Immunology-Pharmacology

Question 1

What is Cyclosporine?

Answer 1

A calcineurin inhibitors that binds cyclophilin and blocks T cell activation by preventing IL-2 transcription for use in transplant rejection prophylaxis, psoriasis, and rheumatoid arthritis

Question 2

What are the AEs of cyclosporine?

Answer 2

Nephrotoxicity (highly), HTN

hyperlipidemia

neurotoxicity

gingival hyperplasia

hirsutism

Question 3

What is tacrolimus (FK506)?

Answer 3

a calcinueron inhibitor that binds Fk506 binding protein (FKBP) and blocks T cell activation by preventing IL-2 transcription mainly for use as a transplant rejection prophylatic

Question 4

What are the AEs of Tacrolimus?

Answer 4

Similar to cyclosporine but with additional increased risk of diabetes and neutrotoxicity

no ginigival hyperplasia or hirsutism

Question 5

What is Sirolimus (Rapamycin)?

Answer 5

an mTOR inhibitor that binds FKBP and blocks T cell activation and B cell differentiation by preventing the response to IL-2 for primary use as a kidney transplant rejection prophylatic (synergistic with cyclosporine)

Question 6

What are the main AEs of Sirolimus (Rapamycin)?

Answer 6

Anemia, thrombocytopenia, leukopenia,

insulin resistance

hyperlipidemia

NOT NEPHROTOXIC

Question 7

What is Daclizumab and Basiliximab?

Answer 7

MABs that bind to and block IL-2R for kidney transplant rejection prophylaxis

Question 8

What are the main AEs of Daclizumab and Basiliximab?

Answer 8

Edema, HTN, and tremor

Question 9

What is Azathioprine?

Answer 9

Antimetabolite precursor for 6-MP that inhibits lymphocyte proliferation for use in transplant rejection and autoimmune diseases

Question 10

What are the main AEs of Azathioprine?

Answer 10

Leukopenia, anemia, and thrombocytopenia

Question 11

6-MP is broken down by ______

Answer 11

xanthine oxidase so increased toxicity with allopurinol

Question 12

How do glucocorticoids work?

Answer 12

Inhibit NF-kB to suppress both B and T cell function by decreasing transcription of many cytokines

Question 13

What are some AEs of glucocorticoids?

Answer 13

Hyperglycemia

osteoporosis

central obesity/Iatrogenic Cushing syndrome

muscle breakdown

psychosis

acne

HTN
cataracts

avascular necrosis

Question 14

What are the main uses of Aldesleukin (recombinant IL-2)?

Answer 14

renal cell carcinoma, melanoma METS

Question 15

What are the main uses of Epoietin Alfa (recombinant EPO)?

Answer 15

Anemias (esp. in renal failure)

Question 16

What are the main uses of Filgrastim (recombinant G-CSF)?

Answer 16

Recovery of bone marrow

Question 17

What are the main uses of Sargamostim (recombinant GM-CSF)?

Answer 17

Recovery of bone marrow

Question 18

What are the main uses of IFN-a?

Answer 18

chronic hep B and C, Kaposi, and melanoma METS

Question 19

What are the main uses of IFN-B?

Answer 19

MS

Question 20

What are the main uses of IFN-y?

Answer 20

CGD

Question 21

What are the main uses of romiplostim and eltrombopag?

Answer 21

Thrombocytopenia

Question 22

What are the main uses of Oprevlvekin (recombinant IL-11)?

Answer 22

Thrombocytopenia

Question 23

What is the target of Alentuzumab and what are its main uses?

Answer 23

CD52 for CLL tx

Question 24

What is the target of Bevacizumab and what are its main uses?

Answer 24

VEGF for tx of colorectal cancer, renal cell carcinoma

Question 25

What is the target of Cetuximab and what are its main uses?

Answer 25

EGFR for tx of stage IV CRR and head/neck cancer

Question 26

What is the target of Rituximab and what are its main uses?

Answer 26

CD20 for tx of B-cell non-Hodgkine lymphoma, CLL, rheumatoid arthritis, and ITP

Question 27

What is the target of Adalimumab and infliximab and what are its main uses?

Answer 27

Soluble TNF-a for x of IBD, rheumatoid arthritis, ankylosing spondylitis, and psoriasis

Question 28

What is Etanercept?

Answer 28

A decoy TNF-a receptor (not an MAB)

Question 29

What is the target of Eculizumab and what are its main uses?

Answer 29

Complement protein C5 for tx of paroxysmal nocturnal hemoglobinuria

Question 30

What is the target of natalizumab and what are its main uses?

Answer 30

a4-integrin for tx of MS and Crohn disease

Question 31

What is the target of Abciximab and what are its main uses?

Answer 31

Platelet glycoproteins IIb/IIIa for prevention of ischemic complications in pts udnergoing percuraneous coronary interventon

Question 32

What is the target of Denosumab and what are its main uses?

Answer 32

RANKL for tx of osteoporosis (inhibits osteoCLAST maturation and mimic osteoportergerin)

Question 33

What is the target of Digoxin immune Fab and what are its main uses?

Answer 33

Digoxin for digoxin toxicity

Question 34

What is the target of omalizumab and what are its main uses?

Answer 34

IgE for tx of allergic astham (prevents IgE from binding to FceR1)

Question 35

What is the target of Palivizumab and what are its main uses?

Answer 35

RSV F protein for RSF prophyalxis in high-risk infants

Question 36

What is the target of Ranibizumab and what are its main uses?

Answer 36

VEGF for tx of neovascular age-related macular degen (can also use bevacizumab and other drugs)