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Pharm > Immunomodulary drugs/ anti-inflammatory drugs > Flashcards

Immunomodulary drugs/ anti-inflammatory drugs Flashcards

0
Q

BCG

A

Live attenuated bacillus calmette-guerin
pamp on APC increased activity
some CA and TB vaccine
Septic shock

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1
Q

Alum

A 
Adjuvant
in must us vaccines
Form deposits -> prolonged exposure
May increase APC activity
Few Side effects
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2
Q

IL-2

A

Increases cytotoxicity of killer cells
metastatic melanoma tx
Renal carcinoma tx
AE serious capillary leak syndrome, hypotension, death

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3
Q

IFN-gamma

A

for treating severe infection

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4
Q

IFN alpha and beta

A

Not Immunomodulary agents; endogenous antivirals by tissue
tx viral hepatitis
tx hairy cell leukemia, melanoma, lymphoma
tx MS

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5
Q

Cyclophosphamide

A 
DNA alkylating agent (nitrogen mustard)
kills all proliferating cells
tx auto immune diseases
tx bone marro transplant
AE Myelosuppresion, n/v, infertility
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6
Q

azathioprine

A 
purine antimetabolite
prodrug-> 6-mercaptopurine
inactivated by xanthine ocidase
tx renal and other transplant
tx lupus and RA
AE myelosuppression, n/v
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7
Q

mycophenolate mofetil

A

prodrug-> mycophenolic acid
inhibits inosine monophosphate dehydrogenase
-> blocks purine syntheis
tx solid organ txpt (alternative tx to cyclosporine)
Some auto immune disease
AE Myelosuppression, N/V

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8
Q

Methotrexate

A

anti folate
drug of choice for RA
Some autoimmune diseases
AE Nausea, mucosal ulcers, hepatotoxicity, myelosuppression

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9
Q

Leflunomide

A

prodrug
inhibits dihydroorate dehydrogenase
tx RA and some autoimmune diseases
AE diarrhea, hepatotoxicity, Myelosuppression

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10
Q

Prednisone

A

first line immunosuppressant for solid organ transplant and hematopoietic stem cell transplant
some autoimmune diseases, asthma, allergic reactions
no Myelosuppression
AE (tx longer than 2 weeks): Cushing’s syndrome, glucose intolerance, ocular issues, GI ulcerations, osteoporosis, HTN, psychiatric issues

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11
Q

Cyclosporine

A

binds to cyclophilin to inhibit calcineurin (T cell receptor pathway)
tx kidney, liver and heart transplant
tx RA, IBD, Asthma
can be effective by itself but often in combinations
AE Nephrotoxicity, HTN, Hyperglycemia, liver dysfunction, increased CA risk

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12
Q

Tacrolimus

A

binds with FKBP12 to inhibit calcineurin activity
more potent than cyclosporine but not more effective
tx kidney, liver and heart transplant
tx RA, IBD, Asthma
can be effective by itself but often in combinations
AE Nephrotoxicity, HTN, Hyperglycemia, liver dysfunction, increased CA risk

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13
Q

Sirolimus

A

IL-2 receptor pathway inhibitor (mtor)
used alone or combination
tx solid organ transplant, steroid resistant GVHD, Hematopoietic stem cell transport
antagonizes tacrolimus but not clinically important
AE myelosuppression, hyperlipidemia, HTN, edema, hepatotoxicity

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14
Q

Rh(D)

A

Rh- mother
IV
prevents fetal hemolytic disease

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15
Q

Anti T cell Globulin (ATG)

A 
Animal antibodies
prolonged T cell Depletion 
tx late rejection
AE cytokine release syndrome: fever, chills, HA, N/V, mailase
Serum sickness, Anaphylaxis
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16
Q

belatacept

A

Fusion protein (Fc bount to B7 binding ligand)
blocks coactivation (B7 of APC with CD28 of T cell) of T cells
tx kidney transplants
->comparable to calcineurin in efficacy
AE anemia, neutropenia, edema, increased risk of infection/CA, PTLD (contraindicated in EBV- patients)

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17
Q

Muromonab

A 
anti CD3 (T-cell receptor component)
prolonged T cell depletion 
AE cytokine release syndrome: fever, chills, HA, N/V, malaise
serum sickness, anaphylaxis
discontinued due to economic reasons
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18
Q

Alemtuzamab

A 
anti CD52 (T, B, monocytes, macrophages, NK cells)
Prolonged T cell depletion
AE Myelosuppression, flu like symptoms
19
Q

Basiliximab

A 
anti CD25 (IL-2r)
blocks clonal expansion of T-cells
well tolerated
moderate effect compared to ATG
reduced immune depletion-> decreased infection risk
20
Q

infliximab

A 
anti TNFalpha
Humanized antibodies
blocks from interacting with receptor, lowers circulating levels
tx RA (usually with methotrexate)
tx Crohns (with azathrioprine)
AE increased uri and uti
21
Q

adalimunab

A 
anti TNFalpha
human antibodies
blocks from interacting with receptor, lowers circulating levels
tx RA (usually with methotrexate)
tx Crohns (with azathrioprine)
AE increased uri and uti
22
Q

Etanercept

A 
anti TNFalpha
Fusion protein (Fc and binding thing)
blocks from interacting with receptor, lowers circulating levels
tx RA (usually with methotrexate)
tx Crohns (with azathrioprine)
AE increased uri and uti
23
Q

anakinra

A 
Anti IL-1
competitive antagonist on IL-1r
tx RA and other inflammatory diseases 
daily injection
AE increased risk of infection
24
Q

tofacitinib

A

General Jak kinase inhibitor
po
tx RA (second line after failing methotrexate)
Comparable to TNFalpha inhibitors
AE anemia, neutropenia, general myelosupperession

25
Q

cromolyn and nedocromil

A 
antihistamine
inhibits degranulation and inhibit cough
poorly soluble salt, inhaled 
long term asthma
well tolerated
26
Q

diphenhydramine

A

first gen antihistamine
motion sickness
AE sedation, anticholinergic (dry mouth, urinary retention, tachycardia), anti adrenergic (orthostatic hypotension), anti seritonin r (increased appetite), local anesthesia (blocks Na channels)

27
Q

dimenhydrinate

A

first gen antihistamine
motion sickness
AE sedation, anticholinergic (dry mouth, urinary retention, tachycardia), anti adrenergic (orthostatic hypotension), anti seritonin r (increased appetite), local anesthesia (blocks Na channels)

28
Q

cyclinzine

A

first gen antihistamine
motion sickness
AE sedation, anticholinergic (dry mouth, urinary retention, tachycardia), anti adrenergic (orthostatic hypotension), anti seritonin r (increased appetite), local anesthesia (blocks Na channels)

29
Q

promethazine

A

first gen antihistamine
anti-emetic
AE sedation, anticholinergic (dry mouth, urinary retention, tachycardia), anti adrenergic (orthostatic hypotension), anti seritonin r (increased appetite), local anesthesia (blocks Na channels)

30
Q

loratidine, cetrizine, fexofenadine

A

2nd gen antihistamine
fewer anti-cholinergic effects (dry mouth, urinary retention, tachycardia)
less sedation

31
Q

NSAID tx target

A 
antipyretic
analgesia
muscle px, tendonitis, bursitis
RA and OA
ASA for cardio prophylaxis (the rest raise cardio risk)
32
Q

Ketorolac

A

NSAID

post surgical analgesic

33
Q

Indomethacin

A

NSAID
RX arthritis/anti inflammatory
AE high risk of intolerance

34
Q

aspirin (ASA)

A

NSAID
OTC analgesic
cardio prophylactic
AE
Salicyslism: hyperventilation, tinnitus, vertigo, emesis, sweating
Reye’s syndrome: (children with viral illness) acute encephalopathy, fatty liver degeneration.

35
Q

Naproxen

A

NSAID
OTC analgesic
RX anti inflammatory

36
Q

Ibuprofen

A

NSAID

OTC analgesic

37
Q

Diclofenac

A

NSAID

RX arthritis

38
Q

Etodolac

A

NSAID

RX arthritis

39
Q

meloxicam

A

NSAID

RX arthritis

40
Q

NSAIDs AE

A

increased Cardio risk (except ASA)
GI toxicty: dysplasia, ulceration, GI bleeds
Renal toxicity
NSAID induced asthma

41
Q

acetaminophen

A

OTC analgesic/antipyretic
non-selective COX inhibitor (deactived by peroxides of inflammation)
lacks effects on platelets, CV and GI systems
well tolerated
AE hepatoxicity on OD

42
Q

Celecoxib, Rofecoxib, Valdecoxib

A

COX-2 selective
tx chronic Arthritis
reduced GI effects
significant increased CV risk

43
Q

Zileuton

A

Leukotriene synthesis inhibitor
PO
tx asthma
AE liver toxicity

44
Q

Zafirlukast, montelukast

A 
LTD4 (leukotriene) receptor inhibitor
PO
tx asthma
permits use of less corticosteroids
decreases bronchoconstriction and edema

Pharm (12 decks)

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