Pharmacology Ch56 Immuno-Rx

Front 1

activated T helper cells secrete this cytokine which causes proliferation and activation of two subsets of T helper cells, TH1 & TH2

Back 1

IL-2

Front 2

function of TH1 cells?

Back 2

cell mediated immunity and delayed hypersensitivity reactions

Front 3

what do TH1 cells produce?

Back 3

IFN-gamma, IL-2 and TNF-B (which activate macrophages, CTLs, & NK cells.

Front 4

what do TH2 secrete when activated?

Back 4

IL-4, IL-5, IL-6 (which promote B cell proliferation and differentiation)

Front 5

what is the action of IL-10?

Back 5

down regulate the action of TH1 cells

Front 6

what is action of IFN-gamma on helper T cells?

Back 6

down regulates TH2 response

Front 7

name an agent that acts at the step of antigen recognition in the immune response?

Back 7

antibodies including Rho(D) immune globulin, antilymphocyte globulin, and muromonab CD3.

Front 8

name an agent that acts at the step of differentiation and synthesis in the immune response?

Back 8

cyclosporine, tacrolimus, dactinomycin, and antilymphocytic globulin and monoclonal anti-T cell antibodies

Front 9

MOA of glucocorticoids?

Back 9

decrease the synthesis of Prostaglandins, leukotrienes, cytokines, and other signaling molecules that participate in immune responses (eg Platelet activating factor). They also inhibit proliferation of T cells and to a lesser degree dampen humoral immunity. continuous therapy lowers IgG levels through inc. catabolism

Front 10

what is the toxicity of corticosteroids?

Back 10

adrenal suppression, growth inhibition, muscle wasting, osteoporosis, salt retention, diabetogenesis and possible psychosis

Front 11

MOA of cyclosporine?

Back 11

binds to cyclophilin to inhibit Calcineurin, a cytoplasmic phosphatase. which prevents T cell production of cytokines that would be produced w/ TCR activation

Front 12

MOA of tacrolimus?

Back 12

binds to FK-binding protein and inhibits calcineurin, a phosphatase that regulates the ability of activated T cells to produce cytokines, thus inhibiting this cytokine production (same action as cyclosporine but diff binding site)

Front 13

MOA of Sirolimus?

Back 13

ALSO binds to FKBP however it inhibits T cell RESPONSE to Cytokines w/o affecting cytokine production (and potent inhibitor of B cell prolif. antibody product. and mononuclear cell responses to colony stimulating factors as well)

Front 14

most frequent toxicities of Cyclosporine and Tacrolimus?

Back 14

renal dysfunction, hypertension and neurotoxicity

Front 15

sirolimus is more likely than cyclospoine or tacrolimus to induce this side effect?

Back 15

HyperTriglyceridemia, hepatotoxicity, diarrhea and myelosuppression

Front 16

MOA of Mycophenolate Mofetil?

Back 16

rapidly converted to mycophenolic acid, which inhibits inosine monophosphate dehydrogenase, an enzyme in the de novo pathway of purine synthesis. SO this suppresses BOTH B & T cell ACTIVATION

Front 17

toxicity of Mycophenolate mofetil?

Back 17

neutropenia

Front 18

MOA of Azathioprine?

Back 18

prodrug transformed to antimetabolie mercaptopurine, which inhibits enzymes in purine metabolism. It is cytotoxic to early phase of lymphoid cell proliferation w/ greater effect on Tcells than B cells

Front 19

toxicity of azathioprine?

Back 19

associated with inc incidence of cancer. toxic effects inc by concomitant use of allopurinol b/c azathio is metabolized by xanthine oxidase

Front 20

MOA of cyclophosphamide?

Back 20

transformed by liver enzymes to an alkylating agent that is cytotoxic to proliferating lymphoid cells. greater effect on B CELLS than T cells and will inhibit an estrablished immune response

Front 21

MOA of etanercept?

Back 21

recombinant form of TNF receptor that binds TNF-a, a proinflamm cytokine, thereby decreasing formation of IL and adhesion molecules (used in RA)

Front 22

name two monoclonal antibodies that block the actions of TNF-alpha?

Back 22

Infliximab and adalimumab

Front 23

MOA of the RA drug Leflunomide?

Back 23

arrests lymphocytes in the G1 phase of cell cycle

Front 24

what is thalidomide used for?

Back 24

Leprosy, SLE, and as an anti-Cancer drug also aphthous ulcers and the wasting syndrome in AIDS is treated with the Rx

Front 25

MOA of thalidomide?

Back 25

sedative drug notorious for teratogenic effects, ALSO suppresses TNF production

Front 26

MOA Antilymphocyte globulin and Antithymocyte Globulin?

Back 26

selectively block cellular immunity rather than Antibody formation, which account for their ability to suppress organ graft rejection, a cell mediated process

Front 27

MOA of RhoD immune globulin?

Back 27

feedback immunosuppression

Front 28

MOA Muromonab-CD3?

Back 28

MAb binds to the CD3 antigen on surface of thymocytes and mature T cells and blocks the killing action of CTLs and other T cell functions

Front 29

MOA of daclizumab?

Back 29

highly specific MAb that binds to the alpha subunit of the IL-2 receptor expressed on T cells and prevents activation by IL-2

Front 30

what is the drug that induces remission in treatment-resistant Crohn's disease?

Back 30

Infliximab (targeted against TNF-alpha)

Front 31

MOA of Aldeslekin?

Back 31

recombinant IL-2, that promotes production of cytoxic T cells and activates NK cells - indicated for adjunctive trx of renal cell carcinoma and malignant melanoma

Front 32

IFN-beta-1b has some beneficial effects in this relapsing disorder?

Back 32

MS

Front 33

what disease is IFN-alpha-2a used for?

Back 33

hairy cell leukemia, chronic myelogenous leukemia, malignant mealnoma, Kaposi's sarcoma and hep B and C

Front 34

this drug is used for immunization against TB?

Back 34

BCG (Bacille Calmette-Guerin) (it activates macrophages and results in enhancement of immune responses)

Front 35

MOA thymosin?

Back 35

stimulates maturation of pre-T cells in thymusand promotes formation of T cells from lymphoid stem cells (Used in DiGeorge's syndrome, thymic aplasia)

Front 36

define mechanism of Type 2 hypersensitivity drug allergy?

Back 36

involves IgG or IgM antibodies that are bound to circulating blood cells.

Front 37

give examples of type 3 hypersensitivity reactions?

Back 37

Drug induced serum sickness and vasculitis, stevens johnson from sulfonamide therapy is another

Front 38

examples of type 4 hypersensitivity?

Back 38

contact dermatitis (cell mediated injury)

Front 39

examples of drugs that commonly cause a type 1 hypersens. rxn?

Back 39

penicillins and sulfonamides