Immunopharmacology

Question 1

inhibits MTOR

inhibits T lymphocyte activation and proliferation downstream of IL 2

Answer 1

sirolimus

evorlimus

Question 2

MOA: cones to FKBP 12, which inhibits a protein kinase; inhibitor of MTOR blocks cell cycle progression at the G1 - S phase transition

Answer 2

sirolimus

evorlimus

Question 3

Uses: prophylaxis of organ transplant rejection in combo with calcineurin inhibitor and glucocorticoids

1st line drug to prevent renal transplant rejection

Answer 3

sirolimus

evorlimus

Question 4

SE: dose dependent increase in S cholesterol and TAGs, hyperglycemia, *BM depression: thrombocytopenia

Answer 4

sirolimus

evorlimus

Question 5

more potent then cyclosporine

MOA: binds to immunophilin (FK506 BP 12), then complex forms (FKBP 12, Ca, Calmodulin)

Answer 5

tacrolimus

Question 6

uses: prophylaxis of solid organ allograft rejection

ADR: hyperglycemia, nephrotoxicity, HTN

Answer 6

tacrolimus

Question 7

1) forms a complex with cyclophilin
2) complex inhibits calcineurin phosphatase activity
3) prevents NFAT dephosphorylation so NFAT doesn’t enter the nucleus, transcription NOT activated

Answer 7

cyclosporine - calcineurin inhibitor

Question 8

Uses: organ transpant, RA, psoriasis

Answer 8

cyclosporine

Question 9

ADR: renal dysfunction, HTN, hyperlipidemia, hyperglycemia

Answer 9

cyclosporine

Question 10

drugs increasing cyclosporine levels

Answer 10

Ca ch blockers, p450 inhibitors

Question 11

drugs decreasing cyclosporine levels

Answer 11

p450 inducers

Question 12

enhanced renal toxicity

Answer 12

cyclosporine and tacrolimus

Question 13

reversibly inhibits of IMPDH
inhibitor if de novo synthesis (guanine)
indicted for prophylaxis of transplant
use din combo with glucocorticoids and calcineurin inhibitor
SE: reversible BM depression (neutropenia)

Answer 13

mycophenolate

Question 14

bind to CD25 on t cells

inhibit IL 2 induced T cell activation

Answer 14

dacliximab

basiliximab

Question 15

causes T cell depletion

can cause cytokine storm

Answer 15

antithymocyte globulin

Question 16

used in RA and crohns

bind to TNF

Answer 16

infliximab

adalimumab

Question 17

use din kidney transplant
CD3 receptor
induces rapid internalization of the T cell receptor

Answer 17

muromonab

Question 18

fusion protein, mimics TNF receptor to bind to free TNF or men bound TNF
used in RA and crohns dz

Answer 18

etanercept

Question 19

restores depressed immune fxn of b and T cells

adjunct therapy with 5 FU after surgical resection on px with colon cancer

Answer 19

levamisole

Question 20

used in tx for px with erythema nodosum leprosum and in multiple myeloma

Answer 20

thalidomide

Question 21

carcinoma in situ of the urinary bladder

Answer 21

bacillus calmette guerin

Question 22

used when fetal RBCs are known or suspected of an Rh negative mother unless the fetus is known also to be Rh negative

use at 28 wks of pregnancy and within 72 hrs after delivery

Answer 22

Rho D immune globulin

rhesus dz if child born

hydrops fetalis fetus in utero