Immunomodulator Flashcards
Prednisone
MOA:
-↓ # of circulating lymphocytes
- Inhibit PMN migration and chemotaxis
- Inhibit phospholipase A2
Indications:
- Any immune mediated chronic disease
- Cerebral edema
- Surfactant production prior to delivery
Toxicity:
-Cushing Syndrome
Methotrexate (Rheumatrex)
MOA
- dihydrofolate reductase inhibitor
- blocks conversion of dUMP → dTMP → DNA synthesis
- S phase specific
Indications
- rheumatoid/juvenile rheumatoid arthritis
- antineoplastic therapy
- many autoimmune diseases
Toxicity
- N/V/D
- bone marrow suppression
- pulmonary fibrosis
- T and B Cell suppression
- hepatotoxicity
Cyclophosphamide (Cytoxan)
DNA alkylating agent
Indications
- RA
- Cancer Chemo
- Wegner’s granulomatosis
Toxicity
- pancytopenia
- infections
- T and B cell suppression
Azathioprine (Imuran)
Purine Analog
Indication
- RA
- transplant rejection
Toxicity
- pancytopenia
- T cell suppression
Cyclosporine (Sandimmune)
binds and inhibits calcineurin
-calcineurin is a transcription factor for IL-2 and inflammatory cytokines
Indications
- RA
- transplant rejection
- Used with azathioprine and steroids
Toxicity
- Nephrotoxic
- HTN
- teratogenic
Mycophenolate Mofetil (Cellcept)
IMP-dehydrogenase inhibitor
-inhibits de novo purine synthesis
Indication
- transplant rejection
- combo therapy with cyclosporine and steroids
Toxcitiy
- N/V/D
- neutropenia
- infections
- T and B cell suppression
Rho Immune Globulin (RhoGam)
human anti-Rh Ig
Indication
- prevention of hemolytic disease of the newborn
- binds and removes and fetal Rh+ blood cells before the mothers body has a chance to mount an immune response
Muromanab-CD3 (OKT3)
anti TCR (CD3) murine IgG
Indication
-transplant rejection
Toxicity
- fever/chills
- hypersensitivity reaction to murine antibody
- T cell suppression
Interferon-gamma (Actimmune)
macrophage activation
-Antibody-dependent cellular cytotoxicity
Indications
- chronic granulomatous disease
- osteoporosis
Interferon beta (Betaseron)
-antiviral and immunoregulatory activity
Indications
-relapsing and remitting MS
Toxicity
-depression/suicide risk
