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41 Cards in this Set
- Front
- Back
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Aldeleuikin
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-Immunostimulant IL-2
-T cell and NK cell activation -Used for renal cell carcinoma and metastatic melanoma |
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IFN-alpha
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-immunostimulator
-activates NK cells, antiviral, and oncostatic -Used for Hep B, Hep C, Kaposi's sarcoma, leukemia, melignant melanoma |
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IFN-beta
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-immunostimulatory
-antiviral, oncostatic, activates NK cells -used for relapsing multiple sclerosis |
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IFN-gamma
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-immunostimulatory
-activates macrophages, CD4s, CD8s, NK cells, and APCs -used for chronic granulomatous diseases |
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Filgrastrim
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-immunostimulatory
-G-CSF -increases granulocytes and myeloid cells |
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Sargramostin
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-immunostimulatory
-GM-CSF -increases granulocytes, myeloid cell, monocytes, and eosinophils |
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Oprelvekin
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-IL-11
-stimulates platelet production |
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TNF alpha
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-Activates macrophages
-used for melignant melanoma and soft tissue sarcomas |
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Immune Globulin Intravenous (IgIV)
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-Preparation of Ig pooled from a large population of donors
-Used as "normalizing serum" for humoral deficiencies at low doses -At high doses, used for Kawasaki syndrome, severe asthma, some AI disorders |
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Rho Immunoglobulin
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-Concentrated solution of human IgG anti-Rho(D) antigen on RBCs
-Prevents sensitization of Rho negative mother to Rho positive infant -Administered to mother within 24 to 72 hours after birth |
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Hyperimmune Immunoglobulin
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-Immunoglobulin prep from pools of selected human or animal donors that have a high titer to particular Ags, such as CMV or respiratory syncitial virus
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Glucocorticoids (prednisone)
-MOA |
-inhibit gene expression, decreasing innate and adaptive immune responses
-down regs TNFa and IL expression -Inhibits PLA2, decreasing eicosanoid, PAF, seratonin, and bradykinin production -Effects mostly T cells, but also decreases primary and secondary antibody responses |
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Glucocorticoids
-Uses |
-Solid organ transplant
-Hematopoietic stem cell transplants -Rheumatoid arthritis -SLE -attentuating allergic RXns |
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Glucocorticoids
-Adverse effects |
-Taper off because can lead to adrenal insufficiency
-Cushings Syndrome -mood swings -diabetes -reduced resistance to infections -osteoporosis -cataracts -weight gain -hypertension |
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Azothioprine
-MOA |
-Prodrug non-enzymaticaly converted to Mercaptopurine by reacting with GSH
-Inhibits purine synthesis -Cytotoxic and depletes expanding lymphocytes |
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Azothioprine
-Uses |
-kidney transplant
-autoimmune diseases |
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Azothioprine
-Adverse effects |
-Bone marrow suppression and leukopenia
-rash -hepatotoxicity -GI disturbances -Degraded by XO; Taking with allopurinol increases azothioprine levels |
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Mycophenolate Motefil (MMF)
-MOA |
-Converted to mycophenolic aci by pseudoesterase
0Inhibits inosine monophosphate DH II, which inhibits purine synthesis more selectively than azothioprine -cytostatic to lymphocytes and causes apoptosis |
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Mycophenolate Motefil
-Adverse effects |
-Headache
-Hypertension -GI distrubances |
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Mycophenolate Motefil
-Uses |
-More specific to lymphocytes and more efficacious in preventing organ rejection than azothioprine
-Autoimmune diseases |
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Cyclosporine (Cyclosporin A)
-MOA |
-Binds cyclophilin and as a complex inhibits calcineurin...
-calcineurin is a Ca/calmodulin dependent phosphatase that dephosphorylates NFAT...dephosph NFAT then incerases IL-2 gene transcription -Therefore Cyclosporin decreases IL-2 production, and is highly specific to T cells |
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Cyclosporine (Cyclosporin A)
-Uses |
-Wide variety of organ transplants
-Graft vs. Host disease in combination with corticosteroids -psoriasis -Rheumatoid arthritis |
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Cyclosporine (Cyclosporin A)
-Adverse effects |
-#1=nephrotoxicity; dose dependent, caused by vasoconstriction...need to monitor cyclosporin blood levels and Cr clearance
-HPTN -Hyperlipidemia -Neurotoxicity: tremor and seizures -Hepatotoxicity -Increased risk of viral infection -Increased risk of lymphoma -Metabolized by cyt P450 -Can prevent dose-dependent effects by using it with synergistic drugs (sirolimus/rapamycin) |
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Tacrilomus (FK506)
-MOA |
-Macrolide antibiotic
-Inhiits calcineurin by binding to FKBP -Decreases IL-2 synthesis, but 10-100X more potent than cyclosporine |
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Tacrilomus
-Uses |
-wide variety of organ transplants
-standard prophylactic agent for graft vs. host disease -topically for atopic dermatitis (eczema) -topically for psoriasis -Rheumatoid arthritis |
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Tacrilomus
-Adverse effects |
-same as cyclosporin, but more severe because more potent and soluble
-#1=nephrotoxicity; need to monitor kidney function -HPTN -hyperlipidemia -hepatotoxicity -metabolized by cyt P450 -increased risk of viral infection and lymphoma |
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Sirolimus (rapamycin)
-MOA |
-binds to FKBP like tacrilomus, but inhibits mTOR...this arrests lymphos in G1 phase and inhibits IL-2 translation
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Sirolimus (rapamycin)
-Uses |
-Prevention of transplant rejection
-prevents smooth muscle proliferation around stents |
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Sirolimus (rapamycin)
-Adverse effects |
-Hyperlipidemia
-Leukopenia -Thrombocytopenia -hepatotoxicity -NOT nephrotoxic -metabolized by cytP450 |
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OKT3 (Muromonab)
-MOA |
mouse mAb against CD3 on CD4 and CD8 cells, which activates complement to kill them
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OKT3 (Muromonab)
-Uses |
Induction/preparation for organ transplants
-prevention of acute rejection -depletion of T cells from donor bone marror |
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OKT3 (Muromonab)
-Adverse effects |
-Major transient immunosuppresion
-May cause "cytokine release syndrome" within first few doeses: fever, myalgia, nausea, diarrhea |
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ATG and ALG
-MOA |
-polyclonal animal Abs against thymocytes (ATG) or lymphocytes (ALG)
-deplete long lived peripheral lymphocytes, has little effect on B cells |
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ATG and ALG
-Uses |
-Induction and prevention of acute transplant rejection
-Depletion of donor T cells from donor bone marrow |
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ATG and ALG
-adverse effects |
-cytokine release syndrome within first few doses: fever, myalgia, nausea, diarrhea
-profound, transient immunosuppression |
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Daclizumab
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-anti-CD25 antibody (CD25=IL-2 receptor)
-Inhibits already activated T cells (CD25 only present on activated T cells) -Used for induction and acute rejection prevention |
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Belatacept
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-CTLA-4 (CD28) linked to IgG: binds B7 on APC and prevents co-stimulation
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Drugs used for induction
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-Daclizumab
-anti-CD3 (OKT3) -ATG |
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Drugs used for acute rejection
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Calcineurin inhibitor (Tacrilomus and cyclosporine) PLUS cell cycle inhibitor (MMF or sirolimus PLUS/MINUS corticosteroids
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Drugs used for graft vs. host disease
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-start with high dose steroids
-add MMF, sirolimus, tacrolimus, Daclizumab |
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Drugs used for chronic rejection
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Can't prevent chronic rejection
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