Immune Modulating Drugs

Question 1

indications for immunosuppressive drugs

Answer 1

• organ transplant

- tx for autoimmune conditions

Question 2

risk associated with DMARDs (immunosupporessive)

Answer 2

vulnerability to infection and malignancy

Question 3

side effects of steroidal immunosuppressants

Answer 3

• susceptibility to infection
• poor wound healing
• hyperglycemia
• increased risk for osteoporosis
• adrenal suppression

Question 4

MOA of non-steroidal immunosuppressants

Answer 4

• cause cell death or impair cell proliferation (methotrexate, cyclophosphamide, chorambucil, azathioprine)
• inhibit proliferation of lymphocytes (cyclosporine and tacrolimus)

Question 5

Azathioprine

Answer 5

cytotoxic drug

prevents clonal expansion of B and T lymphocytes

Question 6

methotrexate

Answer 6

• anti-metabolite and folate immunosuppressant and chemotherapeutic
• CA, autoimmune diseases, abortifacient, MS
• nausea, abd pain, fever, dizziness, ulcerative stomatitis

Question 7

azathioprine

Answer 7

• purine anti-metabolite
• prevention of transplant rejection, inflammatory bowel disease, SLE, RA
• inhibits purine synthesis which blocks protein synthesis
• effects rapidly proliferating cells = hair loss, bone marrow suppression, GI, leukopenia, thrombocytopenia

Question 8

cyclosporine

Answer 8

• immunosuppressant from soil fungus
• prevent rejection of kidney, liver, and heart transplants, tx for RA, psoriasis
• t-cell inhibition
• N/V, diarrhea, anorexia, tremors, HA, confusion, coma, gout, gum growth

Question 9

tacrolimus

Answer 9

• immunosuppressant drug related to macrolide antibiotics
• organ rejection and topical for eczema
• t-cell inhibition (100x more potent than cyclosporine)
• N/V, diarrhea, anorexia, HTN, kidney damage

Question 10

DMARDs

Answer 10

• disease modifying anti-rheumatic drugs

- used for autoimmune conditions

Question 11

TNF-alpha blockers

Answer 11

decreases inflammatory response

Question 12

Entanercept

Answer 12

• DMARD, recombinant DNA
• moderate to severe RA, psoriatic arthritis, AS
• reduction of inflammatory response viea anti-TNF alpha therapy
• decreased resistance to infxn, increased risk of leukemia, lymphoma, liver injury, CHF

Question 13

Infliximab

Answer 13

• DMARD, recombinant DNA
• RA, Crohn’s, UC
• anti-TNF- alpha

Question 14

hydroxychloroquine

Answer 14

• anti-malarial drug, immunosuppressant
• RA, SLE, Sjogrens, lyme
• spirochete activity. blocks activation of toll-like receptors on PDCs
• HA, ataxia, N/V, photosensitivity, pruritis
• G6PD def + hydroxycholorquine = severe anemia

Question 15

gold salts

Answer 15

• decrease inflammation related to RA, IBD, psoriatic arthritis, SLE
• anti-mitochondrial effect leading to apoptosis
• anorexia, nausea, hair thinning, diarrhea, rash, thrombocytopenia