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IMMUNOLOGY > IMMUNOLOGY- Immunosuppressants > Flashcards

IMMUNOLOGY- Immunosuppressants Flashcards

1
Q

What are the immunosuppressants?

A

Agents that block lymphocyte activation and proliferation

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2
Q

Which is the clinical use for immunosuppressants?

A

Reduce acute transplant rejection by suppressing cellular immunity

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3
Q

Which is the recommendation to have greater efficacy with decreased toxicity for immunosuppressants use?

A

Frequently combined to achive them

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4
Q

Which is the risk of Chornic suppression with immunosuppressants?

A

Increased risk of infection and malignancy

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5
Q

These drugs are immunosuppressants

A 
Cyclosporine
Tacrolimus
Sirolimus (Rapamycin)
Basiliximab
Azathioprine
Glucocorticoids
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6
Q

This is the mechanism of action of Cyclosporine

A

Calcineurin inhibitor; binds cyclophilin

Blocks T cell activation by preventing IL-2 transcription

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7
Q

Which are the clinical use for Cyclosporine?

A

Transplant rejection, prophylaxis, psoriasis, rheumatoid arthritis

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8
Q

Which are the possible toxic effects of Cyclosporine?

A 
Nephrotoxicity
Hypertension 
Hyoerlipidemia
Hyperglycemia
Tremor
Hirsutism
Gingival hyperplasia
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9
Q

Which are the higher risk of Calcineurin inhibitors?

A

Highly nephrotoxic

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10
Q

Who are consider Calcineurin inhibitors?

A

Cyclosporine

Tacrolimus

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11
Q

How does Tacrolimus works?

A

Binds FK506 binding protein (FKBP)

Blocks T cell activation by preventing IL-2 transcription

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12
Q

This is the use for Tacrolimus

A

Transplant rejection prophylaxis

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13
Q

Which could be the secondary effects of Tacrolimus?

A

Similar to cyclosporine, ↑ risk of diabetes and neurotoxicity; no gingival hyperplasia or hirsutism

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14
Q

Which drugs bind to FKBP?

A

All -limus drugs

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15
Q

Who is inhibited with Sirolimus?

A

mTOR inhibitor

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16
Q

How else is Sirolimus known?

A

Rapamycin

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17
Q

This is the mechanism of Sirolimus

A

Binds FKBP

Blocks T cell activation and B cell diferentiation by preventing IL-2 signal transduction

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18
Q

When is recommended Sirolimus?

A

Kidney transplant rejection prophylaxis

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19
Q

When is consider that Rapamycin caused toxicity?

A 
Anemia
Thrombocytopenia
Leukopenia
Insulin resistance
HyperlipidemiaIs
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20
Q

Is sirolimus nephrotoxic?

A

No

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21
Q

With which medicine is Sirolimus synergistic?

A

Ciclosporine

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22
Q

This is an alternative of using Sirolimus

A

Drug eluting stent

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23
Q

How does Basiliximab works?

A

Monoclonal antibody; blocks IL- 2R

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24
Q

When is recommended to use Basiliximab?

A

Kidney transplant rejection prophylaxis

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25
Q

These are secondary effects of Basiliximab

A

Edema, hypertension, tremor

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26
Q

This immunosuppressant is antimetabolite precursor of 6 mercaptopurine

A

Azathioprine

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27
Q

How does Azathioprine works?

A

Inhibits lymphocyte proliferation by blocking nucleotide synthesis

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28
Q

These are the clinical use for Azathioprine

A

Transplant rejection prophylaxis
Rheumatoid arthritis
Chron disease
Glomerulonephritis

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29
Q

Which are the possible toxic efects of Azathioprine?

A

Leukopenia
Anemia
Thrombocytopenia

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30
Q

Who degrades 6 MP?

A

Xanthine oxidase

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31
Q

Who increases 6 MP toxicity?

A

Allopurinol

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32
Q

What is inhibited by Glucocorticoids?

A

Inhibit NF- kB

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33
Q

What is suppressed by Glucocorticoids?

A

Both B and T cell function by ↓ transcription of many cytokines

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34
Q

These are recommendations of using Glucocorticoids

A

Transplant rejection phrophylaxis (immune suppression)
Many autoimmune disorders
Inflamation

35
Q

These are the classic toxic effects of Gucocoticoids

A 
Hyperglycemia
Osteoporosis
Central obesity
Muscle Breakdown
Psycosis
Acne
Hypertension
Catarcts 
Peptic Ulcers
36
Q

Which enzyme is inhibited by Azthioprine?

A

PPRP Amidotransferase

37
Q

If PPRP Amidotransferase is inhibited by 6- MP, which are the results?

A

Inhibition of Purine nucleotides and last DNA replication

38
Q

Which are Recombinant cytokines?

A 
Epoetin alfa 
Thrombopoietin
Oprelvekin
Filgratim
Sargramostim
Aldesleukin
IFN alfa
IFN beta
IFN gamma
39
Q

What is Epoetin alfa?

A

Erythropietin

40
Q

When is recommended the clinical use of Erythropoietin?

A

Anemias (especially renal failure)

41
Q

Which is the clinical use for Thrombopoietin?

A

Thrombocytopenia

42
Q

Which is the commercial name for Interleukin 1?

A

Oprelvekin

43
Q

This is the recommendation for Interleukin 1 as medication

A

Thrombocytopenia

44
Q

What is filgrastim?

A

Granulocyte colony stimulating factor

45
Q

Which medicines are indicated for Recovery of bone marrow?

A

Filgrastim and Sargramostim

46
Q

What is Sargramostim?

A

Granulocute macrophage colony stimulating factor

47
Q

Commercial name for Interleukin 2

A

Aldesleukin

48
Q

When is Interleukin 2 recommended?

A

Renal cell carcinoma, metastatic melanoma

49
Q

Which is the clinical ise for INF alfa?

A

Chronic hepatitis B and C, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma

50
Q

This is the indication of IFN beta

A

Multiple Sclerosis

51
Q

When is recommended the clinical use of IFN gamma?

A

Chronic granulomatous disease

52
Q

Name therapeutic antibodies cancer therapies

A 
Alemtuzumab
Bevacizumab
Cetuximab
Rituximab
Trastuzumab
53
Q

Which is the target of Aletuzumab?

A

CD52

54
Q

Which is the use of Aletuzumab?

A

CLL

55
Q

This Therapeutic antibody cancer therapy´s target is VEGF

A

Bevacizumab

56
Q

For these cases Bevacizumab is indicated

A

Colorectal cancer

Renal cell carcinoma

57
Q

This is the target of Cetuximab

A

EGFR

58
Q

This Therapeutic antibody cancer therapy is recommended for Stage IV colorectal cancer, head and neck cancer

A

Cetuximab

59
Q

Who is targeted by Rituximab?

A

CD20

60
Q

These diseases can be treated with Rituximab

A

B cell non Hodgkin lymphoma
Rheumatoid arthritis
Idiopathic thrombocytopenic purpura (ITP)

61
Q

Which medication is indicated with Rituximab in order to treat Rhematoid arthritis?

A

MTX

62
Q

Which Therapeutic antibody cancer therapy´s target is HER2/neu?

A

Trastuzumab

63
Q

Which is the clinical use for Trastuzumab?

A

Breast cancer

Gastric cancer

64
Q

Therapeutic antibodies for Autoimmune disease

A

Ifiximab, adalimumab

Natalizumab

65
Q

This medications target is TNF-alfa

A

Ifiximab, adalimumab

66
Q

In this cases Ifiximab, adalimumab are indicated

A

Inflammatory bowel disease (IBD)
Rheumatoid arthritis
Ankylosing spondylitis
Psoriasis

67
Q

This is Natalizumab target

A

α4 Integrin

68
Q

This autoimmune diseases are treated with Nafalizumab

A

Multiple sclerosis

Chron Disease

69
Q

Which is the importance of α4 Integrin?

A

Leukocyte adhesion

70
Q

If John Cunningham virus (JCV) is present and you give Nafalizumab which is the risk?

A

Progressive multifocal leukoencephalopathy (PML)

71
Q

Anti-platelet agent that acts in Glycoprotein IIb/ IIIa

A

Abxicimab

72
Q

What does Abxicimab prevents?

A

Prevention of ischemic complications in patients undergoing percutaneous coronary intervention

73
Q

This is the target of Denosumab

A

RANKL

74
Q

In this cases Denosumab is indicated

A

Osteoporosis

75
Q

How does Denosumab acts in Osteoporosis?

A

Inhibits osteoclast maturation

76
Q

This medication is mimic by Denosumab

A

Osteoprotegin

77
Q

Which therapeutic antibodies act in Digoxin?

A

Digoxin immune Fab

78
Q

Antidote for digoxin toxicity

A

Digoxin immune Fab

79
Q

Which is the target of Omalizumab?

A

IgE

80
Q

This therapeutic antibodies work for Asthma?

A

Omalizumab

81
Q

Prevents IgE binding to FcERI

A

Omalizumab

82
Q

Which is the target of Palivixumab?

A

RSV F protein

83
Q

RSV prophylaxis for high risk infants

A

Palivizumab

IMMUNOLOGY (5 decks)

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