Immuno pharm

Question 1

What is the major adverse effect of calcineurin inhibitors (Tacrolimus and Cyclosporine)

Answer 1

highly nephrotoxic

Question 2

How do Calcineurin inhibitors (Tacrolimus F506 and Cyclosporine) function?

Answer 2

Shut down T cell response by inhibiting production of IL-2 by sequestering Calcineurin

Question 3

Adverse effects of Cyclosporine

Answer 3

Nephrotoxicity, hypertension, hyperlipidemia, neurotoxicity, gingival hyperplasia, hirsuitism

Question 4

Adverse effects of Tacrolimus

Answer 4

Nephrotoxic, neurotoxic, gingival hyperplasia, increased risk of diabetes

Question 5

Which two immunosuppressants bind FKBP

Answer 5

Tacrolimus and Rapamycin (Sirolimus)

Question 6

Mechanism of Sirolimus (Rapamycin)

Answer 6

binds FKBP to block T cell activaiton and B cell differentiation by preventing response to IL-2

Question 7

Major uses for Cyclosporine

Answer 7

Transplant rejection prophylaxis, psoriasis, RA

Question 8

Major uses for Tacrolimus

Answer 8

Transplant rejection prophylaxis

Question 9

Major use for Rapamycin (Sirolimus)

Answer 9

Kidney transplant rejection prophylaxis

Question 10

Adverse effects of Rapamycin (Sirolimus)

Answer 10

Pancytopenia, insulin resistance, hyperlipidemia

Question 11

Side effects of Daclizumab and Basiliximab

Answer 11

hypertension, edema, tremore

Question 12

Use and function of daclizumab, basiliximab

Answer 12

Monoclonal antibodies to IL-2R, kidney transplant rejection prophylaxis

Question 13

Which immuno suppressant is a precursor for 6-mercaptopurine and inhibits purine synthesis by inhibiting PRPP amiodotransferase?

Answer 13

Azathioprine

Question 14

Uses for Azathioprine

Answer 14

Transplant rejection prophylaxis, RA, Crohn, glomerulonephritis

Question 15

Side effects of Azathioprine

Answer 15

Leukopenia, anemia, thrombocytopenia

Question 16

Which immunosuppressant is associated with invasive CMV infection

Answer 16

Mycophenalate mofetil

Question 17

Mechanism of Mycophenolate mofetil

Answer 17

reversibly inhibit IMP dehydrogenase; halt purine synthesis of B and T cells

Question 18

Clinical use of Mycophenolate mofetil

Answer 18

Transplant rejection prophylaxis, lupus nephritis

Question 19

Adverse effects of mycophenolate mofetil

Answer 19

GI upset, pancytopenia, hypertension, hyperglycemia. Less nephro and neurotoxic

Question 20

Mechanism of corticosteroids

Answer 20

Inhibit NFkappaB and suppress both B and T cell function by decreasing transcription of cytokines. Induce apoptosis of T lymphocytes

Question 21

Filgrastim and Sargramostim use

Answer 21

Bone marrow recovery

Question 22

Romiplostim, eltrombopag and Oprelvekin (IL-11) use

Answer 22

Thrombocytopenia

Question 23

Interferon-beta use

Answer 23

Multiple sclerosis

Question 24

Use of Traztuzumab

Answer 24

HER2/neu Antibody; breast cancer

Question 25

Rituximab use

Answer 25

CD20 antibody; B cell lymphomas, CLL, RA, ITP

Question 26

Cetuximab use

Answer 26

EGFR antibody; stage IV colorectal cancer, head and neck cancer

Question 27

Bevacizumab use

Answer 27

VEGF antibody; colorectal cancer, renal cell carcinoma

Question 28

Adalimumab, Certolizumab, Infliximab use

Answer 28

soluble TNF-alpha; IBD, RA, ankylosing spondylitis, psoriasis

Question 29

Eculizumab use

Answer 29

target is C5; PNH

Question 30

Natalizumab use

Answer 30

alpha4-integrin; MS, Crohn (can cause PML--demyelination-- in pts with JC)

Question 31

Abciximab use

Answer 31

gpIIb/IIIa; antiplatelet agent

Question 32

Denosumab use

Answer 32

RANKL antibody; Osteoporosis

Question 33

Palivizumab

Answer 33

RSV prophylaxis for high-risk infants

Question 34

Ranibizumab, bevacizumab use

Answer 34

VEGF antibody; neovascular age-related macular degeneration

Question 35

How can high-doses of corticosteroids cause neutrophilia and induced psychosis?

Answer 35

Cause demargination of neutrophils from blood vessel walls, leading to an increase in circulating neutrophils

Question 36

Mechanism of Bortezomib (treatment for mulitple myeloma)

Answer 36

Inhibit 26s proteosome, allow buildup of pro-apoptotic factors that induce apoptosis in neoplastic cells

Question 37

Mycophenolate mechanism

Answer 37

Selectively targets B and T cell proliferation, promotes T cell apoptosis by inhibiting IMP dehydrogenase (stops purine synthesis)

Question 38

Used to treat CMV retinitis

Answer 38

Cidofovir

Question 39

Cidofovir side effect

Answer 39

Nephrotoxicity manifesting as proteinuria or elevated creatinine

Question 40

Inhibits nonstructural protein 5B (NS5B) an RNA-dependent RNA polymerase needed for Hep C

Answer 40

Sofosbuvir

Question 41

Used in ganciclovir-resistant CMV and associated with severe neutropenia

Answer 41

Valganciclovir

Question 42

Aprepitant is a ___ receptor antagonist used to treat chemotherapy-induced emesis

Answer 42

Neurokinin-1 receptor antagonist

Question 43

Fosaprepitant is a ____ receptor antagonist used to treat chemotherapy-induced emesis

Answer 43

Neurokinin 1

Question 44

Ondansetron and Granisetron are ____ receptor antagonists used to treat chemotherapy-induced emesis

Answer 44

5-HT3

Question 45

Scopolamine is a ____ used to to treat motion sickness

Answer 45

antimuscarinic

Question 46

Diphenhydramine, Meclizine and Promethazine are ___ used to treat motion sickness

Answer 46

Antihistamines

Question 47

How do calineurin inhibitors (Tacrolimus or Cyclosporine) cause renal failure?

Answer 47

Lead to afferent and efferent arteriolar vasoconstriction in kidneys, leading to obligerative vasculopathy and scarring