Immunopharmacology

Question 1

Acute rejection defined as

Answer 1

rejection that occurs 24 hours to several weeks following organ transplantation

Question 2

Adrenocortical steroids used for

Answer 2

induction and maintenance of immunosuppression

Question 3

What do adrenocortical steroids do?

Answer 3

reduce circulating lymphocyte levels, block lymphocyte activation required for antigen presentation, and block T-cell proliferation

Question 4

Name an alkylating agent

Answer 4

cytotoxic drug cyclophosphamide (VERY TOXIC)

Question 5

Inhibitors of de novo purine synthesis

Answer 5

azathiprine and 6-mercaptopurine (1st gen)

mycophenolate mofetil and inosine 5’ monophosphate deydrogenase inhibitor (2nd gen)

Question 6

methotrexate is in which class of immunosuppressants

Answer 6

inhibitor of de novo purine synthesis

Question 7

inhibitors of de novo pyrimidine synthesis inhibit which enzyme

Answer 7

dihydroorotate dehydrogenase

Question 8

Cyclosporine and tacrolimus are drugs used for

Answer 8

the induction and maintenance of immunosuppression

block T-cell signaling pathways that stimulate IL-2

Question 9

Cyclosporine associates with

Answer 9

calcineurin and inhibits its phosphatase activity

prevents translocation of NFAT family of transcription factors

Question 10

limiting factor for the use of cyclosporine

Answer 10

renal toxicity

Question 11

Tacrolimus

Answer 11

macrolide antibiotic

100X more potent than cyclosporine

Question 12

Tacrolimus binds

Answer 12

to cytoplasmic protein FK506-binding protein 12 - creates a complex that inhibits the phosphatase activity of calcineurin

Question 13

Sirolimus inhibits

Answer 13

calcineurin by binding FKBP12 and mTOR

Question 14

Belatacept

Answer 14

targeted immunosuppressant drug for the replacement of calcineurin inhibitors over time

Question 15

Belatacept inhibits

Answer 15

CD28-mediated T cell costimulation by binding to CD80 and CD86 on antigen presenting cells

Question 16

Common adverse effects of belatacept

Answer 16

anemia, neutropenia, UTIs, headache, and peripheral edema

Question 17

Rapamycine is

Answer 17

a marocyclic lactone that targets mTOR

used in treatment against acute transplant rejection

Question 18

Everolimus is used after

Answer 18

renal transplantation because it shows very little nephrotoxicity

Question 19

What does FTY720 do

Answer 19

reduces the number of circulating T cells by driving them into lymphoid tissues
treats MS

Question 20

TNF-alpha inhibitors used for

Answer 20

rheumatoid arthritis

Question 21

primary drugs used to treat any autoimmune disease

Answer 21

corticosteroids (prednisone, prednisolone)

Question 22

Why should you avoid long-term corticosteroids

Answer 22

increases the risk of infections, ulcers, hyperglycemia and osteoporosis

Question 23

Cyclophophamide

Answer 23

interferes with DNA synthesis and function by alkylation

Question 24

Azathioprine

Answer 24

antimetabolite that interferes with DNA synthesis

metabolized to mercaptopurine

Question 25

Mercaptopurine

Answer 25

interferes with RNA and DNA synthesis after conversion into purine antagonist inside cells

Question 26

Leflunomide

Answer 26

prodrug of an inhibitor of pyrimidine synthesis

treats RA

Question 27

What do you measure during cyclosporine treatment

Answer 27

blood levels because of the variability in cyclosporine absorption
patient must be on a strict diet

Question 28

Antihistamines

Answer 28

H1 blockers

diphenhydramine, promethazine, chlorpheniramine

Question 29

Immunostimulants

Answer 29

1. Echinacea
2. Acemannan
3. Beta-1,3-glucan
4. QS-21
   5 Detoxififed Freund’s adjuvant