Immuno Drugs

Question 1

Cyclosporine

Answer 1

• Calcineurin inhibitor, binds Cyclophilin. Blocks T cell activation by preventing IL-2 transcription
• Also used for psoriasis & RA
• Adverse effects: Nephrotoxicity, hypertension, hyperlipidemia, neurotoxicity, gingival hyperplasia, hirsutism

Question 2

Tacrolimus (FK506)

Answer 2

• Calcineurin inhibitor, binds FK506 binding protein (FKBP). Blocks T cell activation by preventing IL-2 transcription
• Adverse effect: Nephrotoxicity, Similar to cyclosporine, ↑ risk of diabetes and neurotoxicity, no gingival hyperplasia or hirsutism

Question 3

Sirolimus (Rapamycin)

Answer 3

• mTOR inhibitor (binds FKBP). BLocks T-cell activation & B-cell differentiation by preventing response to IL-2
• Kidney transplant rejection prophylaxis
• Adverse effects: “pansirtopenia”, insulin resistance, hyperlipidemia, not nephrotoxic
• Synergistic w/ cyclosporine
• Used in drug-eluting stents

Question 4

Basiliximab

Answer 4

• Monoclonal Ab that blocks IL-2R
• Kidney transplant rejection prophylaxis
• Adverse effects: Edema, hypertension, tremor

Question 5

Adalimumab, Certolizumab, Golimumab, Infliximab

Answer 5

• Soluble TNFα
• Treats IBD, RA, Ankylosing spondylitis, Psoriasis
• Etanercept is a decoy TNFα receptor and not a monoclonal antibody

Question 6

Daclizumab

Answer 6

• Target = CD25 (part of IL-2 receptor)
• Used for relapsing MS

Question 7

Eculizumab

Answer 7

• Target = Complement protein C5
• Treats Paroxysmal Nocturnal Hemoglobinuria

Question 8

Natalizumab

Answer 8

• Target = α4-integrin (for WBC adhesion)
• MS, Crohn disease
• Risk of PML in patients w/ JC

Question 9

Ustekinumab

Answer 9

• Target = IL-12/IL-23
• Psoriasis, psoriatic arthritis

Question 10

Ranibizumab

Answer 10

• Like Bevacizumab
• Targets VEGF
• For neovascular age related macular degeneration, diabetic retinopathy and macular edema