immuno Flashcards
Romiplostim
TPO analog - treats thrombocytopenia
Aldesleukin
IL-2) Renal cell carcinoma, metastatic melanoma
Alemtuzumab
targets CD52
CLL, MS “Alymtuzumab”—chronic
lymphocytic leukemia
Bevacuzimab
TargetsVEGF Colorectal cancer, renal cell
carcinoma, non-small cell
lung cancer
Treats wet macular degeneration
can cause bleeding, increases risk of thrombotic events
Cetuximab
EGFR- Stage IV colorectal cancer,
head and neck cancer
Can cause a papulopustular acneiform rash
Adverse effects of trastuzumab
causes cardiotoxicity -decreased LVEF, heart failure
Daclizumab
Daclizumab targets CD25 (switched from alemtuzumab) (part of IL-2 receptor) Relapsing multiple sclerosis
Eculizumab
Eculizumab Complement protein C5
Paroxysmal nocturnal hemoglobinuria
Natalizumab
targets α4-integrin Multiple sclerosis, Crohn disease α4-integrin: WBC adhesion Risk of PML in patients with JC virus
Ustekinumab
Ustekinumab
IL-12/IL-23 Psoriasis, psoriatic arthritis
Denosumab
RANKL Osteoporosis; inhibits osteoclast
maturation (mimics
osteoprotegerin)
Denosumab affects osteoclasts
Palivizumab
Targets RSV F protein
RSV prophylaxis for high-risk
infants
Ranibizumab
targets VEGF Neovascular age-related macular degeneration, proliferative diabetic retinopathy and macular edema
Tisagenlecleucel
CAR T-cell Therapy that is indicated for relapsed B-cell acute lymphoblastic leukemia by targeting the CD19 antigen
The way this drug works is that a patients T cells are extracted, genetically engineered to target CD19, then infused back into the patient
- Tisagenlecleucel has a 82% response rate
The main acute side effect of Tisagenlecleucel is Cytokine Release Syndrome while a potential long term risk is the potential for insertional mutagenesis
- the main symptoms of cytokine storm are a high fever, extreme fatigue, nausea; potential to be fatal; also occurs in GVHD, ARDS, Sepsis
- because Tisagenlecleucel is generated by using a retrovirus, concerns that it could modify a protoconcogene / tumor suppressor are warranted
Pegademase
Pegademase is a recombinant Adenosine Deaminase used for treatment of the second most common form of SCID
Ivacaftor
In the treatment of Cystic Fibrosis, Ivacaftor works by stimulating activity of the CFTR protein
- this opens Cl- channels to improve chloride transport (Ivacaftor invokes activity)
- this is for patients with two copies of the Phe508 deletion
Dornase Alfa
cleaving DNA present in the mucus of Cystic Fibrosis patients thus reducing the visocity of lung secretions
pancrelipase
mix of pancreatic enzymes used to restore pancreatic function
Lumacaftor
Lumacaftor works by facilitating proper folding of the CFTR protein
- corrects misfolded proteins and improves transport to cell surface (lumacaftor lubricates proper folding)
- this is for patients with two copies of the Phe508 deletion
Azithromycin in the tx of cystic fibrosis
In the treatment of Cystic Fibrosis, Azithromycin is used as an anti-inflammatory agent
Works by inhibiting phospholipase A2 in alveolar macrophages
Cyclosporine
Cyclosporine - binds cyclophilin and this complex is a Calcineurin inhibitor (a transcription factor for IL-2).
Blocks T-cell activation by preventing IL-2 TRANSCRIPTION.
Tx for mainly acute transplant rejection and also Psoriasis, rheumatoid arthritis.
AE:
*Nephrotoxicity,
hypertension,
hyperlipidemia,
neurotoxicity,
gingival hyperplasia,
hirsutism.
Tacrolimus
Tacrolimus binds to FK506 binding protein (FKBP). This complex inhibits calcineurin phosphatase. The drug inhibits calcium-dependent events, such as interleukin-2 gene transcription Tx: only acute transplant rejection AE: *Nephrotoxicity, hypertension, hyperlipidemia, **Increased risk of diabetes and neurotoxicity; no gingival hyperplasia or hirsutism.
Sirolimus
Sirolimus (Rapamycin) mTOR inhibitor by binding FKBP which is same protein as tacrolimus but different results. {effects are more downstream]
Blocks T-cell activation and B-cell differentiation by
preventing RESPONSE to IL-2 (in addition to transcription).
Tx for Kidney transplant rejection prophylaxis
specifically.
AE:
“PanSirtopenia” (pancytopenia),
insulin resistance,
hyperlipidemia;
NOT nephrotoxic.
Kidney “sir-vives.”
Synergistic with cyclosporine.
**Also used in drugeluting
stents.
Basiliximab
Basiliximab Monoclonal antibody blocks IL-2R. Treats acute transplant rejection AE: Edema hypertension, tremor.
Azathioprine
Azathioprine Antimetabolite precursor of 6-mercaptopurine. Purine terminating analog that Inhibits lymphocyte proliferation Treats: Acute transplant rejection Rheumatoid arthritis, Crohn disease, glomerulonephritis, other autoimmune conditions. AE: Pancytopenia. 6-MP degraded by xanthine oxidase; toxicity decreased by allopurinol. Pronounce “azathiopurine.”
Mycophenolate Mofetil
Mycophenolate
Mofetil
Mech: Reversibly inhibits IMP dehydrogenase, preventing purine synthesis of B and T cells. Uses: Acute transplant rejection Lupus nephritis. AE: GI upset, pancytopenia, hypertension, hyperglycemia. Less nephrotoxic and neurotoxic. Associated with invasive CMV infection
Glucocorticoids Inhibit NF-κB. Suppress both B- and T-cell function by decreasing transcription of many cytokines. and Induce T cell apoptosis.
USes: and AE
Adrenal insufficiency, asthma, CLL, non-Hodgkin lymphoma. Many autoimmune and inflammatory disorders,
AE: -Cushing syndrome, -osteoporosis, -hyperglycemia, -diabetes, -amenorrhea, -adrenocortical atrophy, -peptic ulcers, -psychosis, -cataracts, -avascular necrosis (femoral head). Demargination of WBCs causes artificial leukocytosis. Adrenal insufficiency may develop if drug is stopped abruptly after chronic use.
