Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > Immunosuppressives > Flashcards

Immunosuppressives Flashcards

(57 cards)

Start Studying
1
Q

Define autograft

A

a graft of tissue from one point to another of the same person’s body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define allograft

A

one donating to another within same species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define xenograft

A

getting donation from another species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are 3 types of graft rejection?

A

1) hyperacute: in minutes
2) acute: 7-21 days
3) chronic: > 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are 2 types of drugs that act on immune response induction phase?

A

1) Interleukin-2 production inhibitors: cyclosporine, tacrolimus
2) Cytokine gene expression inhibitor: glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cyclosporine (CsA) indication:

A
  • Organ transplant tx

- Autoimmune disease tx (e.g.: RA) at low doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cyclosporine administration:

A

PO (slow and incomplete absorption), IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cyclosporine metabolism:

A

occurs in GI, liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is cyclosporine concentrated?

A

In peripheral tissue (lymphomyeloid, adipose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name 4 AEs of cyclosporine:

A

1) Nephrotoxicity
2) HTN
3) Increased risk of infection
4) Liver dysfunction (management: regular blood level monitoring to avoid kidney and liver toxicity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name 4 classes that inhibit CsA metabolism:

A

1) Ca channel blockers
2) Antifungal agents (azoles)
3) Antibacterial agents (erythro/clarithromycin)
4) Grapefruit juice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name 2 classes that induce CsA metabolism:

A

1) Anticonvulsants (Phenytoin)

2) AntiTB agents (Isoniazid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tacrolimus administration:

A

PO, IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tacrolimus metabolism:

A

liver (99%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tacrolimus indication:

A

To prevent organ transplant rejection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tacrolimus AEs:

A

Similar to cyclosporine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name 5 classes of anti-rejection drugs

A

1) Interleukin 2 inhibitor: sirolimus
2) Purine synthesis inhibitor:
3) Alkylating cytotoxic agents
4) Immune response suppressor
5) Immunosuppressive antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is sirolimus?

A

New macrolide antibiotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What do anti-rejection drugs work on?

A

Effector phase of immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Mycophenolate Mofetil administration:

A

PO (well absorbed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What impairs mycophenolate absorption?

A

Al, Mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name the metabolites of mycophenolate (2) and their fate.

A

Metabolites: mycophenolic acid, glucuronide conjugate
Fate: undergoes enterohepatic circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mycophenolate elimination:

Study These Flashcards
A

via kidneys as inactive glucuronide

24
Q

Mycophenolate indication:

Study These Flashcards
A

transplant recipients (+ cyclosporine, steroids)

25
Name 3 indications for Azathioprine:
1) IV loading dose on transplant day 2) PO dosing for maintenance 3) Used in combo with other immunosuppressant drugs for kidney/liver transplants + RA
26
Name a major SE of azathioprine:
bone marrow depression
27
What is cyclophosphamide?
Nitrogen mustard, alkylating agent
28
Cyclophosphamide indication:
Lupus, RA tx
29
Cyclophosphamide administration:
PO, inactive until metabolized by liver into active phosphoramide mustard
30
Cyclophosphamide AE (2):
1) bone marrow depression (leukocytes > platelets) 2) GI 3) hemorrhagic cystitis
31
Name 3 glucocorticoids
Prednisone Methylprednisolone Dexamethasone
32
Name 3 clinical uses of glucocorticoids:
1) Anti-inflammatory and immunosuppressive tx: asthma, AR, RA, organ transplant 2) Neoplastic disease: Hodgkin's disease, acute lymphatic leukaemia 3) Replacement tx: Addison's syndrome
33
Name 4 AEs of glucocorticoids:
1) Insomnia, mood changes (take in AM) 2) Increased appetite, weight gain 3) Suppress response to injury or infection 4) Metabolic effects: fluid retention, osteoporosis, hyperglycemia, GI bleeding
34
What are immunosuppressive antibodies?
Antibodies against human lymphocytes or their surface receptors have significant immunosuppressant actions
35
What are polyclonal antibodies?
Binds to proteins on lymphocyte surface --> lymphocyte lysis (affects all T cells)
36
What are monoclonal antibodies?
Affects induction and effector phases of immune response to allograft - works against specific surface component of T cells
37
Polyclonal ABs AEs:
Newly synthesized ABs can produce anaphylactic reactions
38
Name a monoclonal AB drug:
Infliximab (directed to TNF-alpha)
39
What happens in central tolerance?
Immature lymphocytes are deleted in bone marrow and thymus that recognize self-antigens with high affinity
40
What is peripheral tolerance?
Mature autoreactive lymphocytes are inactivated by various mechanisms
41
What are the 3 stages associated with rheumatoid arthritis (RA)?
1) Initiation phase: inflammation within joint 2) Amplification phase: T cell activation 3) Chronic inflammatory phase: tissue injury due to bone destruction and joint remodelling
42
Anti-TNF alpha and anti-IL therapies are considered what?
Disease-modifyig anti rheumatic drugs (DMARDs)
43
Why are anti-TNF alpha and anti-IL therapies effective DMARDs?
Bc they are released within the joint during the chronic inflammatory phase
44
Name 5 drugs that are anti-TNF based?
1) Entanercept 2) Infliximab 3) Adalimumab 4) Certolizumab 5) Golimumab
45
Thiopurine derivatives MOA:
DNA synthesis inhibitors (may take weeks to months to work)
46
Thiopurines indication:
- Steroid-resistant or dependent pts | - Remission and reduction of UC/CD relapse (NOT acute attacks)
47
What is a risk with thiopurines?
Infection (esp when co-tx with steroids)
48
Methotrexate MOA:
Dihydrofolate reductase inhibitor (blocks DNA synthesis)
49
Methotrexate indication:
Steroid resistant or dependent pts
50
Cyclosporine MOA:
calcineurin inhibitor
51
Cyclosporine indication:
- Tissue transplantation - MOST serious cases of UC/CD - Before surgery
52
What is a SE of cyclosporine?
SEVERE IMMUNE SUPRESSION
53
TNF-a inhibitors MOA:
Inhibits pro-inflammatory ligand (tnf-a)
54
Infliximab (Remicade) TNF-a inhibitor MOA:
Engineered antibody that may kill cell to which it attaches
55
Why does infliximab have a prolonged effect?
Bc - it has a long half-life (8-10 days) - MOA (kills immune cells so they have to repopulate)
56
Entanercept also reduces TNF-a
but NOT effective as an UC tx
57
What is a SE of tnf-a inhibitors?
Increases changes of serious lung infection (esp TB)

Pharmacology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions