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16 Cards in this Set
- Front
- Back
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corticosteroids
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= immunosuppressive agent
mech: decrease production of cytokines/interleukins: IL-1, TNF-a, decrease NO, decrease prostaglandins/leukotrienes (decreases acute inflammation), decreases expression of adhesion molecules |
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mycophenalate mofetil
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immunosuppressive drug
=antimetabolite mech: inhibits de novo guanine synthesis - blocks lymphocyte production since lymphocytes have no salvage pathway |
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azothioprine
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immunosuppressive drug
=antimetabolite mech: is an antimetabolite precursor of 6-mercaptopurine that interferes with metabolism and synthesis of nucleic acids (=toxic to proliferating lymphocytes) tx: kidney transplantation, autoimmune disease toxicity: bone marrow suppression. mercaptopurine = metabolized by xanthine oxidase, so allopurinol can worsen toxicity. |
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cyclosporine
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immunosuppressive drug
=calcineurin inhibitor mech: binds to calcineurin (=Ca-BP), preventing dephosphorylation of NFAT so it can't activate transcription of IL-2 tx: chronic organ rejection suppression, some autoimmune disorders toxicity: predisposes pt to viral infections and lymphoma; nephrotoxic |
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tacrolimus (FK506)
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immunosuppressive
=calcinuerin inhibitor mech: binds FK-BP, inhibiting IL-2 secretion toxicity: significant. nephrotoxicity, peripheral neuropathy, HTN, pleural effusion |
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sirolimus (rapamycin)
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immunosuppressive
mech: binds mTOR, inhibits T cell proliferation in response to IL-2 tx: synergistic with cyclosporine +/- corticosteroids |
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daclizumab
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immunosuppressive
mech: =monoclonal antibody specific for high affinity "a" subunit of IL-2 receptor tx: early phase in acute rejection of transplantation, NOT for chronic tx |
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muromab-CD3 (OKT-3)
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immunosuppressive
mech: monoclonal antibody that binds CD3 (epsilon chain) to prevent intracellular T cell signaling toxicity: cytokine release syndrome, hypersensitivity reactions |
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FTY720
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sphingosine-1-phosphate receptor agonist
prevents egress of lymphocytes from lymph nodes |
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Antithymocyte Globin (THYMOGLUBIN)
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contains cytosolic Abs that bind various CDs and MHC I&II. Abs deplete circulating lymphocytes by direct cytotoxity.
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Rituximab (RITUXAN)
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monoclonal anti-CD20 Ab
Binds CD20 on B cells and induces apoptosis or complement and cell mediated cytotoxicity (ADCC) Used treatment of B-cell non-Hodgkin lymphomas BLACK BOX: progressive multifocal leukoencephalopathy (PML) |
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Abatacept (ORENCIA)
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Human immunoglobulin fused to extra cellular domain of CTLA-4
Mech: Prevents co-stimulation (usu. CD28 with B7) so reduces T cell activation. CTLA-4 binds B7 more avidly that CD28 tx: RA resistant to other drugs contraindications: don't use with 1-TNF antagonist (greatly increases infection risk) |
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Infliximab (REMICADE)
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Anti-TNF reagent
monoclonal anti-TNF Ab |
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Etanercept (ENBREL)
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Anti-TNF reagent
Fc of IgG1 fused ligand binding of TNF-alpha |
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Adalimimab (HUMIRA)
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Anti-TNF reagent
monoclonal anti-TNF Ab |
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methylpredisone/SOLU-MEDROL/A-METHAPRED
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=corticosteroid
tx: reversal of actue transplant rejection, and for exacerbations of autoimmune disease -also used to suppress allergic rxns, so given with muromonab-CD3/OKT3, thymoglobulin to avert "cytokine storm" |
