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33 Cards in this Set
- Front
- Back
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Prednisone blocks cytokines:
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IL-1, IL-2, IL-4, IL-6
TNF-B, IFN-y -inhibit MHC-II expression |
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Prednisone cellular effects
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-reduce TC, BC, E0, M0 circulating
-decrease spleen and LN lymphoid content -increase N0 produced and in vasc. |
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Benefit prednisone over cytotoxic drugs:
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no bone marrow supression
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Prednisone Toxicity
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P- peptic ulcers
R- retention of NA/ H2O E- extra dep. fat D- diabetes N- neurosis I- infection prone S- supression of pituitary- impotence, amenorrhea O- osteoporosis N- negative nitrogen balance E- eye- posterior subcapsular cataracts |
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Cyclosporin blocks cytokines:
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IL-2
IFN-y TNF-B -all via (-) CALCINEURIN |
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Cyclosporin cell effects:
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-block clonal expansion of TC
-block TH activation -prevent activation of CTLs |
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Downside CYclosporing reach:
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-little effect humoral immunity
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What is awesome for GVH disease?
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Cyclosporins
-will not supress BM -will target CTLs |
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SE gingival hyperplasia
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cyclosporins
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Cyclosporin SE
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-hepato- and renal toxicity
-neurotoxic (tremors) -gingival hypertrophy -increased viral infections -hirsituism -nausea |
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Tacrolimus v. cyclosporin
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tacrolimus 100x more potent
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Tacrolimus MOA
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[=] FKBP to (-) calcineurin
(-) IL_2, TGF-B, IFN-y (-) cellular immunity |
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Sirolimus MOA
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[=] FKBP-12 to (-) mTOR
-prevent G1 --> S phase WILL NOT (-) IL-2 |
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Sirolimus cellular effects
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(-) TC and BC clonal expansion, activation
(-) Ig synthesis |
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prevent clonal expansion of TC and BC
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Sirolimus
(-) mTOR |
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prevent Ig secretion
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Sirolimus
(-) mTOR |
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Sirolimus SE
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-anemia
-thrombocytopenia -hypertension -hyperlipidemis |
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Mycophenolate molecular target
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(-) inosine monophosphate
(-) purine de novo synthesis (-) guanine synthesis |
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Mycophenolate cellular target
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(-) lymphocyte synthesis
-target de novo purine synthesis |
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SE CMV sepsis
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Mycophenolate
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Mycophenolate SE
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CMV sepsis
GI hemorrage, diarrhea Leukopenia |
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suppress TC and BC
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Prednisone
Mycophenolate |
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Azathioprine
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-converted to 5-mercaptopurine
-purine analog -kills stimulates lymphocytes (-) promyelocytes/ (-) M0 |
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Allopurinol + Azathiopine
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will worsen S/E
prevents degradation |
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Azathiopine SE
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-n/v/ GI pain
-BM and IM (-) -teratorgenic in animals |
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Ab-(CD3 complex)
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Muromonab-CD3
OKT3 |
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Muromonab CD3 cell targets
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(-) CTL
TC disapprear from blood in minutes (-) activation of TC. BC |
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Cytokine release syndrome
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Muromonab
-immediately after 1' dose -anaphylactic response |
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teratogenic drugs
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Muromonab
Azathiopine |
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SE pulmonary edema
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Moromonab
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targets CD3
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Moromnab
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targets CD25 of IL-2 rec.
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Basiliximab
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Basiliximab
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target CD25 of IL-2 rec.
(-) activation/ proliferation of TC |
