Immunopharmacology

Question 1

What released IL-2? What are the functions of IL-2?

Answer 1

• T lymphocyte releases IL-2 in response to interaction with APC
• IL-2 further activates releasing lymphocyte and activates T helper cells

Question 2

what is corticosteroids’ immunosuppressive effect

Answer 2

• broad

Question 3

corticosteroids side effects

Answer 3

• cushing’s like syndrome

Question 4

MOA T cell suppressants

Answer 4

Calcineurin inhibitors

Question 5

Name the two T cell suppressants

Answer 5

• calcineurin inhibitor
  
  • cyclosporine
  • tacrolimus

Question 6

list toxicites shared in T-cell suppressants

Answer 6

• HTN
• nephrotoxicity
• Hyperglycemia

Question 7

metabolism of cyclosporine and Tacrolimus

Answer 7

metabolized by CYP3A4 in liver

• narrow theraputic range
• many drug interactions

Question 8

patients who are taking cyclosporine should not drink

Answer 8

grapefruit juice

Question 9

name three drugs that are potent inducers of CYP3A4 and would decrease cyclosporine concentration

Answer 9

• rifampin
• phenytoin
• phenobarbital

Question 10

name three drugs that are potent inhibitors of CYP3A4 and would increase cyclosporine concentration

Answer 10

• erythromycin
• ketoconazole
• verapamil

Question 11

toxicity of cyclosporine

Answer 11

• gingival hyperplasia

Question 12

FK506, Tacrolimus toxicity

Answer 12

• insomnia

Question 13

Name the 4 proliferation signal inhibitors

Answer 13

• Sirolimus
• Pimecrolimus
• Mycophenolate Mofetil
• Thalidomide

Question 14

benefit of sirolimus

Answer 14

• no renal toxicity

Question 15

Use of Pimecrolimus

Answer 15

topical cream for atopic dermatitis

Question 16

MOA of Mycophenolate-Mofetil

Answer 16

• decreases DNA synthesis by inhibiting monophosphate dehydrogenase which is needed by T and B cells for purine synthesis
• therefore high specificity

Question 17

Mycophenolate-Mofetil is often combined with which drug

Answer 17

tacrolimus

Question 18

side effects of Mycophenolate-Mofetil

Answer 18

• rash
• serious infections

Question 19

MOA of Azathioprine

Answer 19

• converted to 6-mercaptopurine
• inhibits purine synthesis

Question 20

toxicity of Azathioprine

Answer 20

• bone marrow suppression
• teratogenic

Question 21

How is Azathioprine metabolized

Answer 21

metabolized by xanthine oxidase

*reduce dose if used with allopurinol

Question 22

MOA of cyclophosphamide

Answer 22

• direct effect on T and B cells
• blocks response to new antigens
• can inhibit established immune response

Question 23

toxicity of cyclophosphamide

Answer 23

• Hemorrhagic cystitis
  
  • prevent with hydration and MESNA
• bone marrow suppression

Question 24

MOA of methotrexate

Answer 24

• human dihydrogolate reductase inhibitor

Question 25

toxicity of Methotrexate

Answer 25

* fetal toxicity (teratogenic) * Hepatotoxicity

Question 26

Use of Methotrexate

Answer 26

RA

Question 27

What cytokines to T helper 1 cells produce

Answer 27

* interferon-gamma * TNT-Beta

Question 28

MOA of Daclizumab/Basiliximab

Answer 28

* bind to IL-2 receptor on activated T-cells, inhibit IL-2 activation

Question 29

use of Daclizumab/Basiliximab

Answer 29

* used right after transplant-induction * no drug interactions

Question 30

MOA of Bevacizumab, Ranibizumab, Pegaptanib, aflibercept

Answer 30

* bind to VEGF-A * drugs for macular degeneration

Question 31

Interleukin-2 is used in treatment of what two CA

Answer 31

* renal cell carcinoma * malginant cell carcinoma

Question 32

Function of Granulocyte colony stimulating factor; Filgrastim (Neupogen)

Answer 32

* human recombinant used for treatment of severe **neutropenia** induced by stem cell transplant or chemotherapy

Question 33

Function of Epoetin-alpha (Epogen)

Answer 33

* human recombinant form of erythropoetin used for treatment of severe anemia

Question 34

what interferon is used in the treatment of multiple sclerosis

Answer 34

interferon beta-1b

Question 35

MOA of Glatiramer in the treatment of multiple sclerosis

Answer 35

antibodies bind to drug instead of nerve (decoy drug) used in mulitple sclerosis

Question 36

Dimethyl Fumarate is used to treat what condition

Answer 36

multiple sclerosis