Week 3 Immonosuppresants Flashcards

(59 cards)

1
Q

What are immunosuppressants?

A

A class of drugs that decrease the activity of the immune system in conditions such as autoimmune diseases, organ transplantation, and malignancies.

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2
Q

What is the general effect of immunosuppressants?

A

Dampening of the immune response.

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3
Q

What are biologic agents?

A

Medications derived from living organisms that target particular components of the immune system.

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4
Q

List the primary targets of biologic agents.

A
  • Tumor necrosis factor (TNF)
  • Interleukins (ILs)
  • B- or T-cell activity
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5
Q

What do calcineurin inhibitors do?

A

They halt the activity of calcineurin, a phosphatase involved in T-cell activation.

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6
Q

What is the role of corticosteroids?

A

They interfere with the cell cycle of inflammatory cells and modify the activity of other immune components.

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7
Q

What do mTOR inhibitors do?

A

They are proliferation signal inhibitors that reduce immune-cell proliferation.

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8
Q

What types of conditions are treated with immunosuppressants?

A
  • Autoimmune conditions
  • Organ transplant rejection
  • Malignant diseases
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9
Q

What is the mechanism of action of B-cell inhibitors?

A

They reduce inflammation and decrease immune response by decreasing antibody production, antigen presentation, T-cell activation, and proinflammatory cytokine production.

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10
Q

Name a few B-cell inhibitors.

A
  • Belimumab
  • Ocrelizumab
  • Rituximab
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11
Q

What is the mechanism of action for IL-1 inhibitors?

A

They block the IL-1 receptor or inhibit IL-1beta.

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12
Q

List some IL-6 inhibitors.

A
  • Sarilumab
  • Tocilizumab
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13
Q

What are tumor necrosis factor inhibitors?

A

Agents that bind to tumor necrosis factor (TNF) and block its interaction with TNF receptors.

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14
Q

What are the adverse effects of TNF inhibitors?

A
  • Infections
  • Malignancy
  • Heart failure
  • Demyelinating disease
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15
Q

What is the mechanism of action of T-cell inhibitors?

A

They inhibit T-cell activation by blocking the interaction between CD28 on T cells and CD80/CD86 on antigen-presenting cells.

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16
Q

Give examples of calcineurin inhibitors.

A
  • Cyclosporine
  • Pimecrolimus
  • Tacrolimus
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17
Q

What are the indications for corticosteroids?

A
  • Allergic/respiratory conditions
  • Dermatologic conditions
  • Endocrinologic conditions
  • Gastroenterologic conditions
  • Hematologic conditions
  • Ophthalmologic conditions
  • Rheumatologic conditions
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18
Q

What are some common adverse effects of corticosteroids?

A
  • Cardiovascular issues
  • Skin atrophy
  • Hyperglycemia
  • Adrenal suppression
  • Osteoporosis
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19
Q

Fill in the blank: Calcineurin inhibitors target _______.

A

[calcineurin]

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20
Q

True or False: Corticosteroids can be used for the treatment of uveitis.

A

True

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21
Q

What is the effect of IL-17 inhibitors?

A

They target IL-17 to reduce inflammation in conditions like plaque psoriasis and psoriatic arthritis.

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22
Q

List some adverse effects of mTOR inhibitors.

A
  • Infections
  • Nephrotoxicity
  • Hyperlipidemia
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23
Q

What is the role of biologic agents in treating autoimmune diseases?

A

They specifically suppress components or pathways of the immune system.

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24
Q

What is the significance of the nomenclature for biologic agents?

A

Names indicate their structure and origin, such as ‘-mab’ for monoclonal antibodies.

25
What is hyperglycemia?
Elevated blood glucose levels ## Footnote Often associated with diabetes mellitus.
26
Define diabetes mellitus.
A group of diseases that affect how the body uses blood sugar (glucose).
27
What is adrenal suppression?
Decreased production of adrenal hormones.
28
List some Cushingoid features.
* Moon facies * Buffalo hump * Central obesity * Skin changes
29
What is the consequence of growth suppression in children?
Impaired growth and development.
30
What gastrointestinal condition is associated with corticosteroids?
Peptic ulcer.
31
What are common genitourinary effects of corticosteroids?
Menstrual irregularities.
32
List musculoskeletal effects of corticosteroids.
* Aseptic necrosis of the humeral head/femoral head * Susceptibility to fractures * Myopathy * Osteoporosis
33
Identify neurologic and psychiatric effects of corticosteroids.
* Headache * Idiopathic intracranial hypertension * Paresthesia * Seizures * Vertigo * Psychosis * Agitation * Insomnia
34
What ophthalmic conditions can arise from corticosteroid use?
* Glaucoma * Cataracts
35
What is a common consequence of corticosteroid therapy?
Impaired wound healing.
36
What are the contraindications for corticosteroids?
* Hypersensitivity to the drug or its components * Recent administration of live or live attenuated vaccines * Uncontrolled active infections * Uncontrolled diabetes * Uncontrolled psychotic states * Uncontrolled hypertension * Peptic ulcer
37
True or False: Corticosteroids enhance the adverse effects of live vaccines.
True.
38
What effect do corticosteroids have when used with NSAIDs?
Increased risk of GI ulcers and bleeding.
39
How do corticosteroids affect warfarin?
They increase anticoagulant effects.
40
What are mTOR inhibitors?
Medications that reduce the activity of mTOR serine/threonine kinase.
41
What is the role of the mTOR signaling pathway?
Involved in cell growth, metabolism, and immune cell proliferation.
42
List the drugs classified as mTOR inhibitors.
* Everolimus * Temsirolimus * Sirolimus
43
What are the two complexes formed by mTOR?
* mTORC1 * mTORC2
44
What is the pharmacokinetics of everolimus?
* Oral * Rapid absorption * 74% protein-binding * Half-life: approximately 30 hours * Hepatic metabolism * Excretion: mostly in feces
45
What are the indications for everolimus?
* Renal cell carcinoma * Prevention of transplant rejection * Tuberous sclerosis complex-associated partial-onset seizures * Neuroendocrine tumors * Breast cancer
46
What adverse effects are associated with mTOR inhibitors?
* Serious infections * Pulmonary toxicity * Angioedema * Increased lipid levels * Secondary malignancy
47
What is azathioprine?
A prodrug of mercaptopurine used for immunosuppressive therapy.
48
What is the mechanism of action of azathioprine?
Inhibits purine synthesis, reducing cell proliferation.
49
List indications for azathioprine.
* Prevention of transplant rejection * Rheumatoid arthritis * Off-label: Crohn's disease, psoriasis
50
What are common adverse effects of azathioprine?
* Alopecia * Myelosuppression * GI toxicity * Hepatotoxicity * Increased infections
51
What is the mechanism of action of cyclophosphamide?
Alkylating agent that binds alkyl groups to DNA.
52
What are the indications for hydroxychloroquine?
* Systemic lupus erythematosus (SLE) * Rheumatoid arthritis (RA)
53
What is the mechanism of action of methotrexate?
Inhibits dihydrofolate reductase, decreasing DNA synthesis.
54
What are the indications for mycophenolate?
To prevent organ transplant rejection.
55
What is thalidomide used for?
* Multiple myeloma * Erythema nodosum leprosum
56
List common drug interactions for leflunomide.
* Activated charcoal and cholestyramine * Immunosuppressive drugs * Vaccines
57
What is the general mechanism of cytotoxic agents?
Interfere with nucleic acid and protein synthesis.
58
What class of drugs does methotrexate belong to?
Antimetabolite agents.
59
List common indications for immunosuppressive agents.
* Rheumatoid arthritis * Inflammatory bowel disease * Transplant rejection