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CMBM exam 4 > Anti-inflammatory and Immune drugs > Flashcards

Anti-inflammatory and Immune drugs Flashcards

1
Q

Immunostimulant

A

Given to boost immunity

Recombinant cytokines

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2
Q

Immunosuppressant

A

Given to treat inflammatory diseases

Atopy, autoimmune disease, prevent transplant rejection

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3
Q

What can alpha-IFN be used to treat?

A

Warts from papilloma and Kapsoi’s sarcoma

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4
Q

What can beta-IFN be used to treat?

A

Therapy for Multiple sclerosis

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5
Q

What can gamma-IFN be used for?

A

Boost phagocyte NADPH oxidase system in pts with chronic granulomatous disease

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6
Q

What agents stimulate leukocyte production from bone marrow?

A

Recombinant G-CSF, GM-CSF

Pts with secondary neutropenia secondary to chemotherapy

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7
Q

What are the steps in inflammation?

A

Activation of innate immune cells
Release of inflammatory mediators
B and T cells become activated

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8
Q

What types of drugs interfere with arachidonic acid metabolites?

A

Non-steroidal anti-inflam (NSAIDS)
Leukotriene inhibitors
Corticosteroids

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9
Q

What types of drugs interfere with cytokines?

A 
Corticosteroids
Cytokine inhibitors (monoclonal antibodies)
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10
Q

What drugs are used to inhibit T and B cell responses?

A 
Corticosteroids
Cytotoxic drugs
Cyclosporine
Cytokine inhibitor 
Biological inhibitors of lymphocyte activation/inducers of apoptosis
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11
Q

What drug blocks phopholipases?

A

Steroid inhibit (corticosteroid)

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12
Q

What drug blocks cyclooxygenase?

A

Non-steroidal inhibitors

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13
Q

What are leukotriene inhibitors used for?

A

Mild or moderate asthma since leukotrienes cause bronchoconstriction and eosinophil attraction

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14
Q

Which leukotriene inhibitor inhibitors lipoxygenase?

A

Zileuton

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15
Q

Which leukotriene inhibitors are receptor antagonists?

A

Zafirlukast

Montelukast

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16
Q

What is the mechanism of action for corticosteroids?

A

GSC enters cell binds to GCSR
Complex binds to DNA
Up regulates lipocortins which block AA metabolism
Inhibits transcription of cytokine genes by blocking NFKB and up-regulating transcription factor inhibitors

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17
Q

Glococorticoids block the action of ______ inhibiting the formation of ______.

A

Phospholipase A2, Free arachidonic acid

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18
Q

What is the action of Cytotoxic drugs?

A

Kill rapidly dividing cells

Lymphocyte proliferation in clonal expansion, bone marrow cells

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19
Q

What are cytotoxic used for treatment of?

A

Autoimmunity or to prevent grapft rejection

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20
Q

What drugs are cytotoxic?

A

Azathiprine (purine analogue - nucleic acid synth)
Cyclophosphamide (Alkylating agent - DNA binding)
Methotrexate (Folic acid antagonist - DNA + RNA)

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21
Q

What drugs inhibit cytokine secretion and T cell proliferation?

A

Cyclosporine and Tacrolimus

22
Q

What were cyclosporin and tacrolimus used for?

A

Prevent transplant rejection and now used for moderate to severe psoriasis

23
Q

How do cyclosporin and tacrolimus work?

A

T cell activation leads to an influx of Ca++ and in combination with calmodulin they bind to calcinerin which activates NFAT to transcribe IL-2 and other
The drugs block calcineurin from activating NFAT

24
Q

What are the biologicals?

A

Monoclonal antibodies against cytokines or cytokine receptors
Small molecule inhibitors of cytokine signaling

25
Q

Murine monoclonal antibody

A

Entire antibody of mouse origin
Recognized as foreign in human
No long-term treatment use

26
Q

Chimeric monoclonal antibody

A

Monoclonal antibody that has human Fc mouse Fab

Have -ximab in name

27
Q

Humanized monoclonal antibody

A

Parts of Fab are human

Have -umab in name

28
Q

Human monoclonal antobody

A

Entire molecule is human

29
Q

What are anti-TNF drugs used for?

A

Rheumatoid arthritis, psoriasis and Chron’s disease

30
Q

What is the anti-TNF drug which uses chimeric monoclonal antibodies?

A

Infliximab (Remicade)

31
Q

Which anti-TNF drug uses chimeric monoclonal antibodies?

A

Adalimumab (Humira)

32
Q

Which anti-TNF drug uses recombinant TNF receptors fused to immunoglobulin?

A

Etanercept

33
Q

What is Etanercept?

A

Human soluble TNF receptor fused to the Fc segment of human IgG

34
Q

How does Ustekinumab work?

A

The ustekinumab binds to the p40 which is bound to either p35 or p19
It is kept from binding with the IL-12 (p35), IL-23 (p19)

35
Q

What interleukin does Tocilizumab go after?

A

IL-6

36
Q

What does IL-6 do?

A

Activates T and B cells, macrophages, chronodrocytes and synovial fibroblasts, and osteoclasts

37
Q

What is Anakinra?

A

Recombinant IL-1 receptor antagonist

38
Q

Which disease does IL-1 play a role in?

A

Rheumatoid arthritis pathogenesis

39
Q

How does Toficitinib (Xeljanz) work and what is it used for?

A

Inhibits JAK kinases which is involved for cytokine signaling
Rheumatoid arthritis

40
Q

Which drug blocks T cell activation?

A

Abatacept - used for Rheumatoid Arthritis

41
Q

Which drug inhibits LFA-3/CD2 interaction, thus inhibits T lymphocyte activation?

A

Alefacept

42
Q

Which drug causes the death of the B cell upon binding?

A

Rituximab

43
Q

What type of hypersensitivity is asthma and explain how it works.

A

Type 1

Inflammation in bronchial walls

44
Q

What drugs are used for asthma?

A

Bronchodilators
Leukotriene inhibitors
Corticosteroids

45
Q

Explain psoriasis

A

T-cell induced proliferation of keratinocytes leading to unsightly plaques of red, raised, rough areas of skin

46
Q

What are the drug used to treat psoriasis?

A

Methotrexate
Corticosteroids
Cytokine inhibitors
Biologicals

47
Q

Explain rheumatoid arthritis

A

T-cell mediated inflammation of joints with resoprtion of bone and joint deformity

48
Q

What drugs are used to treat rheumatoid arthritis?

A

Nonsteroidal anti-inflammatory drugs (NSAIDS)
Cytotoxic drugs (methotrexate)
Cytokine inhibitors and other biologicals (anti-TNF, rituximab)
Corticosteroids

49
Q

What are the key cells and cytokines involved in the pathogenesis of rheumatoid arthritis?

A 
T cells
B cells
Macrophages
Neutrophils 
TNF
IL-1
IL-6
50
Q

What are the key cells and cytokines involved int he pathogenesis of psoriasis?

A 
Th1
Th17
TNF
IL-1
IL-23
IL-12

CMBM exam 4 (27 decks)

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