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39 Cards in this Set
- Front
- Back
activated T helper cells secrete this cytokine which causes proliferation and activation of two subsets of T helper cells, TH1 & TH2
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IL-2
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function of TH1 cells?
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cell mediated immunity and delayed hypersensitivity reactions
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what do TH1 cells produce?
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IFN-gamma, IL-2 and TNF-B (which activate macrophages, CTLs, & NK cells.
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what do TH2 secrete when activated?
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IL-4, IL-5, IL-6 (which promote B cell proliferation and differentiation)
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what is the action of IL-10?
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down regulate the action of TH1 cells
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what is action of IFN-gamma on helper T cells?
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down regulates TH2 response
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name an agent that acts at the step of antigen recognition in the immune response?
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antibodies including Rho(D) immune globulin, antilymphocyte globulin, and muromonab CD3.
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name an agent that acts at the step of differentiation and synthesis in the immune response?
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cyclosporine, tacrolimus, dactinomycin, and antilymphocytic globulin and monoclonal anti-T cell antibodies
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MOA of glucocorticoids?
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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
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what is the toxicity of corticosteroids?
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adrenal suppression, growth inhibition, muscle wasting, osteoporosis, salt retention, diabetogenesis and possible psychosis
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MOA of cyclosporine?
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binds to cyclophilin to inhibit Calcineurin, a cytoplasmic phosphatase. which prevents T cell production of cytokines that would be produced w/ TCR activation
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MOA of tacrolimus?
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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)
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MOA of Sirolimus?
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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)
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most frequent toxicities of Cyclosporine and Tacrolimus?
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renal dysfunction, hypertension and neurotoxicity
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sirolimus is more likely than cyclospoine or tacrolimus to induce this side effect?
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HyperTriglyceridemia, hepatotoxicity, diarrhea and myelosuppression
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MOA of Mycophenolate Mofetil?
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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
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toxicity of Mycophenolate mofetil?
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neutropenia
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MOA of Azathioprine?
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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
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toxicity of azathioprine?
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associated with inc incidence of cancer. toxic effects inc by concomitant use of allopurinol b/c azathio is metabolized by xanthine oxidase
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MOA of cyclophosphamide?
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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
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MOA of etanercept?
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recombinant form of TNF receptor that binds TNF-a, a proinflamm cytokine, thereby decreasing formation of IL and adhesion molecules (used in RA)
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name two monoclonal antibodies that block the actions of TNF-alpha?
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Infliximab and adalimumab
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MOA of the RA drug Leflunomide?
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arrests lymphocytes in the G1 phase of cell cycle
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what is thalidomide used for?
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Leprosy, SLE, and as an anti-Cancer drug also aphthous ulcers and the wasting syndrome in AIDS is treated with the Rx
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MOA of thalidomide?
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sedative drug notorious for teratogenic effects, ALSO suppresses TNF production
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MOA Antilymphocyte globulin and Antithymocyte Globulin?
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selectively block cellular immunity rather than Antibody formation, which account for their ability to suppress organ graft rejection, a cell mediated process
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MOA of RhoD immune globulin?
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feedback immunosuppression
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MOA Muromonab-CD3?
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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
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MOA of daclizumab?
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highly specific MAb that binds to the alpha subunit of the IL-2 receptor expressed on T cells and prevents activation by IL-2
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what is the drug that induces remission in treatment-resistant Crohn's disease?
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Infliximab (targeted against TNF-alpha)
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MOA of Aldeslekin?
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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
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IFN-beta-1b has some beneficial effects in this relapsing disorder?
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MS
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what disease is IFN-alpha-2a used for?
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hairy cell leukemia, chronic myelogenous leukemia, malignant mealnoma, Kaposi's sarcoma and hep B and C
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this drug is used for immunization against TB?
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BCG (Bacille Calmette-Guerin) (it activates macrophages and results in enhancement of immune responses)
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MOA thymosin?
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stimulates maturation of pre-T cells in thymusand promotes formation of T cells from lymphoid stem cells (Used in DiGeorge's syndrome, thymic aplasia)
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define mechanism of Type 2 hypersensitivity drug allergy?
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involves IgG or IgM antibodies that are bound to circulating blood cells.
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give examples of type 3 hypersensitivity reactions?
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Drug induced serum sickness and vasculitis, stevens johnson from sulfonamide therapy is another
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examples of type 4 hypersensitivity?
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contact dermatitis (cell mediated injury)
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examples of drugs that commonly cause a type 1 hypersens. rxn?
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penicillins and sulfonamides
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