Bone marrow, Immune, and compliment modulating drugs

Question 1

Aldesleukin

Answer 1

IL12 - stimulate T cells

Tx: RCC and metastastic melanoma

Question 2

Filgrastim, sargramostim

Answer 2

GM-CSF analog

Question 3

Erythropoietin

Answer 3

stimulate bone marrow –> increased RBC

Interstitial cells of kidney make endogenous EPO

Question 4

Thrombopoietin

Answer 4

increase platelets

Question 5

Oprelvekin

Answer 5

IL11

tx thrombocytopenia

Question 6

IFN alpha

Answer 6

tx genetial warts
HBV, HCV
Kaposi sarcoma
Hairy cell leukemia
melanoma

Question 7

IFN beta

Answer 7

MS tx

Question 8

IFN-gamma

Answer 8

tx chronic granulomatus disease

Question 9

TNF alpha inhibitor

Answer 9

Infliximab
Adalimumab

Etanercept - decoy receptor binds TNFa

Tx Seronegative spondyloarthropathies, RA

Question 10

Rituximab

Answer 10

bind CD20 –> complement lyse B cell

tx nonhodgkin lymphoma - most B cell tumors

Question 11

Omalizumab

Answer 11

Ab against IgE

tx: severe asthma not responding to other tx

Question 12

Digoxin immune Fab

Answer 12

overdose w/ severe cardiac toxicity

Question 13

Abciximab

Answer 13

Ab to glycoprotein IIb/IIIa receptor of platelets, inhibits activity

angioplasty and stenting of cardiac vessels
unstable angina or MI

Question 14

Trastuzumab

Answer 14

protein ERBB2 ab

-Her2-neu breast cancer

Question 15

Sirolimus

Answer 15

binds FK bindign protein 12 (FKBP12) –> inhibit mTOR (mammalian target of rapamycin) –> inhibits T cell proliferation - can’t respond to IL2

not nephrotoxic

Question 16

Mycophenolate (mycophenolate mofetil)

Answer 16

Inhibits inosine monophosphate (IMP) dehydrogenase –> inhibits guanine synthesis –> prevents lymphocyte proliferation

Use: transplants, lupus nephritis (off label)

side effects: hyperglycemia, hypercholesterolemia, htn, infection, lymphoma

teratogenic –> congenital malformations - ear, face, first trimester miscarriage

Question 17

Thalidomide

Answer 17

suppresses TNF a production, increased NK cells and IL2

use in erythema nodosum leprosum (Hansen dz), multiple myeloma

Side effects: phocomelia

Question 18

Cyclosporine

Answer 18

binds cyclophilins
inhibits calcineurin –> no IL2 production

tx: transplant rejection, psoriasis, RA, lupus nephritis

SE: viral infections, lymphomas
NEPHROTOXIC - afferent and efferent vasoconstriction
–> HTN

Question 19

Tacrolimus (FK506) and Pimecrolimus

Answer 19

binds FK binding proteins
inhibit calcineurin –> no IL2

SE: nephrotoxic, HTN + neurotoxicity (HA)

Question 20

Azothiprine

Answer 20

prodrug of 6-mecaptopurine
interfere w/ nucleic acid synthesis

tx: kidney transplants, lupus nephritis, RA

–> bone marrow suppression

Metabolizes xanthine oxidase
-toxic effects increased w/ allopurinol which inhibits xanthine oxidase