Immunology Flashcards
Cyclosporine
Immunosuppressant
MOA: Calcineruin inhibitor (decreased NFAT transcription factor)
Binds cyclophilin
Blocks T cell activation by preventing IL-2 TRANSCRIPTION
Use: transplant rejection prophylaxis, psoriasis, rehumatoid arthritis
Toxicity: NEPRHOTOXICITY, hypertension, hyperlipidemia, hyperglycemia, tremor, hirstutism, gingival hyperplasia
Tacrolimus
Immunosuppresant
MOA: calcineurin inhibitor (decreased NFAT transcription factor)
Binds FK506 binding protein
Blocks T cell activation preventing IL-2 TRANSCRIPTION
Use: transplant rejection prophylaxis
Toxicity: NEPHROTOXICITY, increased risk of diabetes, tremor, hyperlipidemia
Sirolimus (Rapamycin)
Immunosuppresant
MOA: mTOR inhibitor
Binds FKBP
Blocks T cell and B cell differentiation blocking IL-2 SIGNAL TRANSDUCTION
Use: kidney transplant rejection prophylaxis
Toxicity: anemia, thromobocytopenia, leukopenia, insulin resistance, hyperlipidemia,
not nephrotoxic!
Synergistic with cyclosporine
Used in drug eluting stents
Basiliximab
Immunosupppresant
Monoclonal Ab blocks Il-2R
Use: kidney transplant rejection prophylaxis
Toxicity: edema, hypertension, tremor
Azathioprine
Immunosuppressant
MOA: antimetabolite precursor of 6-mercaptopurine
Inhibits lymphocyte proliferation by blocking nucloetide synthesis
Use: transplant rejection prophylaxis, rheumatoid arthritis, Crohn disease, glomerulonephritis, other autoimmune conditions
Toxicity: luekopenia, anemia, thrombocytopenia
Degraded by xanthine oxidase, increased toxicity by allopurinol
Glucocorticoids
Immunosuppresant
MOA: inihibit NF-kB
Suppress both B and T cell function by decreasing transcription of many cytokines
Use: transplant rejection prophylaxis, many autoimmune disorders, inflammation
Toxicity: hyperglycemia, osteoporosis, central obesity, muscle breakdown, psychosis, acne, hypertension, cataracts, peptic ulcers
Can cause Cushing syndrome
Epoetin alfa
Erythropoetin recombinant cytokine
Used in anemias especially renal failure
Thrombopoietin
Recombinant cytokine
Used in thrombocytopenia
Oprelvekin
Recombinant IL-11
Used in thrombocytopenia
Filgrastim
Granulocyte colony stimulating factor recombinant cytokine
Recovery of bone marrow
Saregramostim
Granulcoyte macrophage colony stimulating factor
Recovery of bone marrow
Aldesleukin
Recombinant IL-2
Used in Renal cell carcinoma, metastatic melanoma
IFN-a
Recombinant Cytokine
Used in chronic hepatitis B and C, Kaposi Sarcoma, hairy cell leukemia, condyloma acuminautum, renal cell carcinoma, malignant melanoma
IFN-B
Recombinant Cytokine
Multiple Sclerosis
IFN-y
Recombinant Cytokine
Chronic Granulomatous disease
Alemtuzumab
Targets CD52
Clinical: CLL
Bevacizumab
Target VEGF
Clinical: colorectal cancer, renal cell carcinoma
Cetuximab
Target EGFR
Clinical: stage IV colorectal cancer, head and neck cancer
Rituximab
Target CD20
Clinical: B cell non Hodgkin lymphoma, Rheumatoid arthritis (with MTX), ITP
Trastuzumab
Target Her2/neu
Clinical: Breast Cancer, gastric cancer
Infliximab, adalimumab
Target: TNF-a
Clinical: IBD, rheumatoid arthritis, ankylosing spondylitis, psoriasis
natalizumab
Target: a4-integrin (leukocyte adhesion)
Clinical: mutlpe sclerosis, Crohn disease
Risk of PML patients with JC virus
Abciximab
Target: glycoprotein IIb/IIIa
Clinical: anti-platelet agent for prevention of ischemic complications in patients undergoing percutaneous coronary intervention
Denosumab
Target: RANK-L
clinical: osteoporosis, inhibits ostoeclast maturation
Digoxin immune Fab
target: digoxin
Clinical: digoxin toxicity
Omalizumab
Target: IgE
Clinical: allergic asthma, prevents IgE binding to FCERi
Palivizumab
Target: RSV F protein
Clinical: prophylaxis for high-risk infants
Muromonab
Target: CD3
Clinical: inhibit T-lymphocytes,
Treats acute rejection patients with kidney, heart and liver transplants
