IMMUNOLOGY- Immunosuppressants Flashcards
What are the immunosuppressants?
Agents that block lymphocyte activation and proliferation
Which is the clinical use for immunosuppressants?
Reduce acute transplant rejection by suppressing cellular immunity
Which is the recommendation to have greater efficacy with decreased toxicity for immunosuppressants use?
Frequently combined to achive them
Which is the risk of Chornic suppression with immunosuppressants?
Increased risk of infection and malignancy
These drugs are immunosuppressants
Cyclosporine Tacrolimus Sirolimus (Rapamycin) Basiliximab Azathioprine Glucocorticoids
This is the mechanism of action of Cyclosporine
Calcineurin inhibitor; binds cyclophilin
Blocks T cell activation by preventing IL-2 transcription
Which are the clinical use for Cyclosporine?
Transplant rejection, prophylaxis, psoriasis, rheumatoid arthritis
Which are the possible toxic effects of Cyclosporine?
Nephrotoxicity Hypertension Hyoerlipidemia Hyperglycemia Tremor Hirsutism Gingival hyperplasia
Which are the higher risk of Calcineurin inhibitors?
Highly nephrotoxic
Who are consider Calcineurin inhibitors?
Cyclosporine
Tacrolimus
How does Tacrolimus works?
Binds FK506 binding protein (FKBP)
Blocks T cell activation by preventing IL-2 transcription
This is the use for Tacrolimus
Transplant rejection prophylaxis
Which could be the secondary effects of Tacrolimus?
Similar to cyclosporine, ↑ risk of diabetes and neurotoxicity; no gingival hyperplasia or hirsutism
Which drugs bind to FKBP?
All -limus drugs
Who is inhibited with Sirolimus?
mTOR inhibitor
How else is Sirolimus known?
Rapamycin
This is the mechanism of Sirolimus
Binds FKBP
Blocks T cell activation and B cell diferentiation by preventing IL-2 signal transduction
When is recommended Sirolimus?
Kidney transplant rejection prophylaxis
When is consider that Rapamycin caused toxicity?
Anemia Thrombocytopenia Leukopenia Insulin resistance HyperlipidemiaIs
Is sirolimus nephrotoxic?
No
With which medicine is Sirolimus synergistic?
Ciclosporine
This is an alternative of using Sirolimus
Drug eluting stent
How does Basiliximab works?
Monoclonal antibody; blocks IL- 2R
When is recommended to use Basiliximab?
Kidney transplant rejection prophylaxis
These are secondary effects of Basiliximab
Edema, hypertension, tremor
This immunosuppressant is antimetabolite precursor of 6 mercaptopurine
Azathioprine
How does Azathioprine works?
Inhibits lymphocyte proliferation by blocking nucleotide synthesis
These are the clinical use for Azathioprine
Transplant rejection prophylaxis
Rheumatoid arthritis
Chron disease
Glomerulonephritis
Which are the possible toxic efects of Azathioprine?
Leukopenia
Anemia
Thrombocytopenia
Who degrades 6 MP?
Xanthine oxidase
Who increases 6 MP toxicity?
Allopurinol
What is inhibited by Glucocorticoids?
Inhibit NF- kB
What is suppressed by Glucocorticoids?
Both B and T cell function by ↓ transcription of many cytokines
These are recommendations of using Glucocorticoids
Transplant rejection phrophylaxis (immune suppression)
Many autoimmune disorders
Inflamation
These are the classic toxic effects of Gucocoticoids
Hyperglycemia Osteoporosis Central obesity Muscle Breakdown Psycosis Acne Hypertension Catarcts Peptic Ulcers
Which enzyme is inhibited by Azthioprine?
PPRP Amidotransferase
If PPRP Amidotransferase is inhibited by 6- MP, which are the results?
Inhibition of Purine nucleotides and last DNA replication
Which are Recombinant cytokines?
Epoetin alfa Thrombopoietin Oprelvekin Filgratim Sargramostim Aldesleukin IFN alfa IFN beta IFN gamma
What is Epoetin alfa?
Erythropietin
When is recommended the clinical use of Erythropoietin?
Anemias (especially renal failure)
Which is the clinical use for Thrombopoietin?
Thrombocytopenia
Which is the commercial name for Interleukin 1?
Oprelvekin
This is the recommendation for Interleukin 1 as medication
Thrombocytopenia
What is filgrastim?
Granulocyte colony stimulating factor
Which medicines are indicated for Recovery of bone marrow?
Filgrastim and Sargramostim
What is Sargramostim?
Granulocute macrophage colony stimulating factor
Commercial name for Interleukin 2
Aldesleukin
When is Interleukin 2 recommended?
Renal cell carcinoma, metastatic melanoma
Which is the clinical ise for INF alfa?
Chronic hepatitis B and C, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma
This is the indication of IFN beta
Multiple Sclerosis
When is recommended the clinical use of IFN gamma?
Chronic granulomatous disease
Name therapeutic antibodies cancer therapies
Alemtuzumab Bevacizumab Cetuximab Rituximab Trastuzumab
Which is the target of Aletuzumab?
CD52
Which is the use of Aletuzumab?
CLL
This Therapeutic antibody cancer therapy´s target is VEGF
Bevacizumab
For these cases Bevacizumab is indicated
Colorectal cancer
Renal cell carcinoma
This is the target of Cetuximab
EGFR
This Therapeutic antibody cancer therapy is recommended for Stage IV colorectal cancer, head and neck cancer
Cetuximab
Who is targeted by Rituximab?
CD20
These diseases can be treated with Rituximab
B cell non Hodgkin lymphoma
Rheumatoid arthritis
Idiopathic thrombocytopenic purpura (ITP)
Which medication is indicated with Rituximab in order to treat Rhematoid arthritis?
MTX
Which Therapeutic antibody cancer therapy´s target is HER2/neu?
Trastuzumab
Which is the clinical use for Trastuzumab?
Breast cancer
Gastric cancer
Therapeutic antibodies for Autoimmune disease
Ifiximab, adalimumab
Natalizumab
This medications target is TNF-alfa
Ifiximab, adalimumab
In this cases Ifiximab, adalimumab are indicated
Inflammatory bowel disease (IBD)
Rheumatoid arthritis
Ankylosing spondylitis
Psoriasis
This is Natalizumab target
α4 Integrin
This autoimmune diseases are treated with Nafalizumab
Multiple sclerosis
Chron Disease
Which is the importance of α4 Integrin?
Leukocyte adhesion
If John Cunningham virus (JCV) is present and you give Nafalizumab which is the risk?
Progressive multifocal leukoencephalopathy (PML)
Anti-platelet agent that acts in Glycoprotein IIb/ IIIa
Abxicimab
What does Abxicimab prevents?
Prevention of ischemic complications in patients undergoing percutaneous coronary intervention
This is the target of Denosumab
RANKL
In this cases Denosumab is indicated
Osteoporosis
How does Denosumab acts in Osteoporosis?
Inhibits osteoclast maturation
This medication is mimic by Denosumab
Osteoprotegin
Which therapeutic antibodies act in Digoxin?
Digoxin immune Fab
Antidote for digoxin toxicity
Digoxin immune Fab
Which is the target of Omalizumab?
IgE
This therapeutic antibodies work for Asthma?
Omalizumab
Prevents IgE binding to FcERI
Omalizumab
Which is the target of Palivixumab?
RSV F protein
RSV prophylaxis for high risk infants
Palivizumab