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46 Cards in this Set
- Front
- Back
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What type of immunity responses are most effectively suppressed?
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Primary
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What are some limitations of immunosuppressive therapy?
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> risk of infections and of lymphomas
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What are the primary uses of immunosuppression?
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AI, Transplants and hemolytic anemia of the newborn
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What drugs may you use in a BM transplant?
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Cyclosporine or prednisone or ALG
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What is the drug of choice in AI diseases?
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Prednisone
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What are the 2 classes of steroids?
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Corticosteroids and androgens
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What type of activity does cortisol have?
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Glucocorticoids (carb metabolism)
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What type of activity does Aldosterone have?
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Mineralocorticoid (electrolyte balance)
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What types of activity does a glucocorticoid have?
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carb metabolism
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What type of activity does a minearlocorticoid have?
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electrolyte balance
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What steroid exhibits sodium retention?
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Aldosterone
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What steroid exhibits liver glycogen deposition and atni-inflammatory effects?
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Cortisol
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What type of drug is Betamethasone?
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Synthetic steroid used for anti-inflammatory
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What type of drug is Dexamethasone?
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Synthetic steroid used for anti-inflammatory
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What type of drug is Methylpredisolone?
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Synthetic steroid used for anti-inflammatory
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What type of drug is Prednisone?
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Synthetic steroid used for anti-inflammatory
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What 2 synthetic steroids have the longest duration?
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Betamethasone and Dexamethasone
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How are glucocorticoids metabolized and excreted?
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Met in liver, ex in kidney
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What type of receptors are steroid receptors?
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NOT plasma membrane
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What effect do glucocorticoids have on PMNs?
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< adherence capabilities
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What effect do glucocorticoids have on Lymphocytes?
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Move them to extravascular compartments (DO NOT lyse them)
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What is a risk of polonged, high-dose therapy suddenly stopped?
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Adrenal insufficiency
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How does cyclosporine work?
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binds to the cytoplasmic receptor protein cyclophilin, inhibiting calcineurin activity
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What type of drug is Cyclosporine
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Calcineurin Inhibitors
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What type of drug is Tacrolimus (FK506)
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Calcineurin inhibitors
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Where is cyclosporine met?
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liver
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What is often used for long term therapy for transplantation?
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Cyclosporine
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What is an adverse effect of Cyclosporine and Tacrolimus?
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renal toxicity
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How does Tacrolimus work?
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Binds to cytoplasmic receptor prtoein FKBP
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Which Calcineurin inhibitor is most potent?
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Tacrolimus
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How do Antrproliferative/Antimetabolic drugs (Sirolimus, Mycophenolate Mofetil) work?
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Prevent the clonal expansion of B and T lymphocytes
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What drug may cause a dose dependent > in cholesterol and TG?
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Sirolimus
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What drug is often used in combo therapy for organ transplant rejection>
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Sirolimus
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What drug has a metabolite that is an inhgibitor of IMPDH, an important enzyme in the de novo pathway of guanine nucleotide synthesis?
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Mycophenolate Mofetil
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What type of toxicity does Mycophenolate Mofetil display?
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Hematologic and GI
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Sirolimus displays nephrotoxicity when combined with what drug?
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Cyclosporine
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How does ATG work?
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Binds to thymocytes in the circulation resulting in lymphopenia and impaired T cell response
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What is the primary toxicity of ATG?
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serum sickness and nephritis
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What is used primarily to preven t acute rejection of kindey, liver and heart transplants?
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Muromonab-CD3
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What binds to the CD3 glycoprotein of a TCR?
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Muromonab
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What type of drug is muromonab?
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Ab
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What is the major concern with using muromonab>
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Cytokine release syndrome
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What may prevent cytokine release syndrome?
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Administration of glucocorticoids prior to Muromonab adminsitration
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What type of drug are daclizumab or Basilizimab?
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Ab
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How do Daclizumab or Basilizimab work?
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Anti-IL-2 receptor
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What may occur with Daclizumab or Basiliximab?
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Anaphylaxis but NOT cytokine release syndrome
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