Immunosuppressive drugs Flashcards Preview

Therapeutics Spring 2015 > Immunosuppressive drugs > Flashcards

Flashcards in Immunosuppressive drugs Deck (50)
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1

What are two general types of immunosuppressive agents?

1. anti-rejection induction agents
2. maintenance immunotherapy agents

2

What are anti-rejection induction agents?

short term prophylaxis against early acute rejection

3

What are maintenance immunotherapy agents?

to prevent future rejection reactions from occuring

4

What are three kinds of induction agents?

1. antibody mediated therapies
2. cell depleting antibodies
3. antagonistic antibodies (non cell depleting)

5

What are two kinds of antibody based therapy?

Type 1 and type 2

6

What are type 1 antibody based induction therapy?

Igs that bind surface markers on immune cells

7

What are type 1 antibody based induction therapy?

- Igs that bind surface markers on immune cells
- Deplete immune cells by apoptosis, ADCC, NK cells or CDC

8

What are type 2 antibody based induction therapy?

Not as effective as class 1, but less toxic
Antibodies that are antagonists of the ligands needed for lymphocytes to proliferate and be activated.

9

What are three drugs that belong to the antibody based induction therapy class?

polyclonal antisera
chimerica monoclonals
humanized monoclonals

10

What are three drugs that belong to the antibody based induction therapy class?

polyclonal antisera
chimerica monoclonals
humanized monoclonals

11

What are type 2 antibody based induction therapy?

Not as effective as class 1, but less toxic
Antibodies that are antagonists of the ligands needed for lymphocytes to proliferate and be activated.

12

What kind of agent is polyclonal anti-thymocyte globulins,?

cell depleting induction agent

13

What are some side effects of cell depleting antibodies?

cytokine storm (t cells send out inflammatory mediatiors)
reactivation of herpes viral diseases (CMV, EBV, varicella), dose dependent serum sickness

14

What kind of agent is alemtuzumab?

humanized monoclonal antibody against CD52 expressed on lymphocytes but not hematopoietic precursors
- technically an anti tumor agent, not FDA approved as an induction agent

15

What do cell depleting antibodies do?

They kill T cells through ADCC, CDCC and CDC by binding CD3/CD4/CD28 integrins

16

What are some side effects of cell depleting antibodies?

cytokine storm (t cells send out inflammatory mediatiors)
reactivation of herpes viral diseases (CMV, EBV, varicella)

17

What is the mechanism behind antagonistic antibodies?

Antibodies against CD25, act as antagonists to IL-2 receptor on activated T cells

18

What are ADEs of alemtuzumab?

neutropenia
thrombocytopenia
anemia

19

What kind of antibody is basilixumab (Simulect)?

Chimeric monoclonal ab.
antagonistic antibody (non depleting)

20

What is the mechanism behind antagonistic antibodies?

Antibodies against CD25, act as antagonists to IL-2 receptor on activated T cells

21

What are some ADEs for corticosteroids?

increased risk of infection
decreased wound healing
adrenal insufficiency
decreased bone density
skin fragility
cardiovascular complications
cushings like syndrome
insomnia
psychiatric- irritability and activity

22

What kind of immunosuppressive agent are glucocorticoids?

Maintenance agent

23

How do glucocorticoids (prednisone) suppress the immune system?

Inhibit the expression of cytokines, enzymes, receptors and adhesion molecules.

24

What is the mechanism of cyclosporine?

Cyclosporine binds cyclophylin and together the complex blocks the function of calcineurin (to dephosphorylate NFAT, no NFAT = no IL-2 so no T Cell proliferation)

25

What are two calcineurin inhibitors?

cyclosporine
tacrolimus

26

what kind of molecule is cyclosporine?

nonribosomal cyclic peptide

27

What is the mechanism of cyclosporine?

Cyclosporine binds cyclophylin and together the complex blocks the function of calcineurin (to dephosphorylate NFAT, no NFAT = no IL-2 so no T Cell proliferation)

28

What kind of molecule is tacrolimus?

macrolide antibiotic

29

What kinds of transplants is tacrolimus approved for?

kidney, heart, small bowel, pancreas, lung, trachea, skin, cornea, bone marrow and limb.

30

What is the mechanism of tacrolimus?

It binds to immunophillin FKBP-12 to inhibit calcineurin