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piggy > Immunology - Immunosuppressants > Flashcards

Immunology - Immunosuppressants Flashcards

1
Q

Which immunosuppressant binds to cyclophilins?

A

Cyclosporine

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2
Q

What is the mechanism of action of cyclosporine?

A

Cyclosporine-cyclophilin blocks the differentiation of T cells by inhibiting calcineurin and preventing production of interleukin-2 and its receptor

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3
Q

What are the clinical uses of cyclosporine?

A

Cyclosporine is used to treat some autoimmune disorders

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4
Q

What are the adverse effects of cyclosporine use, and how is it prevented?

A

Nephrotoxicity, which can be prevented with mannitol diuresis

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5
Q

Which immunosuppressant is similar to cyclosporine but functions by binding to FK-binding protein instead of cyclophilins?

A

Tacrolimus (FK-506)

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6
Q

Tacrolimus works by binding to the FK-binding protein, thereby inhibiting the secretion of _____-_____ and other cytokines.

A

Interleukin-2

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7
Q

Tacrolimus is used as an immunosuppressant for which patient population?

A

Organ transplant recipients

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8
Q

What toxicities are associated with tacrolimus use?

A

Nephrotoxicity, peripheral neuropathy, hypertension, pleural effusions, and hyperglycemia

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9
Q

Which two immunosuppressant drugs function as calcineurin inhibitors?

A

Cyclosporine and tacrolimus

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10
Q

Which drug is an antimetabolite derivative of 6-mercaptopurine that interferes with the metabolism and synthesis of nucleic acids?

A

Azathioprine

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11
Q

Why does azathioprine act as an immunosuppressant?

A

Azathioprine is toxic against proliferating lymphocytes

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12
Q

What are the clinical indications for use of azathioprine?

A

As an immunosuppressant during kidney transplantation and for autoimmune disorders

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13
Q

What is the major adverse effect of azathioprine use?

A

Bone marrow suppression

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14
Q

How does allopurinol exacerbate the toxic effects of azathioprine?

A

Mercaptopurine (the active metabolite of azathioprine) is metabolized by xanthine oxidase (which is inhibited by allopurinol)

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15
Q

Muromonab-CD3 (OKT3) is a monoclonal antibody that binds to which protein on the surface of T cells?

A

CD3

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16
Q

How does muromonab-CD3 (OKT3) work?

A

By blocking binding to the CD3 protein on the T-cell surface, which inhibits signal transduction and cellular function

17
Q

In what clinical scenario is muromonab-CD3 (OKT3) used?

A

For immunosuppression after kidney transplants

18
Q

What two types of reactions are associated with muromonab-CD3 (OKT3) toxicity?

A

Cytokine release syndrome and hypersensitivity reaction

19
Q

What is the mechanism of action of sirolimus, and what effect does this have on immunity?

A

Sirolimus binds mammalian target of rapamycin and inhibits T-cell proliferation in response to interleukin-2

20
Q

What two other drugs are commonly used in conjunction with sirolimus after kidney transplantation for immunosuppression?

A

Cyclosporine and corticosteroids

21
Q

What three toxicities are associated with the use of sirolimus?

A

Hyperlipidemia, thrombocytopenia, leukopenia

22
Q

What is the mechanism of action of mycophenolate mofetil, and what effect does it have?

A

Mycophenelate mofetil inhibits de novo synthesis of guanine and blocks lymphocyte production

23
Q

What is the mechanism of action of daclizumab?

A

Daclizumab is a monoclonal antibody that blocks interleukin-2 receptors on T cells

24
Q

What is aldesleukin?

A

Recombinant interleukin-2

25
Q

What are the indications for use of aldesleukin?

A

Metastatic melanoma and renal cell carcinoma

26
Q

Which recombinant hormone is used to treat anemia secondary to renal failure?

A

Erythropoietin (epoetin)

27
Q

What is filgrastim?

A

Recombinant granulocyte colony-stimulating factor

28
Q

What is sargramostim?

A

Granulocyte macrophage colony-stimulating factor

29
Q

What are the clinical indications for use of -interferon?

A

Leukemias and malignant melanoma

30
Q

Which cytokine therapy can be used to treat multiple sclerosis?

A

β-Interferon

31
Q

Which cytokine therapy can be used to treat chronic granulomatous disease?

A

γ-Interferon

32
Q

What is oprelvekin?

A

Recombinant interleukin-11

33
Q

Oprelvekin (interleukin-11) is used to treat what condition?

A

Thrombocytopenia

34
Q

Thrombopoietin is used to treat what condition?

A

Thrombocytopenia

piggy (83 decks)

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