Immuno Drugs

Question 1

Cyclosporine: Mechanism

Answer 1

Calcineurin inhibitor

• binds to cyclophillins
• complex blocks differentiation and activation of T cells by inhibiting calcineurin thus NO IL-2 and IL-2 receptor production

Question 2

Cyclosporine: Use

Answer 2

Suppresses organ rejection after transplantation; selected autoimmune disorders

Question 3

Cyclosporine: Toxicity

Answer 3

Nephrotoxicity, Hypertension, Hyperlipidemia, Hyperglycemia, Tremor, Gingival hyperplasia

Question 4

Tacrolimus

Answer 4

• Calcineurin inhibitor, binds to FK- binding protein
• inhibits secretion of IL-2
• potent immunosuppressive and used in organ transplant recipients

Question 5

Tacrolimus Toxicity

Answer 5

HYPERlipidemia, HYPERglycemia, Tremor, HTN, Nephrotoxicity

Question 6

Sirolimus (Rapamyocin)

Answer 6

inhibits mTOR. Inhibits T-cell proliferation in response to IL-2

• immunosuppression after kidney transplant in combo with cyclosporine and corticosteroids
• used with drug-eluting stents

Question 7

Sirolimus: Toxicity

Answer 7

Hyperlipidemia, Thrombocytopenia, Leukopenia

Question 8

Azathioprine

Answer 8

antimetabolite precursor of 6-MP that interfers with metabolism and synthesis of nucleic acids. Toxic to proliferating lymphocytes
- used for kidney transplants, autoimmune disorders (glomerulonephritis and hemoluytic anemia)

Question 9

Azathiprine Toxicity

Answer 9

Bone marrow suppression. Active metabolite mercaptopurine can be metabolized by xanthine oxidase.
Toxic effects may be increased by allopurinol

Question 10

Muromonab-CD3 (OKT3)

Answer 10

• monoclonal antibody that binds to CD3 on surface of T cells. Blocks interaction with CD3 protein responsible for T-cell signal transduction
• immunosuppression after kidney transplant

Question 11

Muromonab-CD3 (OKT3) Toxicity

Answer 11

Cytokine release syndrome

Hypersensitivity reaction

Question 12

Aldesleukin

Answer 12

IL-2 - used for renal cell carcinoma, metastatic melanoma

Question 13

Epoetin alfa (

Answer 13

Erythropoitein - used for anemia

Question 14

Filgrastim

Answer 14

G-CSF - used to recovery bone marrow

Question 15

Sargramostim

Answer 15

GM-CSF - used to recover bone marrow

Question 16

Alpha interferon

Answer 16

Used for Hep B and C
Kaposi’s sarcoma
Leukemias
Malignant melanoma

Question 17

B-interferon

Answer 17

Multiple sclerosis

Question 18

Gamma-interferon

Answer 18

Chronic granulomatous fisease

Question 19

Oprelvekin

Answer 19

IL -11 - used for Thrombocytopenia

Question 20

Thrombopoetin

Answer 20

Thrombocytopenia

Question 21

Muromonab-CD3 (OKT3)

Answer 21

• targets CD3

- used to prevent ACUTE transplant rejection

Question 22

Digoxin Immune Fab

Answer 22

• targets Digozin

- antidode for digoxin intoxication

Question 23

Infliximab

Answer 23

• target TNF-alpha

- antidote for Crohn’s disease, RA, Psoriatic arthritis, Ankylosing spondylitis

Question 24

Adalmimumab

Answer 24

• targets TNF-alpha

- Crohn’s disease, RA, psoriatic arthritis

Question 25

Abciximab

Answer 25

• targets Glycoprotein IIB/IIa

- prevent cardiac ischemia in unstable angina and in patients treated with percutaneous coronary intervention

Question 26

Trastuzumab (Herceptin)

Answer 26

• targets HER2

- HER-2 overexpressing breast cancer

Question 27

Rituximab

Answer 27

• targets CD20

- used for B-cell non-Hodgkin’s lymphoma

Question 28

Omalizumab

Answer 28

• targets IgE

- additional line of treatment for severe asthma