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PPP Spring > Immunomodulatory Drugs > Flashcards

Immunomodulatory Drugs Flashcards

1
Q

Which immunomodulatory drugs decrease T cell activation?

BEST BCD

A

Belatacept
Everolimus
Sirolimus
Tacrolimus

Basiliximab
Cyclosporine
Daclizumab

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2
Q

Which immunosuppressants target cytokines?

I TEAA

A 
Infliximab
Adalimumab
Etanercept
Anakinra
Tocilizumab
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3
Q

Which drugs target oncogenic growth factors?

A

Cetuximab
Trastuzumab
Erlotinib

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4
Q

What are the MOA of Cyclosporine and Tacrolimus?

A

Inhibit calcineurin, a phosphatase required for activation of NFAT

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5
Q

What are the indications for cyclosporine and tacrolimus?

A

Transplant rejection prophylaxis

Autoimmune diseases: RA (cyclosporine)

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6
Q

What AEs are associated with cyclosporine and tacrolimus?

⬛️⬛️⬛️

A

⬛️ inc. risk of infections
⬛️ nephrotoxicity (cyclosporine)
⬛️ HTN (tacrolimus)

Inc. risk of malignancies

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7
Q

What is the MOA of belatacept?

A

Fusion protein between CTLA-4 and Fc; binds B7 and prevents activation by CD28

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8
Q

What are indications for belatacept?

A

Transplant rejection prophylaxis

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9
Q

What AEs are associated with belatacept?

A

Inc. risk of infections

Inc. risk of malignancies

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10
Q

What is the MOA of muromonab?

An anti-CD3 antibody

A

Binding of CD3 antibody to CD3 initiates activation of T cell = strong signal 1

(Causes cytokine secretion first, and since there is only 1 signal, cell undergoes apoptosis)

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11
Q

What is Muromonab indicated for?

A

Transplant rejection

Type 1 DM

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12
Q

What AEs are associated with Muromonab?

A

“Cytokine Storm”

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13
Q

What is the MOA of rituximab?

A

depletes B cells

Anti-CD20 antibody activates ADCC for killing of B cells by NK cells

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14
Q

What is rituximab indicated for?

A

Autoimmune diseases: RA, SLE, MS

Certain B cell lymphomas

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15
Q

What AEs are associated with Rituximab?

⬛️⬛️⬛️

A

Inc. risk of infections
(⬛️= HBV exacerbation)

⬛️Inc. risk of PML
(Progressive multifocal leukoencephalopathy)

⬛️serious rash

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16
Q

What is the MOA of glucocorticoids?

A

Binds to glucocorticoid receptor and regulates gene transcription, resulting in

Inc. apoptosis
Dec. inflamm. Cytokines from macrophages and Tecells
Dec. T cell activation

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17
Q

What are indications for glucocorticoids?

A

Transplant rejection
Chronic inflammatory disease (IBD)
Autoimmune diseases (MS, RA)

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18
Q

What AEs are associated with glucocorticoids?

A

Diabetes

Weight gain

Osteoporosis

Fluid retention

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19
Q

What are the MOA of infliximab and adalimumab?

A

TNF antibodies

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20
Q

What is the MOA of Etanercept?

A

TNF receptor fusion protein

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21
Q

What is the MOA of anakinra?

A

IL-1 receptor antagonist

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22
Q

What is the MOA of tocilizumab?

A

IL-6 receptor antibody

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23
Q

What is the MOA of natalizumab?

A

VLA-4 antibody

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24
Q

What are indications and CI for infliximab and adalimumab?

A

Indications:
inflammatory diseases
RA, IBD, psoriatic arthritis

CI: heart failure

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25
Q

What AEs are associated with infliximab and adalimumab?

⬛️⬛️

A

⬛️inc. risk of infections
⬛️inc. risk of malignancies

Inc. liver enzymes
Injection site reactions
GI adverse effects

26
Q

What are the indications for etanercept?

A

inflammatory diseases

RA, IBD, psoriatic arthritis

27
Q

What are the AEs of etanercept?

(Like TNF antibodies - infliximab, adalimumab) ⬛️⬛️

A

⬛️inc. risk of infections
⬛️inc. risk of malignancies

Inc. liver enzymes
Injection site reactions
GI adverse effects

28
Q

What are indications for anakinra?

A

Inflammatory diseases
RA
Hereditary fever syndromes

29
Q

What AEs are associated with anakinra?

A

Inc. risk of infections
Inc. risk of malignancies
Injection site reactions

30
Q

What are indications and CIs for tocilizumab?

A

Indications:
Inflammatory diseases, RA

CI:
Hepatic disease
Hyperlipidemia

31
Q

What AEs are associated with tocilizumab?

⬛️

A

⬛️inc. risk of infections

Inc. risk of malignancies
Inc. liver enzymes

HYPERLIPIDEMIA

32
Q

What is natalizumab indicated for?

A

Inflammatory diseases

RA, MS, IBD

33
Q

What AEs are associated with natalizumab?

⬛️

A

Inc. risk of infections
Inc. risk of malignancies
Inc. liver enzymes

⬛️PML
(Progressive multifocal leukoencephalopathy)

34
Q

What is the MOA of cetuximab?

A

(1) blocks EGFR signaling in order to dec. tumor cell growth and survival
(2) initiates ADCC to kill tumor cells by NK cells

35
Q

What are indications for cetuximab?

A

Tumor’s overexpressing EGFR

36
Q

What AEs are associated with cetuximab?

A

Rash

GI effects

37
Q

What is the MOA of trastuzumab?

A

(1) blocks HER2 signaling in order to dec. tumor cell growth and survival
(2) initiates ADCC to kill tumor cells

38
Q

What are indications for trastuzumab?

A

Tumor’s overexpressing HER2

39
Q

What AEs are associated with trastuzumab?

A

Cardiotoxic

40
Q

What is the MOA of erlotinib?

A

Blocks EGFR tyrosine kinase

41
Q

What is the indication for erlotinib?

A

Tumor’s expressing mutant EGFR

42
Q

What AEs are associated with erlotinib?

A

Rash
Diarrhea
SJ syndrome

43
Q

What is the MOA of bevacizumab?

A

Monoclonal antibody that binds to and neutralizes VEGF

44
Q

What is bevacizumab indicated for?

A

Tumor’s secreting VEGF

45
Q

What AEs are associated with bevacizumab?

A

Dec. wound healing
HTN
Thromboembolism

46
Q

What is the MOA of allergen-specific immunotherapy (SIT)?

A

SQ injections of gradually increasing amounts of specific allergen to activating allergen-specific Tregs to secrete IL-10 and inhibit Th2 response

only therapy that can change underlying TH2 response

47
Q

What AEs are associated with allergen specific immunotherapy?

A

Risk of anaphylaxis

48
Q

What is the MOA of omalizumab?

A

Anti-IgE antibody

Prevents IgE loading onto mast cells

49
Q

What is the indication for omalizumab?

A

Allergic asthma (moderate to severe)

50
Q

What AEs are associated with omalizumab?

A

Injection site reactions

Anaphylaxis (rare)

51
Q

What is the MOA of mepolizumab?

A

Anti-IL-5 antibody

Dec. recruitment of eosinophils

52
Q

What is mepolizumab indicated for?

A

Severe asthma in patients with eosinophilia phenotype

53
Q

What AEs are associated with mepolizumab?

A

Injection site reactions

Hypersensitivity reactions

54
Q

What is the MOA of montelukast?

A

Leukotriene receptor antagonist

55
Q

What are the indications for montelukast?

A

Asthma

AR

56
Q

What AE are associated with montelukast?

A

Neuropsychiatric AEs

57
Q

What are the MOA and indications for albuterol?

A

Beta2 agonist

Asthma

58
Q

What AEs are associated with albuterol?

A

Tremor

CNS effects

Cardiac stimulation

59
Q

What is the MOA, indication, and AE of epinephrine?

A

alpha1, beta1, beta2 agonist

Indicated for anaphylaxis

AE: arrhythmias

60
Q

⬛️Which drugs have BBW for inc. risk of infections?⬛️

C? I TREAT

A 
Cyclosporine
Infliximab
Tacrolimus
Rituximab
Etanercept
Adalimumab
Tocilizumab
61
Q

What drugs have AE of inc. liver enzymes?

I NATE

A 
Infliximab
Natalizumab
Adalimumab 
Tocilizumab
Etanercept

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