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60 Cards in this Set

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Name 7 groups of immunosuppressive drugs
CORTICOSTEROIDS

Immunophilin ligands

Mycophenolate mofetil

Thalidomide

CYtotoxic agents

Antibodies

Monoclonal antibodies
Immunosuppressive drug with LYMPHOLYTIC properties
Corticosteroids
Drug of choice for idiopathic thrombocytopenic purpura (ITP), autoimmune hemolytic anemia, acute glomerulonephritis, autoreactive tissue disorders and transplants (renal, heart, liver and BM)
PREDNISONE
First line immunosuppressive therapy for solid organ recipients and hematopoietic stem cell transplant recipients
Prednisone
This drug can potentially cause osteoporosis, glaucoma, hyperglycemia, hypertension, hypothalamic -pituitary axis suppression, adrenal insufficiency and peptic ulcerations, opportunistic infections, retention of Na, H2O, cataracts, muscle weakness or withdrawal, growth hormone inhibition and delayed wound healing
Glucocorticoids
Name immunophilin ligands (3)
Cyclosporin

Tacrolimus

Sirolimus
Peptide antibiotic used in organ transplantations, treatment of graft vs host disease after hematopoietic stem cell transplant and autoimmune disorders
Cyclosporin
MOA of cyclosporin
Binds to CYCLOPHILIN which forms a complex that inhibits CALCINEURIN which is necessary for activation of T cell specific transcription factor (NF-AT)
Name drugs which increase cyclosporine blood levels
Diltiazem
erythromycin
ketoconazole
danazole
methyltestosterone
BCP
Drugs that decrease half life and blood levels of cyclosporine
Carbamazepine
Isoniazid
Rifampin
Phenobarbital
Phenytoin
This immunosuppressive drug induces renal,liver toxicity, HTN, hyperglycemia, hyperkalemia, altered mental status, seizures and hirsutism
Cyclosporin
Increased incidence of lymphoma and other cancers have been observed in transplant patients on _
Cyclosporine
Immunosuppressive drug which can promotes tumor invasion and metastasis by inducing TGF beta
Cyclosorine
Drug of choice for transplants of kidney, liver, pancrease and HEART!!!
Cyclosporin
Which autoimmune disorders are indication for treatment with cyclosporin
Uveitis
RA
Psoriasis
Macrolide antibiotic with similar MOA as cyclosporine

Molecular target?

How is it compared to cyclosporin
Tacrolimus

Molecular target --> FK binding protein --> inhibition of calcineurin
Used in organ and stem cell transplants, effective therapy for prevention of rejection even after failure of standard rejection therapy including T cell antibodies
Tacralimus
STANDARD PROPHYLACTIC AGENT *usually in combination with MTC or mycophenolate for graft vs host disease
Tacrolimus
How is MOA SIROLIMUS is different from cyclosporine and TACROLIMUS
Doesnt block IL production by activated T cells but BLOCKS THE RESPONSE OF T CELLS TO CYTOKINES
What is the main toxicity of SIROLIMUS
Profound myelosuppression especaially thrombocytopenia
- Used for solid organ transplants for REFRACTORY REJECTION, in combination with prednisone, can be used as ALTERNATIVE TO CYCLOSPORINE OR TACROLIMUS in patients who do not tolerate those drugs
Also used for PROPHYLAXIS of graft vs host disease
Mycophenolate Mofetil
Name cytotoxic agnets (5)
Azathioprine

Cyclophosphamide

Leflunomide

Hydroxychloroquine

Other - vincristine, MTX, cytarabine, pentostatin
MOA Azathioprine
Antimetabolite derivative of 6-mercaptopurine that interferes with the metablolism and synthesis of nucleic acid.
Main SE
BM suppression (leukopenia)
Skin rashes
Fever
N/V/D
GI at high doses
Liver dysfunction
ONE OF THE MOST EFFICACIOUS IMMUNOSUPPRESSIVE DRUGS, alkylating agent

Name drug and MOA
CYCLOPHOSPHAMIDE - destroys proliferating lymphoid cells but also appears to alkylate some resting cells
Cytotoxic drug causing considerable risk of pancytopenia and hemorrhagic cystitis at high doses
Cyclophosphamide
Patient is on cytotoxic drug - presents with thinned or brittle hair, darkened and thickened skin, acne and loss of appetite
CYCLOPHOSPHAMIDE
Drugs that increase toxicity of cyclophosphamide
Allopurinol
Barbiturates
Digoxin
Cytotoxic agent that has LONGEST HALF LIFE (several weeks)
Leflunomide
MOA of Leflunomide
Inhibitor of pyrimidine synthesis
Clinical use of Leflunomide
RA
This cytotoxic drug can potentially elevate liver enzymes with some risk of liver damage, renal impairment, teratogenic effects and incidence of angina/tachycardia
Leflunomide
Antimalarial drug with immunosuppressive properties
Hydroxychloroquine
Adenosine deaminase inhibitor primarily used for LYMPHOID MALIGNANCIES, now frequently used for steroid resistant graft vs host disease after allogenic stem cell transplant
PENTOSTATIN
Muromonab is against which marker
CD3
MAIN SE of Muromonab
CYTOKINE RELEASE SYNDROME (fever, dyspnea, wheezes, headache, hypotension)
This drug should be administered in hypervolemic patients - can cause pulmonary edema
MUROMONAB
What can you do to avoid cytokine release syndrome associated with muromonab
Premedicate with steroid (first 2 doses only), acetaminophen and diphenhydramine
This medication is effective against KAWASAKI DISEASE
IGIV
This drug is used for treatment of B CELL CLL in patients who have been treated with alkylating agents and have failed fludarabine therapy
ALEMTUZUMAB
Alemtuzumab targets _
CD52
ANTIANGIOGENIC DRUG that inhibits growth of blood vessels (angiogenesis) in tumors
Bevacizumab
Bevacizumab targets _
VEGF - vascular endothelial growth factor
FIRST LINE TREATMENT OF PATIENTS WITH METASTATIC COLORECTAL CANCER alone or in combination with 5-FU based chemotherapy
BEVACIZUMAB
Indicated for use in patients with METASTATIC COLORECTAL CANCER whose tumors overexpress EGFR
CETUXIMAB
Target of Cetuximab
EGFR - epidermal growth factor receptor
Target of Gemtuzumab
CD33
Drug for relapsed CD33 AML
Gemtuzumab
Target of Rituximab
CD20
Approved for therapy of patients with relapsed or refractory low grade or follicular B cell NHL
Rituximab
For treatment of metastatic breast CA
Trastuzumab HERCEPTIN
Target of trastuzumab
Her/2neu
Treatment of vasculitis
Steroids
Cyclophosphamide
Azathioprine
Plasma exchange
Anti GBM antibodies - causes rapid destruction of kidneys and bleeding into the lung
Goodpastures disease
Treatment of Goodpastures disease
- Prednisone
- Cyclophosphamide
- Plasma exchange
Treatment of SLE
Azathioprine
Cyclophosphamide
Steroids
Treatment of choice for Sjogrens
Hydroxychloroquine
Patient presents with heliotrope rash, diffuse alopecia and papules on fingers - treatment?
Prednisone
Methotrexate
Azathioprine
Mycophenolate
Hydroxychloroquine
Chloroquine
Treatment of psoriasis
Betamethasone dipropionate
Cyclosporin
Name immunomodulating agents
Thalidomide
Thymosin
Cytokines - interferon alpha, beta, gamma, IL2
Levamisole
Roquinimax
BCG