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33 Cards in this Set
- Front
- Back
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Corticosteroids
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1) Depress macrophage function
2) Inhibit T Cell, NK Cell function (decreased response to IL-2) 3) Inhibit T-cell proliferation 4) Short Term: anti-inflammatory 5) Long Term: decrease antibodies |
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Corticosteroid
Uses |
1) post transplant with other immunosupressants
2) Minimize allergic response to monoclonal antibody 3) Autoimmune disease |
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Corticosteroids
Side effects |
1) Hyperglycemia
2) Osteoporosis 3) Suppression of the Hypothalamic-pituitary-adrenal axis |
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Cyclosporine (Sandimmune, Neoral)
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Inhibits T-cell activation without bone marrow suppression
Inhibits the function of Calcineurin |
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Cyclosporine (Sandimmune, Neoral)
Pharmacokinetics |
Very lipid soluble
Metabolized by CYP3A |
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Cyclosporine (Sandimmune, Neoral)
Drug interactions |
Decrease concentration-phenytoin, rifampin
Increase concentration- erythromycin, ketoconazole, grapefruit juice, verapamil |
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Cyclosporine (Sandimmune, Neoral)
Uses |
Prevent rejection in organ transplant
Bone marrow transplants Autoimmune disorders |
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Cyclosporine (Sandimmune, Neoral)
Toxicity |
Hypertension
Renal toxicity-maintain fluid intake CNS effects Hyperglycemia |
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Tacrolimus (FK506, Prograf)
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Inhibits calcineurin
Inhibits T-cell activation (IL-2,IL-4) DOC Transplant patients Used to rescue during rejection Food decreases absorption by > 80% Take on empty stomach |
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Tacrolimus (FK506, Prograf)
Side effects |
1) Nephrotoxicity
2) Hypertension 3) Hyperglycemic 4) Neurotoxicity: insomnia 5) Increase opportunistic infections and neoplasms 6) Increase risk of skin cancer |
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Tacrolimus (FK506, Prograf)
Drug interaction |
Metabolized by CYP3A
Take on empty stomach Grapefruit juice should not be used Blood level monitored regularly |
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Mycophenylate Mofetil (CellCept), Mycophenyolate (Myfortic)
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1) Inhibits de novo purine synthesis in T and B lymphocytes
2) Selectively supresses lymphocyte proliferation and antibody formation by B-cells |
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Mycophenylate Mofetil (CellCept), Mycophenyolate (Myfortic)
Uses |
Prevent Rejection
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Mycophenylate Mofetil (CellCept), Mycophenyolate (Myfortic)
Side effects |
Increased infections and sepsis (treat prophylacticly with gancyclovir)
Skin rash Leukopenia |
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Azathioprine (Imuran)
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1) Converted in vivo to 6 mercaptopurine
2) Inhibits de novo purine synthesis |
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Azathioprine (Imuran)
Uses |
Prevent Rejection
Acute glomerulonephritis Renal component of Lupus Severe Rheumatoid arthritis |
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Azathioprine (Imuran)
Side effects |
Bone marrow suppression
Increased risk of infection-herpes Embryo-fetal toxicity Metabolism by Xanthine Oxidase- reduce dose if being treated with allopurinol |
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Cyclophosphamide (Cytoxan)
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1) Has a direct effect on T-B-cells, especially those that have undergone antigenic differentiation and division
2) Inhibit established immune response 3) Must be activated by CYP450 |
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Cyclophosphamide (Cytoxan)
Uses |
1) Organ transplant rescue
2) Bone marrow transplants 3) Antineoplastics |
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Cyclophosphamide (Cytoxan)
Side effects |
1) Hemorrhagic cystitis (TX hydration and MESNA)
2) Bone marrow suppression 3) Bladder fibrosis and carcinoma |
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Lymphocyte Immune Globulin
Antithymocyte globulin (Atgam) |
IgG fractions to T-cells form Horses and rabbits
Administered with corticosteroids and cytotoxic drugs (minimize side effects) |
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Lymphocyte Immune Globulin
Antithymocyte globulin (Atgam) Uses |
Acute rejection episode
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Lymphocyte Immune Globulin
Antithymocyte globulin (Atgam) Side effects |
1) Precaution: skin test for sensitivity for equine and rabbit
2) Allergic phenomenon 3) Anaphylaxis 4) Hypotension 5) Lymphomas 6) Leukopenia 7) Thrombocytopenia |
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Muromonab CD3, OKT3 (Orthoclone)
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Antibody to the T3(CD3) site on T-lymphocytes
Decreases circulating cytotoxic T-cells |
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Muromonab CD3, OKT3 (Orthoclone)
Uses |
Acute transplant rejection
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Muromonab CD3, OKT3 (Orthoclone)
Toxicity |
Cytokine release syndrome (flu like response, shock)
fever and chills, nausea |
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Daclizumab (Zenapax)
Basiliximab (Simulect) |
1) Humanized monoclonal antibodies
2) Bind and block IL-2 receptor on activated T-lymphs 3) Reduces rejection (Renal transplant) 4) Few side effects: Anaphylaxis 5) No cytokine release syndromes 6) Long half life |
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Interleukin-2, Aldesleukin (Proleukin)
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1) Stimulates leukocytes
2) Induces IFN gamma |
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Interleukin-2, Aldesleukin (Proleukin)
Uses |
Metastatic renal cell carcinoma
Malignant melanoma |
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Interleukin-2, Aldesleukin (Proleukin)
Toxicity |
1) Severe hypotension
2) Pulmonary 3) Hematological-anemia thrombocytopenia 4) Fever, chills pain |
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Granulocyte colony stimulating factor
Filgrastim (Neupogen) |
Treat Neutropenia
1) After stem cell transplant 2) Cancer chemotherapy or interferon therapy 3) Zidovudine 4) Given subcutaneous or slow IV infusion |
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Interferon alpha-2b (Intron-A;PEG-Intron)
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1) TX Hep B and C for 6 mo to a year
2) For treatment with HCV given with Ribavirin |
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Interferon alpha 2a (Roferon; Pegsys)
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1) Used for Hep C with oral Ribavirin
2) Hairy cell carcinoma 3) AIDS related Kaposi Sarcoma 4) May precipitate liver failure in compensated Cirrhosis |
