Immunostimulants & Immunosuppressants Flashcards
Immunomodulators
substances that either enhance or suppress the body’s immune system
Immunostimulants
BOOST immune system; usually used to treat pt’s w/cancer
Immunosuppressants
DEPLETE immune system; usually used to treat transplant rejection and hyperactive immune responses
Cytokines
substances that help the body mediate and intensify an immune response
Biologic response modifiers
natural cytokines made in enough quantity to treat certain disorders; boost specific functions of immune system
Interferons
cytokines that:
have antiviral and antineoplastic activity; promote protection of uninfected cells, inactivate pathogens, and promote apoptosis of infected cells
interferon alpha 2b (Intron A)
immunostimulant; interferon, biologic response modifier
USE: certain cancers or viral infections
MOA: increase phagocytic activity of macrophages and monocytes; suppress growth of cancer cells
AE: flu-like syndrome, hepatotoxicity, & neurotoxicity
NC: monitor labs, I/O, weights, assess for flu-like syndrome, use high-calorie/high-protein meals; monitor for unexplained bleeds
interleukins
stimulate cytotoxic T cell activity, activate increased production of NK cells, promote inflammation, and stimulate other immune cells
Vaccines
mobilize body against specific antigens
Colony-stimulating factors
promote production of WBCs
aldesleukin (Proleukin)
immunostimulant; biologic response modifier
USE: select cancers
MOA: activates interferons and other interleukins; promotes proliferation of B cells and T cells, macrophages, and NK cells
BLACK BOX WARNING: capillary leak syndrome
AE: systemic infection (if severe fatigue develops, hold med)
NC: use w/extreme caution in pt’s w/hx of cardiac or pulmonary disease
Calcineurin inhibitors
drugs of choice when preventing transplant rejection; blocks IL2 and suppresses immune response
Cytotoxic agents & Antimetabolites
used to suppress proliferating B cells and T cells
Antibodies
used to prevent acute transplant rejection, autoimmune disorders, and malignancies
Corticosteroids
widely used as immunosuppressants but have significant long-term effects
cyclosporine (Gengraf)
immunosuppressant; calcineurin inhibitor
USE: prophylaxis of heart, liver, and kidney transplant rejection, psoriasis, severe RA, and xerthalmia
MOA: inhibits function of calcineurin = decreased activity of B cells and T cells
AE: nephrotoxicity (up to 75% experience decreased urine flow), HTN, tremor, infections, and decreased leukocytes
BLACK BOX WARNING: only administered by experienced HCPs
azathioprine (Imuran)
immunosuppressant; cytotoxic drug
USE: prophylaxis of kidney transplant rejection & severe RA
MOA: inhibits DNA synthesis = DNA damage & chromosome breakage
AE: myelosuppression, serious infections/reactivated HSV or VZV, n/v
BLACK BOX WARNING: may result in serious/fatal infections & possible malignancies
NC: monitor CBC & hepatic functioning
Pregnancy: contraindicated unless benefits to mother outweigh risks to baby
antibodies
proteins produced following antigen challenge to help the body get rid of an antigen
monoclonal antibodies
names end in -mab; harvested from antibodies produced by single B cell; target only single type of target cell/receptor
basiliximab (Simulect)
immunosuppressant; monoclonal antibody
USE: prophylaxis against acute kidney transplant rejection
MOA: inhibits binding of IL2 to CD25 on surface of activated T cells = inhibit cytokine release that would attack transplanted tissue
AE: n/v, diarrhea, abd pain
BLACK BOX WARNING: only administered by qualified HCP
Pregnancy: effects unknown; use contraception during & 4 months post treatment
corticosteroids/glucocorticoids
names end with -sone; used as immunosuppressants but have significant long-term adverse effects; drugs of choice for short-term therapy for severe inflammation
long term effects of corticosteroids
osteoporosis
cataracts
mental status changes
fluid and salt retention
HTN
hyperglycemia
obesity
adrenal atrophy
