Immunomodulators

Question 1

Immunosuppressants

Answer 1

Indications:
-Organ transplant rejection
-Chronic inflammatory diseases
-Autoimmune diseases

Major AE:
-Increase risk of infections
-Increase risk of malignancies (skin cancer, some lymphomas)

Question 2

Cyclosporine / Tacrolimus

Answer 2

T OR G he’s NINE

MOA: Inhibit T cell intracellular signal 1 (block T cell activation)

USE: RA, OT rejection

AE:
-Nephrotoxicity
-Increase BP
-Neurotoxicity
-Electrolyte abnormalities
-Gingival hyperplasia, hirsutism

Question 3

Rituximab

Answer 3

HI B what’s ur MRN

MOA: Binds CD20 on B-cells, then initiates complement or ADCC to kill B-cells

USE:
-MS
-RA/SLE
-Non Hodgkin’s B lymphoma

AE:
-Hepatitis B reactivation
-Increase risk of progressive
multifocal encephalopathy

Question 4

Prednisone

Answer 4

MOA: binds to GCR, regulates gene transcription
-Lower dose: anti-inflam
-Higher dose: immune suppress

USE:
-OT rejection
-Inf diseases (OA, RA, SLE, IBD)
-GVHD
-Poison oak, chronic asthma

AE:
-Diabetes
-Weight gain
-Ostreoporosis
-Fluid retention
-Mental (psychosis)
-Throat irritation/thrush

Question 5

Infliximab

Answer 5

RIIIP

MOA: prevents TNF from activating its R = decrease TNF inflammatory effects

USE:
-RA, IBD
-Psoriatic arthritis

AE:
-Increase inf/mal
-Increase risk of tuberculosis

Question 6

Cetuximab

Answer 6

MOA:
-blocks EGFR
-IgG mAb binding = ADCC to allow NK cells to kill tumor cells

USE:
-Tumors overexp. EGFRs

AE:
-Rash
-Diarrhea

Question 7

Albuterol

Answer 7

MOA: stimulates β2 Rs on airway SM

USE:
-Acute allergic asthma

AE:
-Tremor
-CNS effects: anxiety,
apprehension
-Increase HR

Question 8

Epinephrine

Answer 8

MOA:
-Stimulates β2 Rs
-Stimulates α1 Rs on VSM/EC

USE:
-Anaphylaxis

AE:
-Increase HR
-Cardiac arrhythmias

Question 9

Negative TB test required prior to its use

Answer 9

Infliximab (Anti-TNFα mAbs) and Adalimumab

Question 10

Anti-IgE mAb AE

Answer 10

-Injection site reactions
-Anaphylaxis (rare)

Question 11

Type 1 hypersensitivity response inhibitors AE

Answer 11

Anaphylaxis (rare)

Question 12

Belatacept

Answer 12

MOA: CTLA-4 binds to C7, prevents T cell activation via CD28 (signal 2)

USE: organ transplant rejection pro

AE:
-Increase risk of inf/mal
-Post transplant lymphoproliferative disorder

Question 13

Natalizumab

Answer 13

NATALIE PIM IS MOVING

MOA: inhibit T cell extravasation (max blocks VLA-4)

USE: autoimmune disease - MS

AE:
-Increase risk of inf/mal
-Increase risk of PML

Question 14

Anakinra

Answer 14

I’LL(1) give ANA the fever

MOA: prevents IL-1 R activation

USE: hereditary fever syndrome

AE:
-Increase risk of inf/mal

Question 15

Tocilizumab

Answer 15

MOA: binds to IL-6 R, decrease inflammatory effects

USE: RA

AE:
-Increase risk of inf/mal

Question 16

Trastuzumab

Answer 16

SHES TRASH

MOA: mab to HER2 (blocks HER2)

USE: tumors exp. HER2

Question 17

Anti CTLA 4 mAB

Answer 17

MOA: prevents inhibition of clonal expansion of T cells

USE: melanoma

AE:
-Excessive T cell mediated inflammation in organs

Question 18

Anti PD 1 or L1 mAB

Answer 18

MOA: prevent inhibitory signal and allow CD8 T cells to kill cancer cells

USE: melanoma/colon/lung/lymphomas

AE:
-Excessive T cell mediated inflammation in organs