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Cology 2 Exam 3 > Immunostimulants > Flashcards

Immunostimulants Flashcards

1
Q

What agents do we have to stimulate the immune system?

A

Interferons
Interleukins
Colony stimulating factors

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2
Q

What interferons are available? HOw do they work?

A

alpha, beta, and gamma

Activate NK cells and upregulate Th1 cells and macrophages

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3
Q

What interleukins do we have available? How do they work?

A

Interleukin-2

Work in maturation and differentiation of T cells

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4
Q

What coloy stimulating factors do we have?

A

G-CSF (Granulocyte colony stimulating factor)
GM-CSF (Granulocyte-macrophage colony stimulating factor)
SCF (Stem cell growth factor)
Thrombopoietin (Platelet growth factor)
Erythropoietin (Red blood cell growth factor)

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5
Q

How is SCF used?

A

It us a recombinant human SCF that is used to stimulate blood progenitor cells for transplant
It increases the release of stem cells from marrow into the blood

It is used in combination with G-CSF

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6
Q

What is GM-CSF?

A

Sargramostim - Granulocyte Macrophage CSF

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7
Q

What actions does Sargramostin Granulocyte Macrophage CSF have on immature granulocyte macrophages?

A

Enhance maturation, differentiation, and proliferation
They decrease cell cycle time by 33%
Increase RBC, platelets, neutrophils, monocytes, and eosinophils

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8
Q

What actions does Sargramostin Granulocyte Macrophage CSF have on mature WBC?

A

Increase oxidative metabolism
Increase phagocytosis, cytotoxicity
Increase antigen presentation by antigen presenting cells
Doubles the life-span of neutrophils
Enhances superoxide production in macrophages

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9
Q

Indications for Sargramostin GM-CSF?

A

Stimulate bone marrow after transplant
Neutropenia after chemotherapy (malignant lymphoma, lymphoblastic leukiemia, Hodgkins disease, Acute myelogenous leukemia)
Aplastic anemia

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10
Q

Adverse effects of Sargramostin GM-CSF?

A 
Use caution in renal or hepatic disease
Malaise, fever, nausea, vomiting
Alopecia
Bone pain
Edema, capillary leak syndrome
Liver damage
Pulmonary disorders
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11
Q

How is Sargramostin GM-CSF made?

A

Produced in yeast, differs from humans because there is a leucine instead of argenine at position 24, and so glycosylation may be different

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12
Q

How is Sargramostin GM-CSF administered?

A

SubQ administration

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13
Q

What is Filgrastim - Granulocyte CSF?

A

Glycoprotein produced by fibroblasts and endothelial cells of bone marrow

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14
Q

How does Filgrastim - Granulocyte CSF work?

A

Produced in E. coli, not glycosolated
Stimulates proliferation, differentiation, and functional activity of neutrophils, increases WBC in 2-3 days in normal individual

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15
Q

What does Filgrastim - Granulocyte CSF do to immature neutrophils?

A

Reduces maturation time from 5 days to 1 day

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16
Q

What does Filgrastim - Granulocyte CSF do to mature neutrophils?

A

Enhances chemotaxis (talking to eachother)
Enhances superoxide production (kills engulfed cells)
Enhanced release from bone marrow

17
Q

Indications for Filgrastim - Granulocyte CSF?

A

Bone marrow transplants
Neutropenia after chemotherapy (acute leukemia, AIDs, hairy cell leukemia)
Decrease infections after chemotherapy

18
Q

Adverse effects for Filgrastim - Granulocyte CSF?

A 
Bone pain, may be severe
Headache, fatigue
Nausea, vomiting, diarrhea
Thrombocytopenia
Alopecia, rash, fever
Arrhythmias, MI (monitor!)
19
Q

What is Pegfilgrastin?

A

Pegylated human G-CSF from E coli (conjugated to polyethylene glycol)

20
Q

How is Pegfilgrastin different from Filgrastim and Sargomostin?

A

Pegfilgrastim has decreased renal excretion and increased duration of action so you can have less frequent dosing

21
Q

What is Interleukin-11 Oprelvekin?

A

Recombinant human IL-11 made in E. Coli

22
Q

How is Interleukin-11 Oprelvekin administered?

A

SubQ given daily

23
Q

How does Interleukin-11 Oprelvekin work?

A

Increases megakaryocyte maturation in 5-7 days

24
Q

When is Interleukin-11 Oprelvekin used?

A

Used in chemotherapy induced thrombocytopenia

25
Q

Adverse effects of Interleukin-11 Oprelvekin?

A 
Fluid retention
Tachycardia
Palpitations
Edema --> Shortness of breath
Blurred vision
26
Q

What is thrombopoietin?

A

Recombinant human thrombopoietin

27
Q

How does thrombopoietin work?

A

Selectively increases megakaryocytes
Clinical trials show promise in thrombocytopenia

Platelets increase by day 4, peaking at 12-14 days

28
Q

How is thrombopoietin administered?

A

Usually combined with GM or G-CSF, erythropoietin

Cology 2 Exam 3 (11 decks)

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