Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Semester 5 > 6.1: Immunosuppression > Flashcards

6.1: Immunosuppression Flashcards

1
Q

What is the difference between arthralgia and arthritis?

A

Both pain and inflammation of a joint, arthralgia is w/o swelling but arthritis is with swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mechanism of action of corticosteroids?

A

Lipophilic so binds to intracellular receptor and in the nucleus
Prevents the production of pro-inflammatory interleukins IL-1 and IL-6 by macrophages
Also inhibit all stages of T cell activation (systemic, hence side effects)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does azathioprine work?

A

Active ingredient is 6-MP, which is broken down into an anti metabolite that decreases purine synthesis, so less DNA and RNA are produced fro WBCs hence the immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some adverse effects of azathioprine?

A
  • bone marrow suppression (hence monitor FBC)
  • increased risk of malignancy
  • increased risk of infection
  • hepatitis (so many LFTs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ciclosporin and tacrolimus are examples of which type of drug?

A

Calcineurin inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do calcineurin inhibitors work?

A

Prevent IL-2 production in T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some side effects of calcineurin inhibitors?

A

Many side effects, so rarely used (often used topically for psoriasis)

Nephrotoxic 
Headaches
Hepatotoxicity
HTN
Diabetes
Electrolyte disturbances
Hitruism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which DMARD is affected by polymorphism?

A

Azathioprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does genetic polymorphism for TPMT affect azathioprine treatment?

A

TPMT breaks down 6MP, the active ingredient in azathioprine
High levels of TPMT expression will lead to undertreatment (more 6MP broken down)
Low levels of TPMT will lead to increased toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does cyclophosphamide work?

A

It is a prodrug activated by CYP450s to produce alkykating metabolites (to cross link DNA so it can’t replicate)
Selectively acts on cells with higher mitotic rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the man uses of cyclophosphamide?

A

In cancer chemotherapy (lymphoma, leukaemia, solid cancers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some ADRs of cyclophosphamide?

A

Infertility
Teratogenic
Bladder Ca (toxic metabolite to bladder epithelium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What type of immunosuppressants are the agent of choice is transplant immunosuppression?

A

Mycophelonate mofetil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do myclophenolate mofetil exert its action?

A

Inhibits guanosine synthesis

Selective for suppression of B and T lymphocyte proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some side effects of mycophenolate mofetil?

A 
Nausea
Vomiting
Diarrhoea 
Leuko and neutropenia
Myelosuppression
Increased risk of infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the gold standard drug for RA?

A

Methotrexate

17
Q

When should methotrexate be taken?

A

WEEKLY

Due to long half lives of metabolites

18
Q

What is the mechanism of action of methotrexate?

A

Competitive inhibitor with folate for DHFR
So reduces conversion of BHFR to tetrahydrofolate
Inhibits synthesis of DNA, RNA, and proteins

19
Q

During what phase of the cell cycle does methotrexate act?

A

S phase

20
Q

What are some side effects of methotrexate?

A 
Cytotoxic during S phase of cell cycle so affects rapidly dividing cells
Mucositis
Myleosuppression
Highly teratogenic!!
Hepatitis
Cirrhosis
Increased infection risk
21
Q

Which DMARD is best for IBD and why?

A

Sulfasalazine

As it is broken down to its active ingredient in the colon

22
Q

Which DMARD is safe in pregnancy?

A

Sulfasalazine

23
Q

What is sulfasalazine use in?

A

IBD and RA

24
Q

What is the active component of sulfasalazine that treats IBD?

A

5-ASA

25
Q

How does sulfasalazine work in treating RA?

A

Inhibits T cell proliferation and IL-2 production
T cell apoptosis
Reduces chemotaxis of neutrophils and degranulation

26
Q

What are some side effects of sulfasalazine?

A 
Nausea
Fatigue
Headache
Myelosuppression
Hepatitis
27
Q

What type of drugs in infliximab and how does it work?

A

Biological agent
Monoclonal antibody that is a TNF-alpha inhibitor
Reduces inflammation, joint destruction and angiogenesis

Semester 5 (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions