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POD exam 4 > Immunopharmacology > Flashcards

Immunopharmacology Flashcards

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1
Q

primary or secondary immune response which one is more easily and effectively affected

A

primary

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2
Q

when does immunosuppressive therapies work the best

A

used before rather then after exposure

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3
Q

name 3 clinical uses for immosupressive drugs

A

organ transplantation
Selective immunosuppression - Rh
autoimmune disease

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4
Q

name 2 limitations to therapy

A
  • increase risk of infection

- increase risk of lymphomas and related cancers

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5
Q

Cyclosporine inhibits what

A

Calcineurin

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6
Q

MOA for Cyclosproine

A
  • binds cyclophilin A in T cells
  • complex binds to calcineurin
  • inhibits synthesis of cytokines (IL2), protooncogenes, and cytokine receptors (IL-2R)
  • Increase production of transforming growth factor B-(TGF-B)
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7
Q

Cyclosporine is selective for what lymphocyte

A

T lymphocytes

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8
Q

what is cyclosporine used for

A
  • prevention and treatment of organ rejection

- autoimmune disorders

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9
Q

what is the toxicity for Cyclosporin

A

nephrotoxicity

hypertension

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10
Q

Tacrolimus (FK506) inhibits what

A

Calcineurin

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11
Q

MOA of Tacrolimus

A

binds FK506 binding protein-12 (FKBP)

-inhibits calcinerurin and calcineurin mediated events

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12
Q

difference between Tacrolimus and Cyclosporine

A

tacrolimus more potent

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13
Q

what is the toxicity for Tacrolimus

A

Nephrotoxicity
neurotoxicity
hypertension
diabetes

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14
Q

Sirolimus and Everolimus MOA

A

binds to FKBP

  • does not inhibit calcineurin
  • inhibits mTor
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15
Q

what is the role of mTor

A

kinase for T cell proliferation

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16
Q

Where does Sirolimus/Everolimus block the T cell cycle

A

G1 to S phase

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17
Q

Toxicities for Sirolimus and Everolimus

A

Not nephrotoxic

increase cholesterol and triglycerides in serum

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18
Q

Glucocorticoid MOA

A

unclear, inhibit T-cell proliferation, T-dependent immunity, and expression of genes encoding cytokines

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19
Q

what is the use for Glucocorticoid

A

prevent organ rejection

autoimmune disease

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20
Q

What are the cytotoxic drugs

A

Azathioprine

Mycophenolate mofeitl

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21
Q

What is the MOA for Azathioprine

A

6-MP metabolites inhibit purine biosynthesis, then inhibits DNA synthesis, inhibits T cell proliferation

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22
Q

What is Azathioprine used for

A

prevention of organ transplant rejection

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23
Q

what is the drug interaction for Azathioprine

A

Allopurinol is given, then reduce Azathioprine

  • Allopurinol inhibits Xanthine oxidase
  • Xanthine oxidase catabolizes Azathioprine metabolites
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24
Q

what is the toxicity for Azathioprine

A

bone marrow supression
leukopenia
thrombocytopenia
anemia

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25
Q

Mycophenolate mofetil MOA

A

prodrug converted to MPA

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26
Q

role of MPA

A

reversible inhibitor of IMPDH

-inhibits guanine nucleotide synthesis

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27
Q

What is Mycophenolate mofetil used for

A

prophylaxis of transplant reject

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28
Q

What is Mycophenolate Mofetil toxicity

A

GI effects

leukopenia

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29
Q

What should you not take Mycopheonolate mofetil with

A

antacids

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30
Q

Antithymocyte globulin (ATGAM) MOA

A

binds to circulating T lymphocytes which induces lymphonpenia and decreases T-cell function

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31
Q

what is antithymocyte globulin (ATGAM) used for

A

prevent and treat acute allograft rejection

32
Q

what is the toxicity for antithymyocyte globulin ( ATGAM)

A

serum sickness
nephritis
chills, fever, rash

33
Q

Muromonab-CD3 (Orthoclone) MOA

A

induces internalization of T cell receptor complex, reduces T cell circulating

34
Q

How is Muromonab-CD3 made

A

mouse monoclonal antibody against CD3 glycoprotein

35
Q

what is the toxicity for Muromonab-CD3

A

cytokine release syndrome
anaphylactic reactions
CNS toxicity increased risk for infections and malignancy

36
Q

Daclizumab/Basiliximab

A

bind IL-2 receptor on T cells

  • inhibit T-cell activation
  • prophylaxis of acute rejection in renal transplantation
37
Q

Alemtuzumab ( Campath -1H)

A

binds CD52 glycoprotein on B cells and T cells, monocytes, macrophages, NK cells

  • induces lympholysis
  • Chronic lymphocytic leukemia CLL
38
Q

Efalizumab

A

binds CD2a subunit of leukocyte function associated LFA-1, which inhibits T cell adhesion and activation

39
Q

what does Efalizumab treat

A

prevent organ transplant rejection

treat psoriasis

40
Q

Tocilizumab

A

binds IL-6 receptors, inhibits IL-6 actions

41
Q

what is Tocilizumab used to treat

A

juvenile rheumatoid arthritis

increase risk of infection

42
Q

Rituximab

A

binds CD20 on B lymphocytes

induces B lymphocyte lyses

43
Q

what is Rituximab used to treat

A

chronic lymphoid leukemia
non-Hodgkin’s lymphoma
rheumatoid arthritis

44
Q

What are the anti-TNF drugs

A

Infliximab
Adalimumab
etanercept

45
Q

What is Infliximab

A

mouse-human chimeric monoclonal antibody

46
Q

Adalimumab

A

humanized monoclonal antibody

47
Q

Etanercept

A

fusion of protein consisting of ligand binding domain of TNF receptor fused to IgG1 fragment

48
Q

What is the MOA for Anti-TNF drugs

A

bing TNF and neutralizes TNF activities

49
Q

what are Anti-TNF drugs used for

A

rheumatoid arthritis
psoriasis
crohn’s disease

50
Q

what is the toxicity for anti-TNF drugs

A

increased risk for infection, lymphomas

51
Q

name 2 fusion proteins

A

Afefacept

Abatacept/Belatacept

52
Q

Alefacept

A

LFA-3IgG1 fusion protein binds CD2 on T cells

  • inhibits interaction between LFA-3 and CD2
  • inhibits T cell activation
53
Q

what is Alefacept used for

A

psoriasis

54
Q

Abatacept/Belatacept

A

CTLA4-IgG1 fusion proteins that bind CD8 and
CD 86 on APC cells
-inhibits CD80/CD86 an CD28 on t-cell
-inhibits co-stimulatory pathway

55
Q

what is Abatacept used to treat

A

juvenile idiopathic arthritis

rheumatoid arthritis

56
Q

What is Belatacept used for

A

prevent organ transplant rejection

57
Q

name 2 natureal adjuvants

A

immune globulins

Bacillus Calmette-Geurin ( BCG ) vaccine

58
Q

what is immune globulins

A

contains all immunoglobulin subclasses to provide passive immunity

59
Q

when are immune globulins used

A

prevent measles, hep A, tetanus, hemolytic diseases

60
Q

Bacillus Calmette-Guerin ( BCG ) vaccine

A

viable attenuated strain of Mycobacterium bovis; muramyl dipeptide is active part
- stimulates NK and T cell activity

61
Q

what is BCG vaccine used for

A

bladder cancer

62
Q

what is the toxicity for BCG

A

severe hypersensitivity reactions and shock can develop

63
Q

What are 3 immunostimulants synthetic agents

A

Levamisole
Isoprinosine
Thalidomide

64
Q

Levamisole

A

anthelminic agent
inhibits T supressor cells
- used in colon cancer

65
Q

Isoprinosine

A

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

66
Q

Thalidomide

A

decreases circulating TNF-alpha

67
Q

what is the contraindiction in Thalidomide

A

pregnant due to teratogenic properties

68
Q

name 3 cytokines

A

interferone alpha
interleukin - 2 (Proleukin)
Granulocyte colony stimulating factors

69
Q

interferon alpha activates

A

activates macrophages, T-lymphocytes, NK T cells

70
Q

interferon alpha treats what

A

Hep B and C

71
Q

what is toxicities for Interferons alpha

A

flu like symptoms and boxed warning regarding development of pulmonary hypertension

72
Q

Interleukin -2 (Proleukin) MOA

A

activates cellular immunity

73
Q

what is IL2 (Proleukin) used for

A

metatstic melonoma
renal cell carcinoma
AIDS patients

74
Q

toxicity of IL2 ( proleukin)

A

severe hypotension and life threatenting cardiovascular toxicity

75
Q

what is dose limiting in IL2

A

pulmonary edema ( capillary leak syndrome)

76
Q

Granulocyte colony stimulating factors (G-CSFs) - myeloid growth factor

A

stimulate increases in the number of granulocytes and monocytes
-reduce neutropenia

POD exam 4 (6 decks)

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