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28 Cards in this Set
- Front
- Back
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general uses of immunosupressants?
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organ transplantation
treatment of autoimmune disorders prevention of Rh hemolytic dz of newborn |
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examples of immunosuppressant drugs?
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corticosteroids
calcineurin inhibitors proliferation signal inhibitors mycophenolate mofetil thalidomide cytotoxic drugs antibodies |
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cyclosporine mechanism?
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binds cyclophilin --> inhibits phophatase activity of calcineurin and consequent T cell activation via IL-2 production
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cyclosporine adverse effects?
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nephrotoxicity
hirsutism gingival hyperplasia hypertension neurotoxicity hepatotoxicity hyperkalemia hyperglycemia increased risk of infections and malignancies |
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drugs necessitating drug monitoring?
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cyclosporine
tacrolimus sirolimus |
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tacrolimus mechanism?
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binds FKBP --> inhibit phosphatase activity of calcineurin --> block IL-2 transcription and consequent T cell activation
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tacrolimus adverse reactions?
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renal
hypertension neurotoxicity hyperglycemia hyperkalemia gi problems increased risk of infections and malignancies |
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sacrolimus mechanism?
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binds FKBP --> inhibitor of mTOR --> inhibition of IL-2 driven T cell proliferation
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mTOR?
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mammalian target of rapamycin
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sacrolimus adverse effects?
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hyperlipidemia
myelosuppression (esp thrombocytopenia) increased risk of infections and maliganancy |
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mycophenolate mofetil mechanism?
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converted to active metabolite;
inhibits de novo pathway of guanine nucleotide synthesis by inhibiting inosine monophosphate dehydrogenase |
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inhibits inosine monophosphate dehydrogenase and consequence?
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mycophenolate mofetil;
decreased guanine |
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why is mycophenolate mofetil somewhat specific to lymphocytes?
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lymphocytes rely on de novo synthesis of guanine, whereas other cells are more dependent on salvage pathways
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mycophenolate mofetil adverse effects?
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teratogenic
gi leukopenia increased risk of infections and malignancies |
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thalidomide mechanism?
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immunomodulator
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thalidomide adverse effects?
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severe human teratogenicity
peripheral neuropathy venous thromboembolic events |
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STEPS?
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system for thalidomide education and prescribing safety: restricted distribution program for thalidomide which has many requirements for prescribers, pharmacists, and patients
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cytotoxic immunosuppressants?
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azathioprine
cyclophosphamide etc |
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azathioprine?
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converted to 6-MP
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use of antithymocyte globulin?
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transplantation
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muromonab-CD3?
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binds to CD3
for renal transplantation rejection episodes |
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basiliximab?
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binds IL-2 receptor (CD25)
renal transplantation |
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daclizumab?
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binds IL-2 receptor (CD25)
renal transplantation |
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adalimumab?
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binds TNF
rheumatoid arthritis, other |
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etanercept?
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binds TNF
rheumatoid arthritis, other |
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infliximab?
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binds TNF
rheumatoid arthritis, other |
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immunomodulation therapy used for?
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immunodeficiency
chronic infections cancer |
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immunomodulation therapy?
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aka immunostimulants
cytokines (IFNs, IL-2, etc) |
