Immunosuppressants

Question 1

How do steroids work?

Answer 1

Upregulate anti-inflam cytokines, downregulate inflam cytokines.

Rapid onset

Question 2

How does methotrexate work?

Answer 2

Inhibits folic acid synthesis by preventing nucleotides from entering DNA synthesis.

Question 3

How is methotrexate given?

Answer 3

With folic acid 4 days later, oral or SC. Takes a few weeks to kick in

Question 4

How does azathioprine work?

Answer 4

Converted to nucleoside analogue, incorporates into DNA or RNA and terminates strands, inhibiting DNA synthesis.

Works best in lymphocytes

Question 5

How is azathioprine given?

Answer 5

Orally daily. Need to check patients have TPMT enzyme so it doesn’t accumulate.

Question 6

How does cyclosporin work?

Answer 6

Inhibits calcineurin which inhibits T cell activation by preventing signal transduction.

Question 7

How does tacrolimus work?

Answer 7

Same as cyclosporin by more potent and better tolerated. Orally once daily

Question 8

What is tacrolimus used for?

Answer 8

SOT