Immunopharm Flashcards

1
Q

glucocorticoids AE: short/long term

A

short term: HTN, hyperglycemia, psychosis, cognitive impairment

long term: myopathy, Cushing syndrome, osteoporosis

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2
Q

cyclosporine

A

calcineurin inhibitor

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3
Q

tacrolimus

A

calcineurin inhibitor

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4
Q

cyclosporine AE

A
*nephrotoxicity
tremor
hyperglycemia/hyperlipidemia
osteoporosis
*hirsutism
*gum hyperplasia
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5
Q

Cyclosporine interactions

A

CYP3A4 metabolizer

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6
Q

cyclosporine uses

A

organ transplant, uveitis, RA, psoriasis

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7
Q

tacrolimus AE

A

same as cyclosporine: nephrotoxicity, hyperglycemia/lipidema, hyperkalemia AND neuro sxs!!

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8
Q

tacrolimus use

A

prevent rejection of transplanted kidneys, liver, heart

topical for atopic dermatitis and psoriasis

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9
Q

sirolimus AE

A

myelosuppresion
hepatotoxicity
hyper TG
pneumonitis

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10
Q

sirolimus

A

proliferation signal inhibitors
binds FKBP - inhibits mTOr kianse = block T cell proliferation

mTOR blocks IL-2 driven T cell proliferation: Th1

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11
Q

thalidomide

A

angiogenesis inhibitor and TNF-alpha inhibitor

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12
Q

thalidomide use

A

erythema nodosum leprosum and MM

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13
Q

lefluonomide

A

anti-metabolite - cytotoxic agent

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14
Q

mycophenolate mofetil

A

anti-metabolite - cytotoxic agent

inhibits inosine monophoshpate dehydrogenase

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15
Q

methotrexate

A

anti-metabolite - cytotoxic agent

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16
Q

azathioprine

A

anti-metabolite - cytotoxic agent

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17
Q

azathioprine AE

A

BM suppression, GI disturbances, inc in infections

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18
Q

azathioprine warning

A

if taken with allopurinol, dec dose of azathioprine

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19
Q

azathioprine use

A

prevent organ transplant rejection

severe RA

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20
Q

MTX AE

A

mucosal ulcers
luekopenia
anemia
hepatotoxicity

can be reduced with leucovorin or folic acid
contraindic in pregnancy

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21
Q

MTX uses

A

RA
psoriasis
ankylosing spondylitis
SLE

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22
Q

mycophenolate mofetil AE

A

n/v/d
HA
HTN
reversible myelosuppresion

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23
Q

mycophenolate mofetil uses

A

prophylaxis of transplant rejection

SLE

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24
Q

leflunamide AE

A
reversible alopecia
myelosuppresion
INC aminotransferase activity
monitor CBC and LFTs
carcinogenic and teratogenic in animals
diarrhea

contraindicated in pregnancy

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25
Q

leflunomide use

A

RA, SLE, MG

26
Q

cyclophosphamide

A

alkylating agent

27
Q

cyclophosphamide AE

A
BM suppression
hemorrhagic cystitis
bladder carcinoma
acrolein = urine toxin
infertility
28
Q

hydroxychloroquine AE

A

hemolysis in G6PD def

retinal damage

29
Q

sulfasalazine AE

A
neutropenia
thrombocytopenia
drug induced Lupus
hemolysis in G6PD
n/v
30
Q

sulfasalazine use

A

UC
RA
CD
ankylosing spondylitis

31
Q

rituximab

A

anti-CD20 - depletes B cells

nonhodgkins lymphoma, CLL, RA

32
Q

basiliximab

A

IL-2 antagonist

33
Q

omalizumab

A

anti-IgE antibody

34
Q

etanercept

A

TNF-alpha binding

35
Q

adalimumab

A

anti-TNF alpha

human IgG1

36
Q

infliximab

A

anti-TNF alpha

chimeric monoclonal antibody

37
Q

anakinra

A

IL-1 blocker

38
Q

leflunoamide MOA

A

inhibits dihydroorate dehydrogenase

39
Q

MTX MOA

A

inhibit AICAR transformylase (aminoimidazolecarboxamide ribonucleotide transformylase)

responsible for catalyzing final steps of purine synthesis and IMP synthesis

40
Q

aldesleukin

A

recombinant IL-2

promotes production of cytotoxic T cells and activation NK

41
Q

aldesleukin use

A

adjuvant for renal cell CA and malignant melanoma

42
Q

IFN-alpha use

A
hairy cell leukemia
MCL
malignant melanoma
Kaposi sarcoma
HBV, HCV
43
Q

IFN-beta use

A

relapsing MS

44
Q

IFN-gamma use

A

treat CGD

45
Q

bacillus calmette geurin

A

tx and prophylaxis bladder ca

46
Q

BCG AE

A

hypersensitivity
shock
immune complex disease

47
Q

glucorticoids on PLA-2 and COX-2

A

Inhibit PLA-2

Reduce transcription of COX-2

48
Q

calcineurin mechanism

A

phosphatase necessary for activation of T cell specific transcription factor: NFAT

49
Q

cyclosporine MOA

A

complexes with cyclophilin - immunophillin = this complex inhibits calcineurin

50
Q

tacrolimus MOA

A

binds FK binding protein = immunophilin - inhibits calcineurin

51
Q

tx for erythema nodosum leprosum

A

thalidomide

52
Q

tx for multiple myeloma

A

thalidomide

53
Q

azathioprine MOA

A

converts to 6-MP: inhibit de novo purine synthesis

suppresses B and T cell function, dec IL-2 secretion

54
Q

what accumulates with use of MTX

A

AMP

converted extracellularly to adenosine - potent inflam inhibitor

55
Q

mycophenolate mofetil MOA

A

converted to mycophenolic acid: inhibits IMP dehydrogenase in de novo pathway of GTP synthesis

suppresses B and T activation

56
Q

leflunomide

A

prodrug - terfluonmide
inhibits Dihydroorotate dehydrogenase

Increases UMP - needed for pyrimidine synthesis

57
Q

what lab values should be checked in people leflunomide

A

CBC

LFTs

58
Q

cyclophosphamide MOA

A

alkylates DNA = destroys proliferating lymphoid cells

59
Q

tx of UC

A

sulfasalazine – the 5-ASA moiety

60
Q

abatacept

A

fusion protein - interferes with T cell activation