Drugs

Question 1

Drug: Azathioprine

Answer 1

“Mechanism: Antimetabolite precursor of 6-mercaptopurine; inhibits lymphocyte proliferation by blocking nucleotide synthesis.”

Question 2

Azathioprine - Indications

Answer 2

“Rheumatoid arthritis

Question 3

Azathioprine - Toxicity

Answer 3

“Pancytopenia.”

Question 4

Azathioprine - Notes

Answer 4

“6-MP degraded by xanthine oxidase; toxicity is increased by allopurinol. Pronounce ‘azaTHIOpurine’.”

Question 5

Drug: Mycophenolate mofetil

Answer 5

“Mechanism: Reversibly inhibits IMP dehydrogenase

Question 6

Mycophenolate mofetil - Indications

Answer 6

“Glucocorticoid-sparing agent in rheumatic disease.”

Question 7

Mycophenolate mofetil - Toxicity

Answer 7

“GI upset

Question 8

Mycophenolate mofetil - Notes

Answer 8

“Associated with invasive CMV infection; less nephrotoxic and neurotoxic.”

Question 9

Drug: Glucocorticoids

Answer 9

“Mechanism: Inhibit NF-κB; suppress B- and T-cell function by decreasing transcription of many cytokines; induce T-cell apoptosis.”

Question 10

Glucocorticoids - Indications

Answer 10

“Many autoimmune and inflammatory disorders

Question 11

Glucocorticoids - Toxicity

Answer 11

“Cushing syndrome

Question 12

Glucocorticoids - Notes

Answer 12

“Abrupt discontinuation may cause adrenal insufficiency due to suppressed endogenous production.”

Question 13

Drug: Cyclosporine

Answer 13

“Mechanism: Calcineurin inhibitor; binds cyclophilin. Blocks T-cell activation by preventing IL-2 transcription.”

Question 14

Cyclosporine - Indications

Answer 14

“Psoriasis

Question 15

Cyclosporine - Toxicity

Answer 15

“Nephrotoxicity

Question 16

Cyclosporine - Notes

Answer 16

“Highly nephrotoxic

Question 17

Drug: Tacrolimus (FK506)

Answer 17

“Mechanism: Calcineurin inhibitor; binds FKBP. Blocks T-cell activation by preventing IL-2 transcription.”

Question 18

Tacrolimus - Indications

Answer 18

“Immunosuppression after solid organ transplant.”

Question 19

Tacrolimus - Toxicity

Answer 19

“Increased risk of diabetes and neurotoxicity; no gingival hyperplasia or hirsutism.”

Question 20

Drug: Sirolimus (Rapamycin)

Answer 20

“Mechanism: mTOR inhibitor; binds FKBP. Blocks T-cell activation and B-cell differentiation by preventing response to IL-2.”

Question 21

Sirolimus - Indications

Answer 21

“Kidney transplant rejection prophylaxis.”

Question 22

Sirolimus - Toxicity

Answer 22

“Pancytopenia

Question 23

Sirolimus - Notes

Answer 23

“Synergistic with cyclosporine; also used in drug-eluting stents.”

Question 24

Drug: Basiliximab

Answer 24

“Mechanism: Monoclonal antibody; blocks IL-2R.”

Question 25

Basiliximab - Indications

Answer 25

“Edema

Question 26

Bone marrow stimulation: Erythropoietin

Answer 26

“Agent: Epoetin alfa (EPO analog). Clinical Uses: Anemias (especially in renal failure). Associated with increased risk of hypertension and thromboembolic events.”

Question 27

Colony-stimulating factors

Answer 27

“Agent: Filgrastim (G-CSF)

Question 28

Thrombopoietin

Answer 28

“Agent: Romiplostim (TPO analog)

Question 29

Immunotherapy: Interleukin-2

Answer 29

“Agent: Aldesleukin. Clinical Uses: Renal cell carcinoma

Question 30

Immunotherapy: Interferons

Answer 30

“IFN-α: Chronic hepatitis B and C