Immunosuppressive And Immunomodulating Drugs

Front 1

Name 7 groups of immunosuppressive drugs

Back 1

CORTICOSTEROIDS

Immunophilin ligands

Mycophenolate mofetil

Thalidomide

CYtotoxic agents

Antibodies

Monoclonal antibodies

Front 2

Immunosuppressive drug with LYMPHOLYTIC properties

Back 2

Corticosteroids

Front 3

Drug of choice for idiopathic thrombocytopenic purpura (ITP), autoimmune hemolytic anemia, acute glomerulonephritis, autoreactive tissue disorders and transplants (renal, heart, liver and BM)

Back 3

PREDNISONE

Front 4

First line immunosuppressive therapy for solid organ recipients and hematopoietic stem cell transplant recipients

Back 4

Prednisone

Front 5

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

Back 5

Glucocorticoids

Front 6

Name immunophilin ligands (3)

Back 6

Cyclosporin

Tacrolimus

Sirolimus

Front 7

Peptide antibiotic used in organ transplantations, treatment of graft vs host disease after hematopoietic stem cell transplant and autoimmune disorders

Back 7

Cyclosporin

Front 8

MOA of cyclosporin

Back 8

Binds to CYCLOPHILIN which forms a complex that inhibits CALCINEURIN which is necessary for activation of T cell specific transcription factor (NF-AT)

Front 9

Name drugs which increase cyclosporine blood levels

Back 9

Diltiazem
erythromycin
ketoconazole
danazole
methyltestosterone
BCP

Front 10

Drugs that decrease half life and blood levels of cyclosporine

Back 10

Carbamazepine
Isoniazid
Rifampin
Phenobarbital
Phenytoin

Front 11

This immunosuppressive drug induces renal,liver toxicity, HTN, hyperglycemia, hyperkalemia, altered mental status, seizures and hirsutism

Back 11

Cyclosporin

Front 12

Increased incidence of lymphoma and other cancers have been observed in transplant patients on _

Back 12

Cyclosporine

Front 13

Immunosuppressive drug which can promotes tumor invasion and metastasis by inducing TGF beta

Back 13

Cyclosorine

Front 14

Drug of choice for transplants of kidney, liver, pancrease and HEART!!!

Back 14

Cyclosporin

Front 15

Which autoimmune disorders are indication for treatment with cyclosporin

Back 15

Uveitis
RA
Psoriasis

Front 16

Macrolide antibiotic with similar MOA as cyclosporine

Molecular target?

How is it compared to cyclosporin

Back 16

Tacrolimus

Molecular target --> FK binding protein --> inhibition of calcineurin

Front 17

Used in organ and stem cell transplants, effective therapy for prevention of rejection even after failure of standard rejection therapy including T cell antibodies

Back 17

Tacralimus

Front 18

STANDARD PROPHYLACTIC AGENT *usually in combination with MTC or mycophenolate for graft vs host disease

Back 18

Tacrolimus

Front 19

How is MOA SIROLIMUS is different from cyclosporine and TACROLIMUS

Back 19

Doesnt block IL production by activated T cells but BLOCKS THE RESPONSE OF T CELLS TO CYTOKINES

Front 20

What is the main toxicity of SIROLIMUS

Back 20

Profound myelosuppression especaially thrombocytopenia

Front 21

- 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

Back 21

Mycophenolate Mofetil

Front 22

Name cytotoxic agnets (5)

Back 22

Azathioprine

Cyclophosphamide

Leflunomide

Hydroxychloroquine

Other - vincristine, MTX, cytarabine, pentostatin

Front 23

MOA Azathioprine

Back 23

Antimetabolite derivative of 6-mercaptopurine that interferes with the metablolism and synthesis of nucleic acid.

Front 24

Main SE

Back 24

BM suppression (leukopenia)
Skin rashes
Fever
N/V/D
GI at high doses
Liver dysfunction

Front 25

ONE OF THE MOST EFFICACIOUS IMMUNOSUPPRESSIVE DRUGS, alkylating agent

Name drug and MOA

Back 25

CYCLOPHOSPHAMIDE - destroys proliferating lymphoid cells but also appears to alkylate some resting cells

Front 26

Cytotoxic drug causing considerable risk of pancytopenia and hemorrhagic cystitis at high doses

Back 26

Cyclophosphamide

Front 27

Patient is on cytotoxic drug - presents with thinned or brittle hair, darkened and thickened skin, acne and loss of appetite

Back 27

CYCLOPHOSPHAMIDE

Front 28

Drugs that increase toxicity of cyclophosphamide

Back 28

Allopurinol
Barbiturates
Digoxin

Front 29

Cytotoxic agent that has LONGEST HALF LIFE (several weeks)

Back 29

Leflunomide

Front 30

MOA of Leflunomide

Back 30

Inhibitor of pyrimidine synthesis

Front 31

Clinical use of Leflunomide

Back 31

RA

Front 32

This cytotoxic drug can potentially elevate liver enzymes with some risk of liver damage, renal impairment, teratogenic effects and incidence of angina/tachycardia

Back 32

Leflunomide

Front 33

Antimalarial drug with immunosuppressive properties

Back 33

Hydroxychloroquine

Front 34

Adenosine deaminase inhibitor primarily used for LYMPHOID MALIGNANCIES, now frequently used for steroid resistant graft vs host disease after allogenic stem cell transplant

Back 34

PENTOSTATIN

Front 35

Muromonab is against which marker

Back 35

CD3

Front 36

MAIN SE of Muromonab

Back 36

CYTOKINE RELEASE SYNDROME (fever, dyspnea, wheezes, headache, hypotension)

Front 37

This drug should be administered in hypervolemic patients - can cause pulmonary edema

Back 37

MUROMONAB

Front 38

What can you do to avoid cytokine release syndrome associated with muromonab

Back 38

Premedicate with steroid (first 2 doses only), acetaminophen and diphenhydramine

Front 39

This medication is effective against KAWASAKI DISEASE

Back 39

IGIV

Front 40

This drug is used for treatment of B CELL CLL in patients who have been treated with alkylating agents and have failed fludarabine therapy

Back 40

ALEMTUZUMAB

Front 41

Alemtuzumab targets _

Back 41

CD52

Front 42

ANTIANGIOGENIC DRUG that inhibits growth of blood vessels (angiogenesis) in tumors

Back 42

Bevacizumab

Front 43

Bevacizumab targets _

Back 43

VEGF - vascular endothelial growth factor

Front 44

FIRST LINE TREATMENT OF PATIENTS WITH METASTATIC COLORECTAL CANCER alone or in combination with 5-FU based chemotherapy

Back 44

BEVACIZUMAB

Front 45

Indicated for use in patients with METASTATIC COLORECTAL CANCER whose tumors overexpress EGFR

Back 45

CETUXIMAB

Front 46

Target of Cetuximab

Back 46

EGFR - epidermal growth factor receptor

Front 47

Target of Gemtuzumab

Back 47

CD33

Front 48

Drug for relapsed CD33 AML

Back 48

Gemtuzumab

Front 49

Target of Rituximab

Back 49

CD20

Front 50

Approved for therapy of patients with relapsed or refractory low grade or follicular B cell NHL

Back 50

Rituximab

Front 51

For treatment of metastatic breast CA

Back 51

Trastuzumab HERCEPTIN

Front 52

Target of trastuzumab

Back 52

Her/2neu

Front 53

Treatment of vasculitis

Back 53

Steroids
Cyclophosphamide
Azathioprine
Plasma exchange

Front 54

Anti GBM antibodies - causes rapid destruction of kidneys and bleeding into the lung

Back 54

Goodpastures disease

Front 55

Treatment of Goodpastures disease

Back 55

- Prednisone
- Cyclophosphamide
- Plasma exchange

Front 56

Treatment of SLE

Back 56

Azathioprine
Cyclophosphamide
Steroids

Front 57

Treatment of choice for Sjogrens

Back 57

Hydroxychloroquine

Front 58

Patient presents with heliotrope rash, diffuse alopecia and papules on fingers - treatment?

Back 58

Prednisone
Methotrexate
Azathioprine
Mycophenolate
Hydroxychloroquine
Chloroquine

Front 59

Treatment of psoriasis

Back 59

Betamethasone dipropionate
Cyclosporin

Front 60

Name immunomodulating agents

Back 60

Thalidomide
Thymosin
Cytokines - interferon alpha, beta, gamma, IL2
Levamisole
Roquinimax
BCG