Immune Stimulation Flashcards
conditions where immune modulation is the goal
immune deficiency, chronic infection, chemo, immunological disorders (MS), cancer, myelogenous blood disorders
antigen specific modulators
active and passive immunization
non-antigen specific modulators
adjuvants (BCG, cytokines, alum, liposomes), macrophage activation, cytokines (IL-2, IFNs), passive immunoglobulins (monoclonal Abs), and drugs
filgrastim
G-CSF stimulating factor (neutrophils); used for neutropenia or in conjunction with chemotherapy
filgrastim dosing
injectable
filgrastim side effects
fever, cough, bone pain, reactions at injection site; severe effects are splenic rupture, sickle cell crisis, acute respiratory distress
IFN-alpha2a, 2b (type I IFNs)
help with viral infections like hepatitis C; recombinant human proteins that are administered weekly (IM or subQ)
type I IFN mechanism
act by inducing IFN-sensitive genes with different antiviral activities, direct effect on viral replication, indirectly elicits T cell response
type I IFN side effects
injection site reaction, flu-like symptoms, depression, breathing problems, leukopenia, neutropenia
epoetin alpha
EPO; can be used for anemia; increases level of RBCs
epoetin alpha dosing
injected 3 times weekly
epoetin alpha side effects
hypertension, headaches, thrombotic events, sensitivity reactions, stroke, death
contraindications for epoetin alpha
bone-marrow based cancers and acute myelogenous leukemia
aldesleukin (IL-2)
immunostimulant that can be used in cases of metastasis
IL-2 mechanism
recombinant human IL-2; must be closely managed during and post IV infusion; induces proliferation of T cells and enhances effector functions
IL-2 side effects
flu-like symptoms, hypotension, drowsiness, vascular/capillary leak syndrome, pulmonary brain edema
sargramostim
GM-CSF for macrophages and neutrophils via STAT pathway
sargramostim side effects
infusion site reactions, hypotension, tachycardia, joint pain, headaches, hair loss, edema, shortness of breath, thrombocytopenia
sargramostim warnings
fluid retention with respiratory, cardio, renal, and hepatic symptoms
IFN-beta1
relapsing-remitting MS; avonex, betaseron
IFN-beta1 dosing
subQ every other day
IFN-beta1 mechanism
acts via IFN receptors to regulate expression of antiviral genes and immune enhancing genes including for cytokines and MHC antigens
IFN-beta1 side effects
flu-like symptoms, depression, rash, anaphylaxis
lenalidomide/thalidomide
affect cytokine release
lenalidomide uses
multiple myeloma, myelodysplastic disorders with del(5q)
lenalidomide side effects
diarrhea, rash, fatigue, leukopenia, thrombocytopenia, blood clots, liver toxicity
thalidomide uses
multiple myeloma, erythema nodosum leprosum
thalidomide side effects
teratogen, drowsiness, nerve damage, birth defects
bacillus-calmette guerin
live attenuated vaccine derived from mycobacterium bovis used for TB vaccine in other countries and invasive bladder cancer
bacillus-calmette guerin side effects
granulomatous lesions at sites, swollen lymph nodes
Rho(D) immune globulin
passively blocks immune system from recognizing Rh differences; used to treat Rh antigen incompatibility
Rho(D) immune globulin side effects
fever, headaches, pain at site, erythrocyte breakdown
immediate drug allergy (type I)
vasoactive mediators; IgE-mediated acute allergic reactions causing mast cell degranulation
autoimmune reaction (type II)
cell destruction; IgG or IgM response to modified host proteins (from drug) which causes cell lysis or Ab-toxicity
examples of type II reactions
lupus from hydralazine, hemolytic anemia from methyldopa, or thrombocytopenia purpura from quinidine
serum sickness (type III)
complement deposition; immune complexes containing IgG and is a multisystem complement-dependent vasculitis due to Ab’s against the drug; arthritis, fever, lymph nodes swollen
examples of serum sickness
sulfonamides, thiouracil, anticonvulsants, antibody therapeutics
cell-mediated reactions (type IV)
contact dermatitis from topically-applied drugs
