Immunopharm

Front 1

Glucocorticoids- Class, MOA, Use

Back 1

Class: immunosuppressive
MOA: 1. decrease PG, LT, and cytokine synth
2. IgG antibody catabolism
- at cell level, inhibit T cell prolif, and at higher levels cytotoxic to T cells
Use: transplantations and autoimmune dz

Front 2

Glucocorticoids- Tox

Back 2

- adrenal suppression, decrease growth, muscle wasting, osteoporosis, salt retention, glucose intolerance, and psychoses

Front 3

Immunophillin ligands- drug names, gen MOA, Use

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- cyclosporin and tacrolimus, and sirolimus
Gen MOA: small cytoplasmic proteins that play roles in T cells responses to TCR activation and cytokines, ligands bind these immunophilins
Use: transplantation of solid organs and bone marrow, autoimmune disease- RA< uveitis, psoriasis, asthma, and DM1

Front 4

Cyclosporine and tacrolimus- MOA,

Back 4

MOA: binds intracell cyclophillin and tacrolimus binds FK binding protein, both forming a complex. The complex inhibits calcineurin- (serine phosphtases that regulate the ability of NFAT to translocate to nucleus)-- results in inhibition of cytokine production

Front 5

Cyclosporine and tacrolimus- PK, AE

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PK: cyclosporine-- slow hepatic metabolism via P450 drug intxn, thus long half life
AE: NEPHROTOX, NEUROTOX, htn, hyperglycemia, hyperlipidemia, cholelithiasis

Front 6

Sirolamus- MOA, AE

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MOA: binds FK binding protein- forms complex that inhibits T cell RESPONSE to cytokines
AE: HYPERtriglyceridemia, hepatotox, diarrhea, myelosuppresion
Class: immunophilins

Front 7

Cytotoxic agents- Drug names, MOA

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Drugs- cyclophosphamide, azthioprine, cytarabine, dactinomycin, methotrexate, vincristine
MOA: transformed by liver enzymes to alkylating agent- acrolein, cytotoxic to proliferating lymphoid cells (B>T)

Front 8

Cyclophosphamide- MOA, AE, Use

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MOA: transformed by liver enzymes to alkylating agent- cytotoxic to proliferating lymphoid cells (B>T)
AE: pancytopenia, HEMORRHAGIC CYSTITIS
Use: transplantation- bone marrow and organs, autoimmune disease and AB induced RBC aplasia

Front 9

Azthioprine- MOA, AE, Use

Back 9

MOA: prodrug that is transformed into mercaptopurine, converted by HGPRT to toxic nucletides-- cytotoxic to proliferrating lyphoid cells- (T>B)
AE: myelosuppression, HYPERURICEMIA
Use: transplantation- renal homografts, autoimmune dz- SLE, RA

Front 10

Leflunomide- Class, MOA, AE, Use

Back 10

MOA: inhibits dihydro-orotic acid dehydrogenase- used in pyrimidine synthesis-- arrests lymphocytes in G1 phase
Class: enzyme inhibitor
Use: RA
AE: liver, renal, CV, tetratogenic

Front 11

Mycophenolate mofetil- MOA, AE, Use

Back 11

MOA: converted to active mycophenolic acid- inhibits inosine monophosphate dehydrogenase-- used in de novo synthesis of purine. Lymphocytes particularily susceptible b/c lack enzymes for alt salvage pathways
AE: myelosuppression, GI
Use: transplantation, successful as sole agent, used in combo w/ cyclosporine to reduce cyclosporines nephro tox

Front 12

Etanercept- MOA, Class, AE, Use

Back 12

MOA: soluble human TNF receptor that binds and competes for TNF alpha, decreases further release of IL and adhesion molecs involved in leukocyte activation
AE: injection site rxn and HSR, increased rate of serious infection and lymphoma
Use: RA, psoriatic arthritis

Front 13

Infliximab- MOA, AE, Use

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MOA: humanized anti TNF alpha mAb that DIRECTLY binds to TNF alpha
AE: infusion rxn, increased rate of infection
Use: RA, psoriatic arthritis, Crohns, UC, ank spodylitis
Class: anti TNF alpha

Front 14

Adalimumab- MOA, Use

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MOA: completely human anti TNF alpha IgG mAb
Use: RA

Front 15

Thalidomide- MOA, AE, Use

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MOA: Many immune effects, suppress TNF, increase IL-10, inhibits angiogenesis, decreasesd phagocytosis, enhanced CMI
AE: teratogenesis-- flipper baby
Use: leprosy, immune dz, apthous ulcers, AIDS wasting

Front 16

Antilymphocyte globulin and antithymocyte globulin- MOA, AE, Use

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MOA: anti sera from horse/sheep, bind to T cells and initiate their destruction via complement
AE: hsr rxn- serum sickness, anaphyl, lymphoma= late complication
Use: transplantation- BEFORE bone marrow transplant to prevent GVHD and in combo w/ bone, heart, and renal transplants

Front 17

Rhogam- MOA, Use

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MOA: blocks B cell response against RH antigen by blocking antigen recognition
Use: given to Rh - mothers to prevent hemolytic dz of the newborn in subsequent pregnancies

Front 18

Muromonab-CD3- MOA, AE, Use

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MOA: binds co receptor, CD3 antigen on thymocyte surface and mature T cells-- blocks killing by cytotoxic T cells
AE: fever chills, dyspnea, pulm edema, and HSR
Use: renal transplantation

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Basiliximab & daclizumab- MOA, Use

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MOA: mAb against IL-2 receptor alpha chain on T cells-- prevent T cell activation by IL-2
Use: renal transplantation in combo w/ others

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Aldesleukin- MOA

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Recom IL- 2, promotes production of cytotoxic T cells and NK cells

Front 21

Filgrastin- MOA

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GCSF for granulocytes

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Sargramostim- MOA

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GM-CSF fro granulocytes/monocytes/eosinophils

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Erythropoietin- MOA

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Stims RBC prod

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Oprelvekin- MOA

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- IL-11 to increase megakaryocytes and platelets for thrombocytopenia

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Thrombopoietin- MOA

Back 25

- stims plt production

Front 26

IFN-alpha

Back 26

- endog glycoprots w/ natural anti cancer acticity

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IFN beta-

Back 27

- beneficial in relapsing MS

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IFN gamma-

Back 28

- increases synth of TNF- decreases infections in pts w/ chronic granulomatous dz- phag def of NADPH