Immunopharmacology Flashcards
What does immunopharmacology (IP) focus on?
Primary and secondary disorders of the immune system and production of modulators of the immune system
What two types of drugs pertain to IP?
Immunosuppressants and immunostimulants
Two kinds of immune reactions?
Natural (nonspecific) and specific (memory based)
Nonspecific immune response involves what?
Natural killer
Monocyte/polymorphonuclear
Specific immune response involves what?
Lymphocytes
Where are lymphocytes produced?
Bone marrow and thymus
Lymph nodes and spleen
B-lymphocytes mediate which system?
Humoral
T-lymphocytes mediate which system?
Cell based immune system
What do T-helper cells do?
Coordination of immune response
Cytotoxic T-cells do what?
Removing virus infected cells from body
Suppressor T-cells do what?
Temper the immune response when it gets overactive
Hyperactive T-cell response does what? Hypoactive
Induces autoimmune response
Immune suppression and incompetence
How long does primary immune response take?
8 to 14 days
How do basophils work?
Bind IgE and release histamine, bradykinin, serotonin, heparin, and slow reacting substance of anaphylaxis
When will best results of immunosuppression be?
When treatment is begun before exposure to the antigen
Acute rejection is defined as what?
Rejection that occurs 24 hours to several weeks following organ transplantation
What controls acute rejection?
T-cells and cytokine
How do Adrenocortical steroids work?
Inhibit IL-2 gene transcription which is required for clonal expansion of B and T-cells
Danger of Adrenocortical steroids?
Long term use gets you increased risk of infection, ulcers, hyperglycemia, and osteoporosis
What are the alkylating agents?
Cytotoxic drug cyclophosphamide
Inhibitor of de novo purine synthesis?
Cytotoxic drug azathioprine
Second generation of inhibitors of de nova purine synthesis?
Mycophenolate mofetil
Methotrexate
How do de novo inhibitors work?
Block or interfere with DNA/RNA synthesis and function and prevent clonal expansion of B and T-cells
Inhibitors of de novo pyrimidine synthesis work by?
Inhibits dihydroorotate dehydrogenase, key enzyme for pyrimidine
How do kinases and phosphatase inhibitors work
Block T-cell signaling pathways that stimulate IL-2 production
What is IL-2 used for?
Clonal expansion of B and T-Cells
Cyclosporin is lumped into what group of drugs/
Kinases and phosphatases group
Where does Cyclosporin concentrate?
Red and white blood cells
Metabolized by liver
When is cyclosporin given?
4-24 hours prior to transplant
Limiting factor surrounding Cyclosporin?
Renal toxicity
How does Cyclosporin work?
Associates with calcineurin and inhibits phosphatase activity. Blocks JNK and p38 signaling induced by antigen recognition
Tacrolimus inhibits how?
Associates with calcineurin and inhibits phosphatase. Same as Cyclosporin
Difference of Tacrolimus and Cyclo?
Tacro: Not as widely distributed, 100 times more potent, used in patients not responding to cyclo
How does Sirolimus work?
Inhibits calcineurin by binding FKBP12
How do you improve Sirolimus?
Combine with cyclo
How do anti lymphocyte globulins work
Bind to lymphocyte surface proteins to inhibit acute graft rejection
