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Anatomy - Head and Neck > Immunomodulatory Agents > Flashcards

Immunomodulatory Agents Flashcards

1
Q

Alum

A
  • # 1 adjuvant in vaccines
  • Directly increases activity of APCs
  • Combines with antigen to prolong its exposure to the immune system
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2
Q

BCG is a vaccine against…

A

Tuberculosis

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3
Q

What type of vaccine is BCG

A

Live attenuated (reduced virulence)

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4
Q

MOA of BCG

A

interact directly with PRR of APCs to increase inflammatory response

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5
Q

BCG can be used to treat what cancer

A

Bladder

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6
Q

IL-2 function

A

Tcell proliferation
IFN-gamma production
Tkiller activity

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7
Q

IL-2 therapy is good for…

A

Metastatic Carcinoma

Renal Carcinoma

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8
Q

Side effects of IL-2 therapy…

A

capillary leak–> hypotension–> decreased organ perfusion

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9
Q

Interferons produce…

A

Anti-viral responses

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10
Q

4 drugs that can be given to increase efficacy of APCs (immunostimulants)

A

Alum
BCG
IL-2
Interferons

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11
Q

Uses for Immuno-suppressants

A

Organ transplant
Inflammatory Disease
Autoimmune disorders
Selective suppression

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12
Q

2 main risk with using immunosuppressants

A

Infection

Cancer

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13
Q

Cyclophosphamide

A

Targets proliferating cells
Chemotherapy medication
(Bischloroethylamine like Mechlorethamine)
Alkylating agent

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14
Q

Side effects of cyclophosphamide

A

Myelosuppression

also hemorrhagic cystitis

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15
Q

Azathioprine

A

Targets proliferating cells
Metabolized to 6-mercaptopurine (Antimetabolite)
Purine inhibitor

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16
Q

Side effect of Azathioprine

A

Myelosuppression

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17
Q

Use of Cyclophosphamide (alkylator)

A

Autoimmune disorders

Marrow transplant

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18
Q

Use of Azathioprine (purine inhibitor)

A

Lupus
Arthritis
IBS

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19
Q

Mycophenolate Mofetil

A

Targets proliferating cells

Purine inhibitor

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20
Q

2 drugs that are purine inhibitors

A

Cyclophosphamide

Mycophenolate Mofetil

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21
Q

Methotrexate

A

Targets proliferating cells
Inhibits DHFR–> No Tetrahydrofolate
Antitumor Antimetabolite
DRUG OF CHOICE FOR R.A.

22
Q

Drug of choice for R.A.

A

Methotrexate

23
Q

Leflunomide

A

Targets proliferating cells

Pyrimidine inhibitor via dihydroorotate dehydrogenase (antimetabolite)

24
Q

Prototype glucocorticosteroid

A

Prednisone

25
Q

Dual action of glucocorticosteroids

A

Anti-inflammatory

Immuno-suppressive

26
Q

MOA of glucocorticosteroids

A

Affect gene transcription

Primary effect is inhibition of IL-2 and IFN-gamma

27
Q

1st line immunosuppressant for ORGAN and STEM CELL transplants

A

glucocorticosteroids

28
Q

Effects of chronic glucocorticosteroids

A 
Cushing's
Glucose intolerance
Ocular probs
GI probs
Ostereoporesis
HTN
29
Q

Do glucocorticosteroids cause myelosuppression

A

Noper

30
Q

TCR activation signalling pathway

A

TCR activation–> CALCINEURIN activation–> dephosphorylation of NFAT–> CYTOKINE transcription

31
Q

Cyclosporin

A

TCR inhibitor

Combines with CYCLOPHILIN proteins–> inhibit calcineurin

32
Q

Tacrolimus

A

TCR inhibitor
Combines with FKB12–> inhibit calcineurin
Higher potency than Cyclosporin but not really clinically significant I think

33
Q

Side effect of cyclosporin

A

NEPHROTOXICITY, HTN, hyperglycemia

34
Q

Sirolimus

A

IL-2 signalling pathway inhibition
aka Rampamycin
targets mTOR using FKB12 proteins–> like Tacrolimus

35
Q

2 drugs that use FKB12 proteins in their MOA

A

Sirolimus (to inhibit mTOR)

Tacrolimus (to inhibit calcineurin)

36
Q

Sirolimus is an agonist with ….. and an antagonist to …..

A

Cyclosporin

Tacrolimus (both compete for FKB12 proteins)

37
Q

Side effects of Sirolimus

A

POTENT myleosupression

HTN, edema, hyperlipids

38
Q

Use of sirolimus

A

Combo or solo- Organ transplant suppression

39
Q

mTOR

A

Kinase required in IL-2 mediated proliferation signalling

mTOR inhibition is the target of Sirolimus

40
Q

Therapeutic Abs have ….. half-lives

A

Loooooooong

41
Q

Therapeutic Abs can

A

Provide passive immunity
Be made for disease specific antigens
Immunosuppression

42
Q

Rh(D) immune globulin

A

IgG’s that opsonize and clear fetus’s Rh+ RBCs so that Rh- mother doesn’t make antibodies against the Rh protein

43
Q

Belatacept

A

Therapeutic Ab–> ligand is B7 (of APC)

Prevents activation of Tcells–> become ANERGIC

44
Q

Adverse effects of Belatacept

A

PTLD–> post-transplant lympho-proliferative disorder

Anemia, neutropenia, edema, increased infection risk

45
Q

Use of Belatacept

A

Prevents tissue rejection

46
Q

PTLD is associated with what therapeutic Ab

A

Post-transplant lympho-proliferative disorder

Belatacept

47
Q

ATG

A

Anti-Tcell Globulin–> opsonizes/kills Tcells

48
Q

Side effects of Anti-Tcell Globulin

A

Cytokine release syndrome from all the Tcells dying

Prolonged Tcell depletion (kinda the goal though)

49
Q

Alemtuzumab

A

Immune Depleter: Targets CD52 on Ts and Bs
(also Mono, Macro, NK)
MYELOSUPPRESSION

50
Q

Basiliximab

A

Immune depleter: Targets CD25–> ACTIVATED Tcells
More selective than Belatacept (targets all Tcells)
Recover faster with Basiliximab

Anatomy - Head and Neck (4 decks)

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