2. farmakoloji imminosupresants Flashcards
Calcineurin inhibitörleri hangileridir?
Cyclosporin
Tacrolimus
Cyclosporin neye bağlanır?
Cyclophilin
Tacrolimus neye bağlanır?
FK-binding protein
cyclophilin-Cyclosporin
FK-binding protein*Tacrolimus
Kompleksleri neyi inhibe eder?
Calcineurin
Costimulation Blockerlar hangileridir?
Belatacept
Abatacept
Belatacept ve Abatacept arasındaki fark nedir?
Belatacept CD80 86 gurubuna daha iyi bağlanır daha güçlüdür
Costimulation Blockerlar neyi inhibe eder?
CD80/86 ile CD28 kompleksi oluşumunu engeller
MTOR inhibitörleri nelerdir?
Sirolimus
Everolimus
imminosupresant Antimetabolitler nelerdir
Azathioprine
Mycophenolate mofetil
Azathioprine neye dönüşür?
6-MP
Mycophenolate mofetil neyi inhibe eder?
IMPDH
İmminosupresant corticosteroidler hangileridir?
Prednisone
Prednisolone
Methyprednisolone
İmminosupresant corticosteroidler neye bağlanır?
GR
Gr’de AP-1e ve NF-kBye bağlanır
imminosupresant antibodyler hangileridir?
Alemtuzumab
Basiliximab
Rituximab
Antitymocyte globulins
signal 1 nedir?
T cell triggering at the CD3 receptor complex
by an antigen presenting cell (APC).
Signal 2 nedir?
CD80 86nın CD 28 ile bağlanması
sinyal 1 ve iki beraber neyi aktive eder?
interleukin (IL) 2 . diğer adıyla CD25
sinyal 3 neyi aktive eder
mTOR
Hybridoma technology nedir?
Hybridoma technology
is a method for producing large numbers of identical antibodies
Neden Antithymocyte globulin kulanılır?
transplantation to prevent early allograft rejection
TUS
Aşağıdaklerden hangisi IL-2 reseptör antikorudur ve bu reseptörün aracılık ettiği T lenfosit Aktivasyonunu engelleyerek immünosupresif etki gösterir?
Deksametazon, talidomit, Metotreksat, siklosporin, daklizumab
daklizumab
TUS
Aşağıdakilerden hangisi T-hücresi reseptör kompleksinin antijen tanımasını bloke ederek İmmunosupresyon yapar:
glukokortikoidler,
takrolimus,
muromonab-CD3,
sirolimus
Alemtuzumab nereye bağlanır
CD52 on both T and B cells
Rituximab nereye bağlanır
CD20 on pre-B cells
Post-Transplant Lymphoproliferative Disease)
Muromonab nereye bağlanır?
CD3 on T3
Rituximab has a boxed warning for reactivation of?
John Cunningham) virüs
leading to progressive multifocal leukoencephalopathy (PML), which has been reported in the nontransplant population
Activation of hepatitis B infection has also been reported following treatment, and hepatitis serologies should be monitored.
Bortezomib neyi inhibe eder
Bortezomib: proteasome inhibitor
Bortezomib hangi hastalıklarda kulanılır?
AMR (Antibody Mediated Rejection)
Bortezomib metabolized primarily by?
cytochrome P450
hepatic dysfunction has rarely been reported
basiliximab neye bağlanır?
CD25 inhibits IL2
Aşağıdaki immünosupresif ajanlardan hangisi kalsineurin bağımlı fosfataz inhibisyonuna neden olur?
Glukokortikoid,
muromonab-CD3,
azotiopürin,
takrolismus,
mikofenolat mofeti
takrolismus
selektif T hücre inhibisyonu yapan ilaç hangisidir Siklofosfamid, siklosporin, kortikosteroid, aktinomisin, bleomisin
siklosporin
Spesifik tedavilere cevap alınamayan Behçet üveiti, psöriazis, atopik dermatit, ve romatoid Artrit tedavisinde kullanılan ve nefrotoksik etkisi olan ilaç aşağıdakilerden hangisidir?
Paramomisin,
metotreksat,
siklofosfamid,
siklosporin,
klorambusil
siklosporin
cyclosporine and tacrolimus absorption and metabolism made by ?
CYP3A4, CYP3A5 and P-glycoprotein (P-gp)
calcineurin inhibitor kulanımını engelleyen limit nedir?
nephrotoxicity
infections
cyclosporine’in yan etkileri nelerdir?
Hirsutism, or excessive hair growth,
sirolimus and everolimus are metabolized by?
CYP3A4
Sirolimus has a longer half-life
Which drug used to prevent allograft rejection can cause hyperlipidemia?
A. Basiliximab
B. Belatacept
C. Mycophenolate mofetil
D. Sirolimus
Correct answer = D. Patients who are receiving sirolimus can develop elevated cholesterol and triglyceride levels,
which can be controlled by statin therapy. None of the other agents have this adverse effect.
Which clinical situation is least appropriate for immunosuppression with sirolimus?
A. A patient with primary renal failure.
B. A patient who has failed calcineurin inhibitors due to neurotoxicity.
C. A patient who is 6 months postliver transplant and the incision site is fully healed.
D. A patient with an abnormal lipid profile.
Correct answer = D. A patient with an abnormal lipid profile is a poor candidate for immunosuppression with sirolimus, since this medication is known to cause or exacerbate hyperlipidemia, particularly triglycerides and total cholesterol. A patient with primary renal failure would be a candidate for sirolimus, since it does not cause
nephrotoxicity as calcineurin inhibitors do. It would be appropriate to switch a patient who has failed calcineurin inhibitors due to neurotoxicity to sirolimus for immunosuppression since it is not associated with that adverse effect. Sirolimus is known to impair wound healing, but a patient with a fully healed incision site could
appropriately be placed on sirolimus.
mycophenolate neyi engeller?
guanosine monophosphate oluşumunu
B-cell proliferation by eliminating de novo production of guanosine monophosphate.
Which immunosuppressant medication avoids the need for therapeutic drug monitoring?
A. Cyclosporine
B. Tacrolimus
C. Mycophenolate mofetil
D. Sirolimus
Correct answer = C. Calcineurin inhibitors (cyclosporine and tacrolimus) and mTOR inhibitors (sirolimus and everolimus) require therapeutic drug monitoring in order to maximize efficacy (prevent rejection episodes) and minimize toxicity (adverse effects). Mycophenolate mofetil is the correct answer since there is no role for routine monitoring with this medication.
using corticosteroids cause?
cause hypercholesterolemia
, cataracts,
osteoporosis,
and hypertension with prolonged use
