immunosuppressants

Question 1

do glucocorticoids have any effect on humoral immunity?

Answer 1

no, but they decr cytokines, lymphocytes, and T cell activation

Question 2

do glucocorticoids have any effect on humoral immunity?

Answer 2

no, but they decr cytokines, lymphocytes, and T cell activation

Question 3

which immunosuppressant is used for GVHD?

Answer 3

glucocorticoids, calcineurin inhibitors

Question 4

what is recommended to block 1st dose cytokine storm in transplant recipeients after muromonab-CD3 admin?

Answer 4

glucocorticoids can be given prophylactically

Question 5

what is an issue with rapid discontinuation of glucocorticoisd?

Answer 5

adrenal crisis

Question 6

what glucocorticoid is the reference standard?

Answer 6

prednisone

Answer 7

low dose

Question 8

> 7.5 mg, but

Answer 8

medium dose

Question 9

> 30 mg, but

Answer 9

high dose

Question 10

greater than 250 mg prednisone eq per day for 1 day or a few days

Answer 10

pulse therapy

Question 11

> 250 mg prednisone eq per day for 1 day or a few days

Answer 11

pulse therapy

Question 12

for what diseases does cyclosporine work after tx failure

Answer 12

1. RA (after methorexate)

2. psoriasis (after failed tx)

Question 13

what is recommended to block 1st dose cytokine storm in transplant recipeients after muromonab-CD3 admin?

Answer 13

glucocorticoids can be given prophylactically

Question 14

grapefruit juice incr which drug concentrations?

Answer 14

cyclosporine + tacrolimus

Question 15

AE: nephrotoxicity, HTN, DM, neurotoxicity?

Answer 15

cyclosporine + tacrolimus

Question 16

less than 7.5 mg prednisone eq per day?

Answer 16

low dose

Question 17

what anti-proliferative immunosuppr is a tx option for crohns disease?

Answer 17

aziothioprine or anti-TNFalpha reagents

Question 18

what sort of tests need to be monitored with aziothioprine admin?

Answer 18

CBC & liver tests

Question 19

AE: bone marrow suppression, incr susceptibility to viral infxns, incr risk of lymphoma

Answer 19

azathioprine

Question 20

MOA: prodrug metabolized into NPA–>inhibs inosine monophosphate dehydrogenase req’d for de novo synthesis of guanine NT?

Answer 20

mycophenolate mofetil

Question 21

does mycophenolate mofetil act in the stomach?

Answer 21

NO, not soluble in low pH

Question 22

for what diseases does cyclosporine work after tx failure

Answer 22

1. RA (after methorexate)

2. psoriasis (after failed tx)

Question 23

major AE assc’d with cyclosporine?

Answer 23

nephrotoxicity

Question 24

grapefruit juice incr which drug concentrations?

Answer 24

cyclosporine + tacrolimus

Question 25

AE: nephrotoxicity, HTN, DM, neurotoxicity?

Answer 25

cyclosporine + tacrolimus

Question 26

MOA: purine antimetabolite used to inhibit lymphocyte proliferation-->metabolized into 6 MP and integrated into DNA-->blocking lymphocyte proliferation

Answer 26

aziothioprine

Question 27

which immunosuppr would you use for intense immunosuppression in the 1st days-weeks post transplant?

Answer 27

antithymocyte globulin

Question 28

what dort of tests need to be monitored with aziothioprine admin?

Answer 28

CBC & liver tests

Question 29

AE: bone marrow suppression, incr susceptibility to viral infxns, incr risk of lymphoma

Answer 29

azathioprine

Question 30

wat can be used to reverse glucocorticoid resistant organ transplant rejection episodes?

Answer 30

muromonab-CD3

Question 31

does mycophenolate mofetil act in the stomach?

Answer 31

NO, not soluble in low pH

Question 32

AE: hematologic, GI, incr infxns with CMV, teratogenic

Answer 32

mycophenolate mofetil

Question 33

contains the ligand-binding portion of a human TNF-α receptor fused to the Fc portion of human IgG1

Answer 33

Etanercept

Question 34

what is the immunosuppressant that can ONLY be administereed orally?

Answer 34

sirolimus

Question 35

MOA: blocks mTOR-->cannot remove inhibitory protein that normally initiates cell cycle proliferation-->cell cycle proliferation blocked

Answer 35

sirolimus

Question 36

what is sirolimus used for?

Answer 36

prophylaxis of organ transplant rejection. | used in combo with glucocorticoids + calcineurin inhib

Question 37

which immunosuppr would you use for intense immunosuppression in the 1st days-weeks post transplant?

Answer 37

antithymocyte globulin

Question 38

MOA: bind CD and HLA 1/2-->complement mediated cytotox and inhib of lymphocyte fxn

Answer 38

antithymocyte globulin

Question 39

MOA: mouse Ab directed at CD3

Answer 39

muromonab-CD3

Question 40

wat can be used to reverse glucocorticoid resistant organ transplant rejection episodes?

Answer 40

muromonab-CD3

Question 41

chimeric monoclonal antibody containing a human constant region and a murine variable region

Answer 41

Inflixamab

Question 42

recombinant human IgG1 monoclonal

Answer 42

Adalimumab

Question 43

contains the ligand-binding portion of a human TNF-α receptor fused to the Fc portion of human IgG1

Answer 43

Etanercept

Question 44

how to inflixamab, Adalimumab, etanercept act?

Answer 44

prevent TNF-alpha from binding receptor