Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PoD - E4 > Immunopharmacology > Flashcards

Immunopharmacology Flashcards

1
Q

Immunosuppression principles

A
  • Primary response are more easily and effectively affected than secondary responses
  • Immunosuppressive agents do not affect all immune responses in the same manner
  • Therapy works best before rather than after exposure to an immunogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical uses of immunosuppression

A
  • Organ transplantation
  • Selective immunosuppression (ie erythematosus fetalis and Rh)
  • Autoimmune disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Limitations of immunosuppressive therapy

A
  • Increased risk of infection - the usual microorganisms as well as opportunistic organisms
  • Increased risk of lymphomas and related cancers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Glucocorticoid - Site of Action (General)

A

Glucocorticoid response elements in DNA (regulate gene transcription)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Muromonab - CD3 - Site of Action (General)

A

T cell receptor complex (blocks antigen recognition)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cyclosporine - Site of Action (General)

A

Calcineurin (inhibits phosphatase activity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tacrolimus - Site of Action (General)

A

Calcineurin (inhibits phosphatase activity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Azathioprine - Site of Action (General)

A

DNA (false nucleotide incorporation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mycophenolate, Mofetil - Site of Action (General)

A

Inosine monophosphate dehydrogenase (inhibits activity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Daclizumab, Basiliximab - Site of Action (General)

A

IL-2 receptor (block IL-2 mediated T cell activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Sirolimus - Site of Action (General)

A

Protein kinase involved in cell cycle progression (mTOR) (inhibits activity)

mTOR = mechanistic/mammalian target of rapamycin
Rapamycin = sirolimus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cyclosporine - Mechanism of Action

A
  • Calcineurin inhibitor
  • Binds to CYCLOPHILIN A (located in cytoplsam) in T cells to form a complex which binds to an inhibits calcineurin and calcineurin mediated events including the synthesis of cytokines (i.e. IL-2), protooncogenes (i.e. myc and H-ras) and cytokine receptors (i.e. IL-2R)
  • Can also increase production of transforming growth factor (TGF-beta)
  • SELECTIVE FOR T LYMPHOCYTES
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cyclosporine - Uses

A
  • Prevent and treatment of organ rejection (+/- corticosteroids)
  • Autoimmune disorders (ie rheumatoid arthritis, Crohn’s disease, nephrotic syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cyclosporine - Toxicity

A
  • Nephrotoxicity
  • Hypertension
  • Hepatotoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tacrolimus - Mechanism of Action

A
  • Calcineurin inhibitor
  • Binds FK506 binding protein-12 (FKBP) (cytoplasmic protein)
  • This leads to inhibition of calcineurin and calcineurin mediated events
  • 100x more potent than cyclosporine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tacrolimus - Uses

A
  • Similar to cyclosporine
  • Prevent and treatment of organ rejection (+/- corticosteroids)
  • Autoimmune disorders (ie rheumatoid arthritis, Crohn’s disease, nephrotic syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tacrolimus - Toxicity

A
  • Nephrotoxicity

- Neurotoxicity (ie tremor, headache, motor disturbance, hypertension, diabetes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sirolimus and Everolimus - Mechanism of Action

A
  • Binds to FK506 binding protein-12 (FKBP) like TACROLIMUS but does NOT inhibit calcineurin
  • Instead inhibits mTOR (an important kinase for T cell proliferation)
  • Blocks T cell cycle at the G1 to S transition
  • Uses similar to calcineurin inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sirolimus and Everolimus - Uses

A
  • Similar to calcineurin inhibitors
  • Prevent and treatment of organ rejection (+/- corticosteroids)
  • Autoimmune disorders (ie rheumatoid arthritis, Crohn’s disease, nephrotic syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Predinisone and Prednisolone - Mechanism of Action

A
  • Glucocorticoid
  • Unclear mechanism
  • Corticosteroids inhibit T cell proliferation, T cell dependent immunity and expression of genes encoding cytokines
  • T cells > B cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Prednisone and Prednisolone - Uses

A
  • Prevent organ rejection
  • Autoimmune diseases
  • Anti-inflammatory properties important
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Azathioprine - Mechanism of Action

A
  • Cytotoxic drug, non-selective
  • Converted to 6-mercaptopurine in vivo
  • Metabolites inhibit purine synthesis
  • Inhibition of purine synthesis inhibits DNA synthesis, which inhibits T cell proliferation
  • Adjunct for prevention of organ transplant rejection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Azathioprine - Interactions

A
  • If allopurinol given, azathioprine dose should be reduced

- Inhibits XANTHINE OXIDASE (catabolizes azathioprine metabolites)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Azathioprine - Toxicity

A
  • Bone marrow suppression
  • Leukopenia
  • Thrombocytopenia
  • Anemia
  • Increased risk for infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Mycophenolate mofetil - Mechanism of Action

A
  • Prodrug converted to mycophenolic acid (MPA)
  • MPA is a reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH)
  • Inhibition of IMPDH inhibits de novo synthesis of guanine nucleotide synthesis
  • B and T lymphocytes require this pathway for proliferation and thus are selectively sensitive to MPA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Mycophenolate mofetil - Uses

A
  • Prophylaxis of transplant rejection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Mycophenolate mofetil - Toxicity

A
  • GI effects
  • Leukopenia
  • Antacids (magnesium and aluminum) decrease absorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Antithymocyte globulin (ATGAM) - Mechanism of Action

A
  • Polyclonal antibody from serum of horses or rabbits immunized with human thymus lymphocytes
  • Binds to circulating T lymphocytes which induces lymphopenia (complement-mediated) and decreases T cell function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Antithymocyte globulin (ATGAM) - Uses

A
  • Used to prevent and treat acute allograft rejection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Antithymocyte globulin (ATGAM) - Toxicity

A
  • Serum sickness
  • Nephritis
  • Chills
  • Fever
  • Rashes
31
Q

Muromonab-CD3 (Orthoclone) - Mechanism of Action

A
  • Mouse monoclonal antibody against CD3 glycoprotein, which is associated with the T cell receptor complex
  • Induces internalization of the T cell receptor complex
  • Decrease in circulating T cells
32
Q

Muromonab-CD3 (Orthoclone) - Uses

A
  • Reverse transplant rejection
33
Q

Muromonah-CD3 (Orthoclone) - Adverse Effects

A
  • Cytokine release syndrome
  • Anaphylactic reactions
  • CNS toxicity
  • Increased risk for infections and malignancy
34
Q

Daclizumab and Basiliximab - Mechanism of Action

A
  • Humanized monoclonal antibodies
  • Bind IL-2 receptor on T cells
  • Inhibit T cell activation (down regulation of IL-2 receptor)
35
Q

Daclizumab and Basiliximab - Uses

A
  • Prophylaxis of acute rejection in renal transplantation
36
Q

Daclizumab and Basiliximab - Adverse Effects

A
  • Increases risk for infections
37
Q

Alemtuzumab (Campath-1H) - Mechanism of Action

A
  • Humanized monoclonal antibody
  • Binds CD52 glycoprotein on B cells, T cells, monocytes, macrophages, natural killer cells
  • Induces lympholysis (profound depletion of T cells - apoptosis mediated)
38
Q

Alemtuzumab (Campath-1H) - Uses

A
  • Chronic lymphocytic leukemia (CLL)
39
Q

Efalizumab - Mechanism of Action

A
  • Humanized monoclonal antibody
  • Binds CDIIa subunit of leukocyte function associated 1 (LFA-1) protein on T and B cells
  • Inhibits interaction between LFA-1 and ICAM-1, which inhibits T cell adhesion and activation
40
Q

Efalizumab - Uses

A
  • Prevent organ transplant rejection

- Psoriasis

41
Q

Tocilizumab - Mechanism of Action

A
  • Humanized monoclonal antibody
  • Binds IL-6 receptors
  • Inhibits IL-6 actions
42
Q

Tocilizumab - Uses

A
  • Juvenile rheumatoid arthritis
43
Q

Tocilizumab - Adverse Effects

A
  • Increases risk for infection
44
Q

Rituximab - Mechanism of Action

A
  • Humanized monoclonal antibody
  • Binds CD20 on B lymphocytes
  • Induces lymphocyte cell lyses
45
Q

Rituximab - Uses

A
  • Chronic lymphoid leukemia
  • Non-Hodgkin’s lymphoma
  • Rheumatoid arthritis
46
Q

Anti-TNF Drugs

A
  • Infliximab: mouse-human chimeric monoclonal antibody
  • Adalimumab: humanized monoclonal antibody
  • Etanercept: fusion protein consisting of the ligand binding domain of TNF receptor fused to IgG1 fragment
47
Q

Anti-TNF Drugs - Mechanism of Action

A

Bind TNF and this neutralizes TNF activity

48
Q

Anti-TNF Drugs - Uses

A
  • Rheumatoid arthritis
  • Psoriasis
  • Crohn’s disease
49
Q

Anti-TNF Drugs - Toxicity

A
  • Increased risk for infection

- Lymphomas and other cancers

50
Q

Alefacept - Mechanism of Action

A
  • Fusion protein
  • LFA-3-IgG1 fusion protein that binds to CD2 on T cells
  • This inhibits the interaction between LFA-3 and CD2, which inhibits T cell adhesion and T cell activation

LFA-3 = lymphocyte function-associated antigen 3

51
Q

Alefacept - Uses

A
  • Psoriasis
52
Q

Abatacept/Belatacept - Mechanism of Action

A
  • CTLA4-IgG1 fusion proteins that bind CD80 and CD86 on APC cells
  • This inhibits the interaction between CD80/CD86 and CD28 on T cell, which INHIBITS THE CO-STIMULATORY PATHWAY
53
Q

Abatacept/Belatacept - Uses

A
  • Juvenile idiopathic arthritis
  • Rheumatoid arthritis (abatacept)
  • Prevent organ transplant rejection (belatacept)
54
Q

Abatacept/Belatacept - Adverse Effects

A

Increases risk for infection

55
Q

Uses of Immunostimulatnts

A
  • Treat conditions of immunodeficiency (i.e. AIDS) or to bolster immunity against specific targets
  • Can act through cellular or humoral immunity
  • Magnitude of stimulation can be highly variable
56
Q

Uses of Immune Globulins

A
  • Immune globulin contains all immunoglobulin subclasses (IgG > IgM) to provide passive immunity
  • Many types available

Used in various immunodeficiency states to prevent:

  • Measles
  • Hepatitis A
  • Autoimmune hemolytic disease
  • Tetanus
57
Q

BCG Vaccine - Mechanism of Action

A
  • A viable, attenuated strain of Mycobacterium bovis
  • Muramyl dipeptide is the active component
  • Stimulates NK cell and T cell activity
58
Q

BCG Vaccine - Uses

A

Treatment of bladder cancer

59
Q

BCG Vaccine - Toxicity

A

Severe hypersensitivity reactions and shock can develop

60
Q

Levamisole - Mechanism of Action

A
  • Synthetic agent

- Inhibits T suppressor cells

61
Q

Levamisole - Uses

A
  • Normally used as antihelminthic agent

- Used as an immunostimulant in colon cancer

62
Q

Isoprinosine - Mechanism of Action

A
  • Synthetic agent

- Increase NK cell cytotoxicity and activity of T cells and monocytes

63
Q

Isoprinosine - Uses

A

Rarely used

64
Q

Thalidomide - Mechanism of Action

A
  • Synthetic agent

- Decreases circulating TNF-alpha

65
Q

Thalidomide - Uses

A
  • May benefit in severe, refractory arthritis

- Erythema nodosum leprosum

66
Q

Thalidomide - Adverse Effects

A

Women who are pregnant or may become pregnant due to teratogenic properties

67
Q

Interferon alpha - Mechanism of Action

A
  • Glycoprotein that is part of our natural antiviral defense
  • Activates macrophages, T lymphocytes and NK cells
  • Currently human recombinant interferon alpha is used clinically
68
Q

Interferon alpha - Uses

A
  • Cancer

- Hepatitis B and C

69
Q

Interferon alpha - Toxicities

A
  • Flu-like symptoms

- Boxed warning regarding development of pulmonary hypertension

70
Q

Interleukin-2 - Mechanism of Action

A
  • Activates cellular immunity

- Available as natural or recombinant forms

71
Q

Interleukin-2 - Uses

A
  • Metastatic melanoma
  • Renal cell carcinoma
  • AIDS patients
72
Q

Interleukin-2 - Toxicities

A
  • Severe hypotension
  • Cardiovascular toxicity
  • Pulmonary edema (capillary lead syndrome) is dose limiting
73
Q

Granulocyte Colony Stimulating Factors - Mechanism of Action

A
  • Glycoproteins produced by monocytes, fibroblasts and endothelial cells
  • Stimulate increases in numbers of granulocytes and monocytes
74
Q

Granulocyte Colony Stimulating Factors - Uses

A

Reduces neutropenia in several instances:

  • Chemotherapy induced neutropenia
  • HIV infection
  • Autologous bone marrow transplantation
  • Congenital neutropenia
  • Myelodysplastic syndromes
  • Aplastic anemia
  • Myelosuppressive therapy in HIV infection
  • Stimulation of peripheral blood stem cells obtained for bone marrow transplant
  • Compromised host (i.e. burn patients)
  • Chemosensitization of myeloid leukemias

PoD - E4 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions