  • 1st drug developed for organ transplant
    *Prodrug of the purine analog 6=mercaptopurine (6-MP)
    *inhibits de novo synthesis of purines required for lymphocyte proliferation –> incorporates into replicating DNS to halt replication
    (affects on GI mucosa and bone marrow)
    (immunosuppressive)
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4
Q

Mycophenolate Mofetil (MMF)*

A

inhibits the enzyme inosine monophosphate dehydrogenase(IMPHD) (essential for guanosine formation) so blocks purine synthesis for lymphocytes
*inhibits type II isoform of IMPDH –>specific for lymphocytes so less adverse effects than azathioprine

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5
Q

Cyclosporine*

A

inhibit IL-2 production so it inhibits lymphocyte signaling. Immunosuppressive for transplant pts
SE: nephrotoxicity - irreversible w/ chronic exposure

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6
Q

Tacrolimus*

A

inhibits IL-2 release and inhibits calcineurin. TX: maintain immunosuppression for transplant pts. more potent than cyclosporine

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7
Q

Rapamycin*

A

mTOR inhibitor. blocks T-cell activation also blocks B-cell proliferation and AB production. Black box warning for lung transplants
immunosuppressive

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8
Q

Leflunomide*

A

antimetabolite/immunosuppressive - inhibits pyrimidine synthesis So inhibits reproduction of rapidly dividing cells by inhibiting DNA/RNA synthesis. TX: rheumatoid arthritis.

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9
Q

Basiliximab*

A

immunosuppressive chimeric mab. prevents t-cell activation and proliferation w/o lysis or destruction of cell (non-depleting)
*AB against T-cell w/ CD25 which is only present in activated T-cells

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10
Q

Alemtuzumab*

A

immunosuppressive AB, depleting agent. works against CD52 which is present in B,T- cells, macrophages, and NKC

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11
Q

Abatacept

A

modified AB that inhibits co-stimulation. prevents APC from delivering the antigen. so they do not activate immune response. Blocks CD80 and CD86
TX: rheumatoid arthritis when anti TNF therapy does not work

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12
Q

Interferon*

A

proteins produced by tumor cells or infected host cells to activate other immune cells and destroy invading pathogens, immunostimulants

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13
Q

Adalimumab*

A

inhibits TNF alpha, anti-inflammatory. tx rheumatoid arthritis

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14
Q

What is the main side effect concern for an immunosuppressive agent?

A

opportunistic infection.

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15
Q

Albuterol*

A

SABA, B2 agonist, rescue inhaler. NOT anti-inflammatory

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16
Q

Levalbuterol*

A

SABA higher B2 selectivity, NOT anti-inflammatory

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17
Q

Salmeterol

A

LABA, needs to be give w/ corticosteroids b/c downregulation of B2 receptors occurs with LABAs

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18
Q

Indacaterol

A

ULABA

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19
Q

Why do LABAs need to be given w/ corticosteroid?

A

because alone, they downregulate the B2 receptors. Corticosteroids counteracts that and helps tx underlying inflammation in asthma (but doesn’t help as anti-inflammatory in COPD)

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20
Q

Theophylline

A

methylxanthine, blocks PDE and blocks adenosine receptors. preventing bronchoconstriction. Also increase diaphragm contraction, clears mucus, and is anti-inflammatory. Used only in hospital setting b/c it has a low therapeutic index

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21
Q

Aminophylline

A

Same as theophylline, but more lipid soluble.

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22
Q

Roflumilast

A

PDE4 inhibitor, specific target for inflammatory and immune cells = less adverse effects. Very good at tx COPD inflammation due to PDE target in neutrophils.

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23
Q

Ipratropium*

A

Short acting antimuscarinic - for acute asthma. block M1 and M3 receptors from binding Ach

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24
Q

Tiotropium

A

Long acting antimuscarinic blocks M1 and M3 slowly. can’t bind Ach and prevents bronchoconstriction

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25
Vilanterol
LAMA
26
Umeclidinium
LAMA
27
Cromolyn* sodium
mast cell stabilizer - tx of asthma, not a rescue medication (no bronchodilation). can be used prophylactically for asthma or exercise induced asthma as anti-inflammatory.. Stop mast cells from degranulation
28
Montelukast
leukotriene modifier. blocks receptor to prevent constriction, inhibits eosinophil chemotaxis, reduces inflammation
29
Zafirlukast
leukotriene modifier, blocks receptor, SE inhibits CYP2C9 resulting in increased warfarin
30
Zileuton
block enzyme to make leukotrienes. SE: elevate hepatic enzymes
31
Omalizumab
binds IgE to prevent them from binding to mast cells. used to Tx allergic asthma
32
Antacids
``` neutralize stomach acid. sodium bicarbonate calcium carbonate MgOH (laxative) AlOH (constipation effect) ```
33
Climetidine
H2 antagonist. Prevents stimulation of parietal cells (no acid made)
34
Famotidine
H2 antagonist | prevents stimulation of parietal cells (no acid made)
35
Omeprazole
protein pump inhibitor. forms disulfide bond preventing acid secretion
36
Lansoprazole
Protein pump inhibitor preventing acid secretion by forming disulfide bond
37
Esomoprazole
protein pump inhibitor preventing acid secretion by disulfide bond
38
What are some side effects of protein pump inhibitors
osteoporosis (protein pumps used to maintain bone) nutrition issues diarrhea
39
Sucralfate
AlOH and sugar form a paste to coat stomach. | SE: constipation, decreased drug absorption
40
Misoprostol
PGE1 increased to inhibit acid secretion and enhance bicarbonate and mucus secretion
41
Bismuth Subsalicylate
coats erosions/ulcers, antimicrobial effects, anti-inflammatory also antidiarrheal
42
Neostigmide
blocks acetylcholinesterase, allows ACH to stimulate peristalsis and also stimulates urination
43
Metoclopramide
D2 receptor antagonist, increase ACH from nerve ending terminals
44
Psyllium
laxative, distends colon and promotes peristalsis
45
Methylcellulose
laxative, distends colon and promotes peristalsis
46
How do stool softeners work?
work as detergent and minimizes surface tension.
47
Dulcolax
stimulant laxative
48
Exlax
stimulant laxative
49
Alvimopan
opioid receptor blocker in GI tract | does not cross BBB
50
Colace
stool softener - allow water to enter fecal mass by decreasing surface tension.
51
Tergaserod
Serotonin agonist to stimulate enteric NS
52
Loperamide
opioid agonist in GI to slow motility and prevent diarrhea
53
Diphenoxylate
opioid receptor agonist GI to slow motility and prevent diarrhea
54
Colestipol
binds bile salts to decrease diarrhea
55
Octreotide
resembles somatostatin. so slows GI motility. | can cause increased fat excretion (steatorrhea) and vitamin K deficiency
56
Ondansetron
serotonin receptor agonist, decrease vomiting by decreasing vagal feedback to CNS tx: chemo pts does not tx motion sickness
57
Aprepitant
neurokinin antagonist, blocks vomiting center receptor in CNS
58
Droperidol
antipsychotic, block dopamine binding to prevent vomiting
59
Diphenhydramine
antihistamine reduce motion sickness | SE: sedation
60
Scopolamine
anticholinergic, reduce motion sickness
61
Tricyclic antidepressants
tx IBS b/c alter perception of pain. SSRI can also do this
62
How else can you tx IBS?
anticholinergics, serotonin antagonists
63
Alosetron
serotonin antagonist used to tx IBS in women w/ diarrhea
64
Lupiprostone
chloride channel activator, release intestinal fluid to help w/ constipation, tx IBS
65
Linaclotide
chloride channel activator. tx IBS w/ constipation
66
Sulfasalazine
aminosalicylate, anti-inflammatory for IBD
67
Sildenafil
ED med, blocks PDE5, blocks cGMP, vasodilate, increases blood flow
68
Vardenafil
block PDE5 - ED medication, lasts 5 hours
69
Tadalafil
ED medication, blocks PDE 5, lasts 36 hours
70
Terazosin
alpha blocker, used to tx BPH by relaxing muscle of prostate and neck of bladder
71
Finasteride
block conversion of testosterone to dihydrotestosterone. reduces epithelium size. tx for men w/ large prostates
72
Acetylsalicylic acid/ aspirin
anti-inflammatory, anti fever and pain, anti thrombotic. SE: Reye's Syndrome in kids. don't give to pts w/ hemophilia reduces GI mucus so could cause ulcers (b/c reduces prostaglandins)
73
Ibuprofen
non-selective cox inhibitor, anti-inflammatory, reduces, pain and fever. does NOT reduce thrombosis
74
Naproxen
non-selective COX inhibitor. reduces inflammation, pain, fever, but not thrombosis
75
Acetaminophen
not an NSAID, but reduces pain and fever. SE: liver toxicity
76
Celecoxib,
Cox 2 inhibitor, reduce inflammation, Black box warning for CV effects TX: osteoarthritis
77
Meloxicam
Cox 2 inhibitor, CV effects
78
Rituximab
blocks CD20 - only found on B-cells. so inactivates B-cells

Pharmacology (6 decks)

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