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Sophia's Path > Immune Modulating Therapies > Flashcards

Immune Modulating Therapies Flashcards

1
Q

Cytotoxic Agents

A

Inhibit DNA synthesis

BM suppression
Infection
Malignancy
Teratogenic

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2
Q

Cyclophosphamide (Cytotoxic)

A

Alkylates guanine base
Used in connective tissue disease - severe vasculitis, GPA, anti-cancer agent
Hairloss, sterility, haemorrhagic cystitis
Infection - PCP
Malignancy - Bladder, haem, non-melanoma skin Ca

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3
Q

Azathioprine (Cytotoxic)

A 
Antimetabolite - purine
Transplantation
Crohns and UC
Hepatotoxicity, neutropenia
TPMT polymorphism = extremelty susceptible to BM suppression
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4
Q

Mycophenolate Mofetil (Cytotoxic)

A

Alternative to azapthioprine - transplantation
Alternative to cyclosphamide - autoimmune vasculitis
Infection - herpes, PML (JC virus)

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5
Q

Methotrexate (Cytotoxic)

A 
Inhibits dihydrofolate reductase
RA, Psoriasis, Crohns
Chemotherapy agent
Abortifacient
Pneumonitis, pulmonary fibrosis, hepatotoxicty, folate deficiency
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6
Q

Plasmapheresis

A

Remove plasma and treat to remove Ig - reinfused (or replaced with albumin - ‘plasma exchange’)

Severe Ab mediated disease - Goodpastures, myasthaenia gravis, Ab mediated rejection

SE - rebound Ab production limits efficacy (give with anti-proliferative agent)

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7
Q

Tacrolimus (inhibits cell signalling)

A

Inhibits calcineurin = reduced Il-2 = reduced T cell proliferation

Transplant rejection prophylaxis

nephrotoxic, HT, neurotoxic, DIABETOGENIC

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8
Q

Cyclosporin (inhibits cell signalling)

A

Inhibits calcineurin = reduced Il-2 = reduced T cell proliferation

Transplant rejection prophylaxis

nephrotoxic, HT, neurotoxic, DYSMORPHISM, GUM HYPERTROPHY

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9
Q

Sirolimus (inhibits cell signalling)

A

Block clonal T cell proliferation

Transplant rejection prophylaxis

HT, less nephrotoxic (cf cyclosporin, tacrolimus)

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10
Q

Tofacitinib (inhibits cell signalling)

A

JAK inhibitor

RA

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11
Q

Apremilast (inhibits cell signalling)

A

PDE4 inhibitor

Psoriasis, psoriatic arthritis

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12
Q

Anti Thymocyte Globulin (ATG)

A

Rabbit derived Ab against human T cells

Allograft rejection (renal, heart)

Infusion reaction, leukopenia, infection, malignancy

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13
Q

Basiliximab

A

AntiCD25 - inhibits T cell proliferation

Allograft rejection prophylaxis

SE - infusion reaction, infection, GI disturbance, longterm malignancy risk

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14
Q

Abatacept

A

CTLA4 Ig (infusion protein) - reduces T cell activation

RA

SE - infusion reaction, infection (TB, HBV, HCV), malignacy, cough

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15
Q

Rituximab

A

AntiCD20 - depletes mature B cells

Lymphoma, RA, SLE

SE - infusion reaction, infection (PML), exacerbates CVD

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16
Q

Natalizumab

A

Anti-alpha4 integrin - inhibits T cell migration

Relapsing-remitting MS, Crohns disease

SE - infusion reaction, infection (PML), malignancy, hepatoxic

17
Q

Tocilizumab

A

Anti-IL6

Castleman’s disease, RA

Infusion reactions, infection, hepatotoxic, hyperlipidaemia, malignancy

18
Q

Muromonab-CD3

A

Blocks CD3 on T cells

Active allograft transplant rejection

Fever, leucopenia

19
Q

Daclizizumab

A

Il2 receptor Ab, targets CD25

Organ transplant rejection prophylaxis

20
Q

Efalizumab

A

AntiCD-IIa

21
Q

Alemtuzumab

A

Monoclonal Ab binds CD25

CLL, MS

SE - CMV infection

22
Q

Infliximab

Adalimumab, certolizumab, golimumab

A

Anti-TNFalpha

RA, ankylosing spondylitis, psoriasis, psoriatic arthritis

Injection site reaction, infection (TB, HBV, HCV), lupus-like condition, demyelination, malignancy (lymphoma)

23
Q

Etanarcept

A

TNF alpha antagonist (inhibits TNF alpha and TNF beta)

RA, ankylosing spondylitis, psoriasis, psoriatic arthritis

Injection site reaction, infection (TB, HBV, HCV), lupus-like condition, demyelination, malignancy (lymphoma)

24
Q

Ustekinumab

A

Anti-IL12 + IL23 (bind p40)

psoriasis, psoriatic arthritis

Injection site reaction, infection (TB), malignancy, cough

25
Q

Secukinumab

A

anti-IL17A

ankylosing spondylitis, psoriasis, psoriatic arthritis

infection (TB)

26
Q

Denosumab

A

anti RANK ligand Ab

osteoporosis, MM, bone mets

Sophia's Path (8 decks)

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