Chapter 16 & 18. Phgenetics and Biotech

Question 1

Indicated for treatment of classical hemophilia A. Storage conditions of the dry concentrate this?
Hemophilia is a genetic disease. It is categorized as hemophilia A and B.

Answer 1

Clotting Factors: Recombinant antihemophilic factor (rAHF).
The dry concentrate of rAHF should be stored between 2 to 8o C and protect from freezing.
• Hemophilia A is due to deficiency of clotting factor 8.
• Hemophilia B is due to deficiency of clotting factor 9 (Christmas factor)

Question 2

Glycoprotein cytokines that promote proliferation, differentiation and activation of immune cells.
Also called hematopoietic growth factors, encourage bone marrow stem cells to divide and develop into platelets, R/WBC. Examples.

Answer 2

CSF

erythropoietin, epoetin alpha, and epoetin beta

Question 3

functions as the messengers of the immune system. They are secreted by cells of immune system in response to stimulations. Give therapeutic types.

Answer 3

Cytokines (lymphokines)

Interferons, interleukins and Colony stimulating factors.

Question 4

This drug stimulates the production of neutrophil within bone marrow. It is approved for chemotherapy related neutropenia. Give storage conditions.

Answer 4

Granulocyte CSF (Filgrastim)

Question 5

This drug is indicated for acceleration of bone marrow for patient with Non Hodgins lymphoma, acute lymphoblastic leukemia.

Answer 5

Granulocyte Macrophage CSF (GM-CSF Sargramostim)

Question 6

These are sialic acid containing proteins secreted by kidney in response to hypoxemia and transported to the bone marrow through the plasma. It resembles an endocrine hormone more any other cytokines.
Explain how it affects erythropoiesis and give indications.

Answer 6

Erythropoietins enhance erythropoiesis by stimulating the formation of proerythroblasts and release of reticulocytes from bone marrow.
Tx for: anemia, assoc. with cancer chemo, chronic renal disease assoc. anemia.

Question 7

Erythropoietins drug examples and dosing

Answer 7

Epoietin alpha once week. It is approved for anemia rel. to cancer chemo, chronic dialysis, and HIV tx
Darbopoietin alpha: every 3 weeks

Question 8

This inh. viral multiplications, for viral infx
• Interferon beta 1b-Betaseron, Interferon-beta 1b (IFNB) for MS
• Interferon alpha 1a for Hep. infx

Answer 8

Interferons:
Hep. B— Interferon alpha (shots) 4 months Lamivudine oral 1 yr
Adefovir dipivoxil oral 1yr
Hep. C— Peginfterferon combination with antiviral ribavirin
Hep. A— No treatment (infected get well on their own)

Question 9

synthesized by monocytes, macrophages, and lymphocytes. Interleukins are soluble messengers between leukocytes. Reg. gr and dev of WBC.

Which lymphokine is for thrombocytopenia- chemo. TmReg. gr and dev of platelets. SEs: fluid reten, peri edema, dyspnea

Answer 9

Interleukins
• IL-1 production of collagen, PG and a.body (Pro-inflamm,
stim. T cells)
• IL-2 Fusion protein (Activates T and B cells)
• IL-3 Hematopoietic growth factor (HgF)
• IL 11 Oprelvekin

Question 10

These are ultra sensitive, hybrid, immune system derived proteins designed to recognise a specific antibodies. And drug examples.

Answer 10

Hybridoma technology (Biologics): Monoclonal antibodies (MAB)
Mouse—100% mouse: Muromonab, capromab
Chimeric—25%: Ritu, Abcixi, Infliximab, Cetu, Basili
Humanized—10%: Trastuzu, Omalizu, Daclizumab
Human— 100% human: Adalimumab

Question 11

Also known as chimeric antibodies, with mixture of mouse and human component, are produced by this.

Answer 11

Human antimouse antibody (HAMA) monoclonal antibody— Chimeric 25% mouse
Example of drugs produced by 5 chimeric antibodies: Rituximab, abciximab, infliximab, cetuximab, basiliximab.

Question 12

Example of drugs produced by this MOUSE 100%

Answer 12

Murine antibody: Muromonab (Orthoclone OKT3), capromab

Question 13

(Human monoclonal antibodies from transgenic mice)

Answer 13

Humanized antibody— 10% mouse
Example of drug produced by 12 Humanized antibody:
Trastuzumab, omalizumab, daclizumab

Question 14

A genetically modified organism, whose genetic information is altered using recombinant DNA technology.

Answer 14

Transgenic mice

Question 15

Example of drug produced by 4 human antibody:

Example of drug produced by 4 immunoadhesin (protein).

Answer 15

-HUMAN ANTIBODY: Adalimumab
100% Human
-Immunoadhesin (protein): Etanercept, abatacept

Question 16

Give corresponding drugs
TNF alpha inh: 
B cell depletor:
T cell co-stimulation inh:
Interleukin-1 inh
Interleukin-6 inh

Answer 16

TNF alpha inh: Adalimumab, Certolizumab, etanercept, golimumab, infliximab. B cell depletor: Rituximab
T cell co-stimulation inh: Abatacept
Interleukin-1 inh. Anakinra
Interleukin-6 inh. Toclizumab

Question 17

-Indicated in acute graft rejection in renal, cardiac and hepatic
transplant patients.
-Binds free IgE, reduces binding to mediator releasing cells (mast cells, basophil).

Answer 17

• Muromonab (Orthoclone OKT3)

- Omalizumab

Question 18

• This enzymes are activated in response to the presence of an intracellular thrombus or clot.
• These are substances produced in small quantities by the inner lining of blood vessels and by the muscular wall of uterus and give MOA.

Answer 18

• Recombinant tissue: The fibrinolytic system enzyme
• Tissue plasminogen activators (t-PA): (Alteplase, tenecteplase, reteplase) Prevents abnormal blood clotting by converting plasminogen to plasmin. The plasmin is broken down to fibrin, the main constituent of blood clot.

Question 19

This drug is indicated in management of acute myocardial infarction.

Answer 19

Recombinant alteplase (Activase)

Question 20

It is produced mainly by activated mononuclear phagocytes, have both beneficial and potentially harmful effects, mediating cytotoxic and inflammatory reactions. Two anti-TNF alpha monoclonal antibodies are approved for the treatment of what diseases?

Answer 20

Tumor Necrosis Factor (TNF):

-rheumatoid arthritis and Crohn’s disease.

Question 21

It is chimeric IgG antibody directed
against TNF alpha (selectively binds with alpha). It is approved for Crohn’s and TA. Admin IV 3 mg/kg, at 0, 2 and 6 weeks and then q8w aft.

Answer 21

Infliximab (Remicade)- should be administered with methotrexate to prevent the formation of antibodies to infliximab.

Question 22

This binds with both TNF alpha and beta: The greater risk of this drug therapy is immunosuppression and subsequent serious infections.

Answer 22

Etanercept

Question 23

Non coding base pairs (stop codons) of messenger RNA. These are SINGLE STRAND of DNA or RNA that are complementary to chosen seq. The antisense RNA protein translation of certain “messenger RNA” by binding to them. The antisense DNA is used to target a specific complementary RNA.

Answer 23

Antisense therapy (Antisense Oligonucleotide therapy): 
Antisense drugs inhibit gene expression by oligonucleotide.

Question 24

Antisense Tx indication and MOA

Answer 24

Indication: b-thalassemia, CMV rhinitis, hemorrhagic fever virus, cancer, HIV- AIDS.
MOA: act on m-RNA and prevents translation.

Question 25

Detects antibodies against nuclear antigens (DS-DNA, SS-A, SS-B,
histone). Positive result indicates what disease?

Answer 25

Antinuclear Antibody Test (ANA)

autoimmune disease rheumatoid arthritis.

Question 26

The pituitary gland secretes this hormone which stimulates an individual
growth.
• 3 Systemic growth hormones:

Answer 26

Human growth hormone (hGH)

Humatrope, protropin, and somatrem.