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17 Cards in this Set
- Front
- Back
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azathioprine (Imuran)
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inhibits purine synthesis. (metablized to mercaptopurine) incorporates into DNA as thio-guanine nucleotide. Inactivated by xanthine oxidase. Uses: renal or other transplant, autoimmune diseases. Adverse: myelosuppression, nausea, vomiting
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cyclophosphamide (Cytoxan)
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crosslinks DNA, effectively killing proliferating cells (prevents expansion of ag specific lymphocytes) uses: autoimmune diseases, bone marrow transplant. Adverse: myelosuppression, nausea, vomiting, infertility
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leflunomide (Arava)
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inhibits pyrimidine synthesis. (metabolized to A7701726) inhibits dihydroorotate dehydrogenase. Enterohepatic recirculation gives 19day½life. Uses: rheumatoid arthritis, some autoimmune diseases. Adverse: diarrhea, hepatotoxicity, milder myelosuppression
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methotrexate
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inhibits purine and thymidine synthesis. Inhibits dihydrofolate reductase (DHFR). Uses: 1st line drug for rheumatoid arthritis. Auto-immune diseases. Adverse: nausea, mucosal ulcers, hepatotoxicity, milder myelosuppresion
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mycophenolate mofetil (Cell-cept)
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inhibits purine synthesis. (hydrolyzed to mycophenolic acid) inhibits inosine monophosphate dehydrogenase. Uses: solid organ transplant (alt. to cyclosporine), some autoimmune diseases. Adverse: myelosuppresion, nausea, vomiting
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prednisone
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anti-inflammatory and immunosuppressive. Induces transcription of annexins. Repressess transcription of Il-1,2,3,5, TNF, IFN, GM-CSF and others (lower Th mediated responses, reduce recruitment of leukocytes. Uses: solid organ and hematopoietic stem cell transplantation. Adverse: cushing's, glucose intolerance, susceptible to infection, osteoporosis, hypertension
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sirolimus (rapamycin, Rapamune)
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prevents cytokine induced growth by inbiting mTOR (2nd messenger in IL-2 signaling pathway) Uses: preserve solid organ transplants, steroid-resistant. Adverse: profound myelosuppresion (block necessary IL-2 cytokine action) and hepatoxicity. Antagonizing to tacrolimus, synergistic with cyclosporine
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cyclosporine (Sandimmune)
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prevents cytokine expression (IL-2). Inhibits calcineurin from dephosphorylating NF-AT. Uses: kidney, liver, cardiac transplants, autoimmune disorders, asthma? Adverse: nephrotoxicity, hypertension, hyperglycemia, liver dysfxn. Synergistic with sirolimus
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tacrolimus (FK506, Prograf)
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prevents cytokine expression (IL-2). Inhibits calcineurin from dephosphorylating NF-AT. Uses: kidney, liver, cardiac transplants, autoimmune disorders, asthma? Adverse: nephrotoxicity, hypertension, hyperglycemia, liver dysfxn. Antagonizing to sirolimus. more potent than Cyclosporine
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anti-lympthocyte globulin (Atgam)
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blocks tcell surface receptors and opsonizes tcells. Adverse: cytokine release syndrome, serum sickness (horse, rabbit, sheep, goat made). Use: prolonged T cell depletion.
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muromonab-CD3 (OKT3)
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anti-CD3 Ab (mouse monoclonal). Blocks/opsonizes TCR (more specific than Ab to general surface proteins). Use: Tcell depletion. Adverse: massive cytokine release on intial binding. Reuse limited bcuz its mouse made
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basiliximab (Simulect)
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anti IL-2 receptor humanized antibody (blocks/opsonizes alpha-chain of IL-2 receptor (CD25) on ACTIVATED tcells
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daclizumab (Zenapax)
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anti IL-2 receptor humanized antibody (blocks/opsonizes alpha-chain of IL-2 receptor (CD25) on ACTIVATED tcells
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Rh(D) immune globulin (BayRho-D, WinRho SDF)
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hemolytic disease prevention
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interleukin-2 (Aldesleukin)
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increaseed proliferation of activated T-cells, production of IFNγ, increased cytotoxic killer cell activity. Uses: tx of metastatic melanoma and renal cell carcinoma. Adverse: capillary leak syndrom, hypotension, reduced organ perfusion
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IFN-γ (Actimmune)
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stimulates cell mediated cytotoxic immune response. Use: treating severe recurrent infections
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BCG
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Live attenuated bacillius calmette-guerin. Increases APC activity.
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