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FRACP > Mibs and Mabs > Flashcards

Mibs and Mabs Flashcards

1
Q

Infliximab

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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2
Q

Adamilumab

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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3
Q

Certoluzimab

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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4
Q

Ertanacept

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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5
Q

Golimumab

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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6
Q

What are anti-TNF alpha’s used to treat?

A 
Ank spond
Psoriatic arthritis
RA
IBD
EVERYTHING (anti-rejection for islet cell)
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7
Q

What are the side effects of anti-TNF treatments?

A 
INFECTION
- Candida & TB
Injection site reactions 
Drug induced lupus 
Demyelination 
Malignancy
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8
Q

Tocolizumab

A

Anti-IL6 receptor
Targets the IL17 pathway

Treats GCA and RA

Tocoliz, Sirukum

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9
Q

Sirukumumab

A

Anti-IL6 receptor
Targets the IL17 pathway

Treats GCA and RA
(Same as tocolizumab)

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10
Q

Abatacept

A

Blocks co-stimulation of T cells

Fusion protein - Fc region of IgG1 fused to CTLA-4 - binds to B7 and prevents CD 28 co-stimulation of T-cells from APCs

Acts as CTLA-4!

Treats RA

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11
Q

Secukinamab

A

Anti-IL 17

IL23 is produced by chronic gut inflammation and enthesis in enteropathic arthritis & spondyloarthropathies
IL23 -> Th17 -> IL17 -> new bone formation & synovitis

Treats ank spond and psoriatic arthritis

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12
Q

Ustekinumab

A

Anti-p40 subunit of IL12/23

Blocks the IL interaction with receptor on APCs/NK cells blocking intracellular signalling + production of TNF alpha

Treats: Crohns, psoriasis, psoriatic arthritis

SEs:

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13
Q

Anakinra

A

IL-1 receptor antagonist

Treats: Gout and other inflammasome conditions

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14
Q

Belimumab

A

anti-BAFF/BLyS

Inhibits B cell activating factor AKA B Lymphocyte Stimulator

Treats SLE

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15
Q

Vedolizumab

A

Anti-integrin

Selectively binds alpha4beta7 integrin on T cells & blocks interaction with MAdCam-1 on intestinal endothelium inhibits trafficking of T cells to sites of gut inflammation

Treats IBD, few side effects

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16
Q

Trastuzumab

A

Anti-HER2
Ligand dependent
Treats : HER2 + breast and some gastric ca
SE’s: cardiomyopathy

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17
Q

Pertuzumab

A

Anti-HER 1/3/4
Inhibits dimerisation stopping signalling
Given in combo with Trastuzumab

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18
Q

Olaparib

A

PARP inhibitor
PARP protein repairs single strand breaks in DNA, ss -> ds breaks
BRCA 1/2 (tumour suppressor genes) repair ds breaks through homologous recombination
PARPi + BRCA deficient/mutent cells -> cell death

Treats: Breast, Ovarian, Prostate

SE’s Nausea, fatigue, myelosup

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19
Q

Dabrafenib

A

B-RAF inhibitor
Inhibits RAS-RAF-MEK-ERK signalling
Treats: B-RAF(V600E) mutant melanoma (60% of melanomas)
SEs: Fevers, SCC

combine with MEKi to combat resistance

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20
Q

Vemurafenib

A

B-RAF inhibitor
Inhibits RAS-RAF-MEK-ERK signalling
Treats: B-RAF(V600E) mutant melanoma (60% of melanomas)
SEs: Fevers, SCC

combine with MEKi to combat resistance

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21
Q

Trametinib

A

MEK inhibitor
combine with B-RAFi to combat resistance

SEs: fever, nausea, diarrhoea, fatigue, vomiting, arthralgia, rash, HTN

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22
Q

Cobimetinib

A

MEK inhibitor
combine with B-RAFi to combat resistance

SEs: fever, nausea, diarrhoea, fatigue, vomiting, arthralgia, rash, HTN

23
Q

Ipilimumab

A

Anti-CTLA-4
therefore T-cell can’t turn off/down regulate co-stimulation

SEs: rash, colitis, hepatic toxicity

24
Q

Pembrolizumab

A

PD-1 inhibitor

PDL-1 (tumour cell) + PD-1 (t cell) -> check point to down regulate proliferating T cells
PDL1/PDL2 are commonly over expressed on tumour cells and infiltrating lymphocytes
Thus, tumours ‘tun off’ innate immune response

Melanoma, NSCLC, HL

SEs: Pneumonitis (more PD1), liver toxicity, Uveitis, Myocarditis, Hypophysitis, Thyroiditis (PD1), Colitis
Also rash, pruritis, GI sx

25
Q

Nivolumab

A

PD-1 inhibitor

PDL-1 (tumour cell) + PD-1 (t cell) -> check point to down regulate proliferating T cells
PDL1/PDL2 are commonly over expressed on tumour cells and infiltrating lymphocytes
Thus, tumours ‘tun off’ innate immune response

Melanoma, NSCLC, HL

SEs: Pneumonitis (more PD1), liver toxicity, Uveitis, Myocarditis, Hypophysitis, Thyroiditis (PD1), Colitis
Also rash, pruritis, GI sx

26
Q

Ceritinib
Crizotinib
Alectinib

A

ALK inhibitor
ALK oncogene forms by an inversion of ALK gene on chromosome 2 resulting in an oncogene, ALK mutation –> fusion of EML4-ALK produces chimeric protein that drives growth of cancer

Treats: lung adeno (young asian non-smokers)

SEs: Hepatitis, pneumonitis, Mild GI, Bradycardia,

Visual disturbance – fuzzy lines, flickering lines on gaze shift from dark to light but not assoc with any eye pathology

Crazy rich asians get Asian Lung Kancer (ALK)

27
Q

Erlotinib
Gefitinib
Afatinib
Osimertinib

A

EGFR inhibitor (intracellular) TKI

Treats: NSCLC

SEs: acneform rash, diarrhoea, N&V, ILD (esp asians)

28
Q

Cetuximab

A

EGFR inhibitor extracellular

Treats: Met CRC (K-Ras wt), NSCLC (K-Ras mut), head and neck.
(With chemo)

SEs: acne, diarrhoea, pruritis (rash good sign!)

29
Q

Bevacizumab

A

VEGF-A inhibitor

Treats: CRC (with chemo, sensitises)

SEs: HTN, clots, poor wound healing, risk of bowel perf

30
Q

Sunitinib, pazopanib, axitinib

A

VEGF-A inhibitor (TKI)

Treats: Renal cell carcinoma (particularly VHL [Von Hipple Lindau] mutations)

SEs: Hand/foot syndrome (thick rash on hands and feet) and cardio toxicity

31
Q

Sorafenib

A

Multiple molecule TKI
treats: HCC
SEs: hand and foot syndrome

32
Q

Lapatinib

A

4 - anilokinizone inhibitor -
TKI of both EGFR and HER receptors

Treats: crosses BBB - met/refractory HER2+ BrCa, brain mets

SEs: cutaneous ractions - palmar plantar; SJS; reduce LVEF; ILD

33
Q

Imatinib, dasatinib, nilotinib, ponatinib

A

BCR-Abl + cKIT inhibitor

  • t(9:22) Philadelphia chromosome
  • places a promoter region next to a proliferation gene -> results in a tyrosine kinase that is always switched on
  • binds and inactivates the tyrosine kinase

Treats: BCR-Abl in CML & cKIT in GIST

SEs: Resistance

34
Q

Venetoclax

A

BH3 mimetic/anti Bcl2

Bcl-2 inhibits apoptosis, this is raised in CLL. BH3 mimetics inhibit Bcl2 hence prevents the inhibition of apoptosis

Treats: CLL

35
Q

Ibrutinib

A

Bruton’s TKI
pathway required for B cell proliferation

Treats: Waldensroms, MM, CLL, mantle cell

SEs: neutropenia, resp, plt dysfunction, haemorrhage

36
Q

Idelisib

A

PI3Kdelta required in B cell proliferation

Treats: CLL and FL

37
Q

Alemtuzumab

A

Anti-CD52

Treats: MS, CLL (if high risk features, 17p deletion or p53 mutation)

SEs: infections, other longterm autoimmune disease – thyroid especially

38
Q

Blinatumomab

A

BITE - Bispecific T cell engager
Binds CD3 on Tcells to target CD19 on cancer cells

Treats: relapsed/refractory ALL

SEs: cytokine release syndrome (give steroids with it), encephalopathy

39
Q

Brentuximab

A

anti-CD30 antibody drug conjugate

Treats: HL

40
Q

Ruxolitinib

A

JAK-1 and 2 inhibitor

Treats: myelofibrosis - reduce splenomegaly, improving QoL and mortality

SEs: myelosuppression

41
Q

Emicizumab

A

Activated factor XI + X

  • antibody that binds to both factor IX and X, thus, crosslinking the two
  • essentially replaces the function of factor VIII
  • is NOT inactivated by VIII inhibitors/antibodies thus it is used in patients on long term factor replacement that now have antibodies/inhibitors

Treats: Haemophilia A (does not work in B)

42
Q

Elotuzumab

A

Anti-SLAMF7

Inhibits SLAM5F present on MM and NK cells
-must be used in combination with dexamethasome and lenolinomide

Multiply refractory MM

43
Q

Natalizumab

A

Alpha 4 integrin blocker (VCAM)
Inhibits lymphocyte migration into the CNS
Treats MS
SEs JC virus -> PML, hypersensitivity reactions, LFTs

44
Q

Daclizuymab

A

Anti-IL2 / anti-CD 25 - binds to CD25 which is the alpha subunit of IL-2 receptor

Treats: MS, renal transplant induction

45
Q

Basiliximab

A

Anti-IL2 / anti-CD 25 - binds to CD25 which is the alpha subunit of IL-2 receptor

Treats: renal transplant induction

46
Q

Ocrelizumab

A

IS RITUXUMAB
anti-CD20

Treats: PPMS, RRMS

SEs infusion rxn

47
Q

Belatacept

A

Blocks co-stimulation
essentially is CTLA4

Treats: renal transplant induction

48
Q

Eculizumab

A

Anti-C5a

Treats: PNH, atypical HUS, C3GN

SEs: neisseria infections

49
Q

Omalizumab

A

Anti-IgE

Treats: allergic asthma

50
Q

Mepolizumab

A

anti-IL5

Treats: eosinophilic asthma

51
Q

Evolocumab

Alirocumab

A

PCSK9 inhibitor
Blocks the degradation of LDL receptors-> increasing the number of LDL

Treats: hypercholesterolaemia in combi with statin if high risk

52
Q

Romosozumab

A

Sclerosin inhibitor
Sclerosin in an osteoblast inhibitor therefore romo removes the inhibition -> more oesteoblast activity
Treats: osteoporosis

53
Q

Bezlotoxumab

A

Anti-toxin B from C. Diff

Treats: recurrent c diff infection, reduces rate of recurrent infection compared with placebo at 12 weeks, use in combination with antibitoics (NEJM 2017)

FRACP (12 decks)

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