Immunopharmacology Flashcards
where do corticosteroids act
at many levels, general suppressors
anti-inflammatory effects are rapid
immunosuppressive effects take time
adverse effects of corticosteroids
HYPERGLYCEMIA
cushing’s like syndrome, weight gain, osteoporosis, pituitary hypothalmic axis suppression
why are T-cell suppressants favorable?
no bone marrow suppression
what are the two calcineurin inhibitors
cyclosporine and tacrolimus
MOA for cyclosporine
inhibits of t-lymphocytes which inhibit calcineurin
cyclosporine use
prevent rejection, maintenance, bone marrow transplants
toxicities of cyclosporine
renal toxicity, gingival hyperplasia, hypertension, CNS side effects, drug interactions!!!! (rifampin, grapefruit juice, erythromycin/ketoconazole)
MOA for tacrolimus
selective inhibition of t-lymphocytes
toxicity of tacrolimus
nephrotoxicity, hypertension, hyperglycemia, tremor, headache, insomnia
MOA for sirolimus
inhibits proliferation of t-cells by binding to mTOR
side effects of sirolimus
increases cholesterol/triglycerides
BUT NO RENAL TOXICITY
MOA of mycophenolate mofetil
inhibits building blocks for purine synthesis
contraindications of mycophenolate mofetil
pregnancy
MOA for azathioprine
inhibits purine synthesis to inhibit DNA and RNA synthesis to induce apoptosis
use for azathioprine
prevents rejection in transplant patients
side effects of azathioprine
bone marrow suppression, tetratogenic
DO NOT USE WITH ALLOPURINOL
MOA for methotrexate
DHF inhibitor, induces apoptosis
side effects for methotrexate
bone marrow suppression, stomatitis
DO NOT USE IN PREGNANCY
cyclophosphamide MOA
DNA-DNA cross linking, blocks response to new antigens and can inhibit established immune response
side effects of cyclophosphamide
hemorrhagic cystitis (must give with MESNA) infertility
basiliximab MOA
binds to IL-2 receptor (CD25)
uses of basiliximab
induction of immunosuppresion, reduces renal rejection by 50%
mostly commonly prescribed drugs to treat psoriasis and RA
abatacept, etancercept, adalimumab
MOA for abatacept
competes with CD28 for CD80/86
MOA for adalimumab and etancercept
antibody or fusion protein that neutralizes the biologic activity of TNF-alpha
neupogen use
treatment for severe neutropenia induced by stem cell transplant or chemotherapy
epogen use
severe anemia induced by antiviral, cancer chemotherapy, or chronic kidney disease
