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USMLE 1 > Immunology- Immunosuppressants > Flashcards

Immunology- Immunosuppressants Flashcards

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USMLE® Step 1 flashcards
1
Q

Cyclosporine

  • Mechanism
  • uses
  • Toxicity
A

Calcineurin inhibitor, preventing IL-2 transcription.

Psoriasis, rheumatoid arthritis.

Nephrotoxicity, hypertension, hyperlipidemia,
neurotoxicity, gingival hyperplasia, hirsutism.

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2
Q

Tacrolimus (FK506)

  • Mechanism
  • Toxicity
A

Calcineurin inhibitor, preventing IL-2 transcription.

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

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3
Q

Sirolimus (Rapamycin)

  • Mechanism
  • uses
  • Toxicity
A

mTOR inhibitor; Blocks T-cell activation and B-cell
differentiation, by preventing IL-2 response.

Kidney transplant rejection prophylaxis specifically.

“PanSirtopenia” (pancytopenia), insulin resistance, hyperlipidemia; not nephrotoxic.

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4
Q

Basiliximab

  • Mechanism
  • uses
  • Toxicity
A

Monoclonal antibody; blocks IL-2R.

Kidney transplant rejection prophylaxis specifically.

Edema, hypertension, tremor.

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5
Q

Azathioprine

  • Mechanism
  • uses
  • Toxicity
A

Antimetabolite precursor of 6-mercaptopurine.
Inhibits lymphocyte proliferation

Rheumatoid arthritis, Crohn disease, glomerulonephritis,
other autoimmune conditions.

Pancytopenia

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6
Q

Mycophenolate Mofetil

  • Mechanism
  • uses
  • Toxicity
A

Reversibly inhibits IMP dehydrogenase, preventing purine synthesis of B and T cells.

Lupus nephritis.

GI upset, pancytopenia, hypertension, hyperglycemia.
Less nephrotoxic and neurotoxic. Associated with
invasive CMV infection.

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7
Q

Glucocorticoids

  • Mechanism
  • uses
  • Toxicity
A

Inhibit NF-κB. Suppress both B- and T-cell function.

Many autoimmune and inflammatory disorders, adrenal
insufficiency, asthma, CLL, non-Hodgkin lymphoma.

Cushing syndrome

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8
Q

Erythropoietin

  • Agent
  • Uses
A

Epoetin alfa (EPO analog)

Anemias (especially in renal failure).

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9
Q

Colony stimulating factors

  • Agent
  • Uses
A

Filgrastim (G-CSF), Sargramostim (GM-CSF)

Leukopenia; recovery of granulocyte and monocyte counts.

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10
Q

Thrombopoietin

  • Agent
  • Uses
A

Romiplostim (TPO analog), eltrombopag (TPO receptor agonist).

Autoimmune thrombocytopenia

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11
Q

Interleukin-2

  • Agent
  • Uses
A

Aldesleukin

Renal cell carcinoma, metastatic melanoma

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12
Q

Interferon

  • Agent
  • Uses
A

IFN-α: Chronic hepatitis C (not preferred) and B, renal
cell carcinoma.
IFN-β: Multiple sclerosis
IFN-γ: Chronic granulomatous disease

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13
Q

Alemtuzumab

  • Target
  • Clinical uses
A

CD52

CLL, MS

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14
Q

Bevacizumab

  • Target
  • Clinical uses
A

VEGF

Colorectal cancer, renal cell carcinoma, non-small cell lung cancer.

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15
Q

Cetuximab

  • Target
  • Clinical uses
A

EGFR

Stage IV colorectal cancer, head and neck cancer.

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16
Q

Rituximab

  • Target
  • Clinical uses
A

CD20

B-cell non-Hodgkin lymphoma, CLL, rheumatoid arthritis, ITP, multiple sclerosis.

17
Q

Trastuzumab

  • Target
  • Clinical uses
A

HER2

Breast cancer, gastric cancer HER2—“tras2zumab”

18
Q

Adalimumab, certolizumab, golimumab, infliximab (Etanercept is a decoy TNF-α receptor)

  • Target
  • Clinical uses
A

Soluble TNF-α

IBD, rheumatoid arthritis, ankylosing spondylitis, psoriasis.

19
Q

Daclizumab

  • Target
  • Clinical uses
A

CD25 (part of IL-2 receptor)

Relapsing multiple sclerosis

20
Q

Eculizumab

  • Target
  • Clinical uses
A

Complement protein C5

Paroxysmal nocturnal hemoglobinuria, HUS

21
Q

Natalizumab

  • Target
  • Clinical uses
A

α4-integrin

Multiple sclerosis, Crohn disease

Risk of PML in patients with JC virus.

22
Q

Ustekinumab

  • Target
  • Clinical uses
A

IL-12/IL-23

Psoriasis, psoriatic arthritis

23
Q

Abciximab

  • Target
  • Clinical uses
A

Platelet glycoproteins IIb/IIIa

Antiplatelet agent for prevention of ischemic complications in patients undergoing percutaneous
coronary intervention.

24
Q

Denosumab

  • Target
  • Clinical uses
A

RANKL

Osteoporosis; inhibits osteoclast maturation (mimics osteoprotegerin)

25
Q

Digoxin immune Fab

  • Target
  • Clinical uses
A

Digoxin

Antidote for digoxin toxicity

26
Q

Omalizumab

  • Target
  • Clinical uses
A

IgE

Refractory allergic asthma; prevents IgE binding to FcεRI

27
Q

Palivizumab

  • Target
  • Clinical uses
A

RSV (respiratory sincital virus) F protein

RSV prophylaxis for high-risk infants

USMLE 1 (73 decks)

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