Immuno drugs

Question 1

Cyclosporine: MOA? Use? Toxicity?

Answer 1

1) Blocks calcineurin (which usually activates IL-2)2) Organ transplant and some autoimmune disorders3) Nephrotoxicity and hypertension, hirsutism, tremor, GINGIVAL HYPERPLASIA

Question 2

Patient with a recent liver transplant uses drug that causes her to grow her on her chin, develops tremor, and her BUN and creatinine both rise

Answer 2

Cyclosporine– blocks calcineurin which inhibits IL2 (could be tacrolimus if it didn’t cause hirsutism)

Question 3

Tacrolimus: MOA? Use? Toxicity?

Answer 3

1) Binds FK binding proteins inhibiting calcineurin2) Organ transplants3) Nephrotoxicity, hypertension, tremor NO GINGIVAL HYPERPLASIA OR HIRSUTISM

Question 4

Sirolimus: MOA? Use? Toxicity?

Answer 4

1) Inhibits mTOR2) Immunosuppression after kidney transplant; used in combo with cyclosporin and corticosteroids3) Hyperlipidemia; thrombocytopenia, leukopenia

Question 5

Drug to use for patient after kidney transplant? Side effects to monitor?

Answer 5

1) Sirolimus2) Leukopenia, and thrombocytopenia

Question 6

Azathioprine: MOA? Use? Toxicity?

Answer 6

1) Antimetabolite precursor of 6MP; toxic to proliferating lymphocytes2) Kidney transplantation, autoimmune disorders3) Active metabolite is degraded by xanthine oxidase so allopurinol may worse effects

Question 7

Patient about to start 6MP, which medication should she also be on? Which medication is contraindicated?

Answer 7

1) Azothioprine2) Allopurinol since active metabolite of 6MP is degraded by xanthine oxidase

Question 8

Muromonab: MOA? Use? Toxicity?

Answer 8

1) Binds CD32) Immunosuppression after kidney transplant3) Cytokine release syndrome; hypersensitivity reaction

Question 9

Patient received drug after kidney transplant. Begins to have hypotension, fever, and shivering

Answer 9

Muromonab– toxicity is cytokine release syndrome

Question 10

Drug for MS?

Answer 10

Beta interferon

Question 11

HER2 target?

Answer 11

Trastuzumab

Question 12

Rituximab?

Answer 12

CD20 target; non-hodgkins lymphoma

Question 13

MOA of corticosteroids?

Answer 13

Inhibit NF-kappa B