Immuno Drugs

Question 1

What does Prednisone do?

Answer 1

Synthetic steroid that suppresses cytokine production. Now these cytokines cannot act on T cells

G0 and G1 phase

Question 2

What does Tacrolimus (FK506) do?

Answer 2

It binds to FKBP in the T cell cytoplasm and this complex inhibits Calcineurin

Calcineurin normally dephosphorylates the TF NFAT.

The dephosphorylated version of NFAT can enter into the nucleus and stimulate production of IL-2 and IL-2R alpha

G0 phase

Question 3

What does Cyclosporine do?

Answer 3

It binds to Cyclophilin in the T cell cytoplasm and this complex inhibits Calcineurin

Calcineurin normally dephosphorylates the TF NFAT.

The dephosphorylated version of NFAT can enter into the nucleus and stimulate production of IL-2 and IL-2R alpha

G0 phase

Question 4

What does Dacluzimab do?

Answer 4

Monoclonal antibody used in acute transplant rejection

It binds to IL-2R alpha (CD25) and inhibits assembly of the high-affinity IL-2R receptor

Note: this means that Dacluzimab inhibits activated T cells that are expressing high-affinity IL-2R but does NOT inhibit naive T cells

Question 5

What does Sirolimus (Rapamycin) do?

Answer 5

It binds to FKBP in the T cell cytoplasm and this complex inhibits mTOR

mTOR normally increases T cell proliferation

G1 phase

Question 6

What does Cyclophosphamide do?

Answer 6

Alkylating agent that inhibits T cell proliferation by killing the dividing cell

Question 7

What does Methotrexate do?

Answer 7

Anti metabolite (folate mimic) that inhibits T cell proliferation

Question 8

What does Mycophenolate Mofetil do?

Answer 8

Antimetabolite that inhibits T cell proliferation

Question 9

What are the side effects of Cyclosporine and Tacrolimus?

Answer 9

Nephrotoxicity, hepatotoxicity, and neurotoxicity

Question 10

What are the side effects of Sirolimus/rapamycin?

Answer 10

Hyperlipidemia

Question 11

What are the side effects of prednisone?

Answer 11

Insomnia, hypomania, ulcers

Question 12

What are the side effects of Cyclophosphamide, methotrexate, and mycophenolate mofetil?

Answer 12

Proliferation-associated toxicities

Question 13

How long after birth must an Rh- mother be given Igs to lyse Rh+ erythrocytes from the fetus?

Answer 13

within 72 hours, otherwise she will generate an immune response and have anti Rh+ antibodies that may affect future pregnancies

Question 14

When is Rh(d) immune globulin a concern?

Answer 14

Rh negative mother + Rh positive father

Question 15

What was the first therapeutic monoclonal antibody approved by the FDA? What was it used for?

Answer 15

Acute transplant rejection drug, OKT3/Muromonab CD3

Targets T cell CD3

Question 16

What suffix is used for murine/mouse monoclonal antibodies?

Answer 16

-omab

Question 17

What suffix is used for chimeric mouse/human monoclonal antibodies?

Answer 17

-ximab and -zumab

Question 18

What suffix is used for human monoclonal antibodies?

Answer 18

-mumab

Question 19

What does Infliximab do?

Answer 19

Monoclonal antibody used in the inhibition of TNF-alpha signaling (neutralizes inflammation)

Used to treat RA (sometimes in combo with methotrexate) and in patients with severe Crohn’s disease who have failed conventional therapy

Question 20

What does Rituximab do?

Answer 20

Monoclonal antibody against CD20 antigen (B cells)

Used to treat non-Hodgkins Lymphoma, MS, and RA (when combined with methotrexate)

Question 21

What does Tocilizumab do?

Answer 21

Anti IL-6 receptor neutralizing antibody

Useful in treating RA

Question 22

Patients with what disease should not get Tocilizumab?

Answer 22

Those with TB

lower immune response and latent TB may become active