Immunosuppr Rx Flashcards

1
Q

Immunosuppressants

A

Cyclosporine Tacrolimus (FK-506) Sirolimus (rapamycin) Azathioprine Muromonab-CD3 (OKT3)

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2
Q

Cyclosporine

A
  1. Post-transplant immunosuppression; select autoimmune disorders 2. Binds to cyclophilins. Complex blocks differentiation and activation of Tcells–> inhibiting calcineurin–> preventing production of IL-2 and its receptor 3. Nephrotoxicity, hypertension, hyperlipidemia, hyperglycemia, tremor, gingival hyperplasia, hirsutism 4. Think old man with diabetes who wants to look good for his date so he put in dentures and got hair plugs: old (renal failure, HTN, cholesterol), diabetes (hyperglycemia), dentures (gum hyperplasia), hair plugs (hirsutism, and he is taking the drug because of his hair transplant)
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3
Q

Tacrolimus (FK-506)

A
  1. Post- organ transplant immunosuppression; POTENT 2. Binds to FK protein->inhibiting calcineurin->preventing IL-2 3. Nephrotoxicity, hypertension, hyperlipidemia, hyperglycemia, tremor 4. Think old with diabetes who is nervous because he is super sick: old (renal failure, HTN, cholesterol), diabetes (hyperglycemia), nervous (tremor), super sick (strong immunosuppressant)
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4
Q

Sirolimus (rapamycin)

A
  1. Immunosuppression post-KIDNEY transplant (Give with cyclosporine); used with drug-eluting stents 2. Inhibits mTOR. Decreased cell proliferation in response to IL-2 3. Hyperlipidemia, thrombocytopenia, leukopenia 4. SIROlimus= SERIOUS complications: immunosuppression
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5
Q

Azathioprine

A
  1. Immunosuppression post-KIDNEY transplant; autoimmune disorders (including glomerulonephritis and hemolytic anemia) 2. Antimetabolite. Blocks 6-mercaptopurine synth-> decreased synthesis of nucleic acids. Toxic to proliferating lymphocytes. 3. Bone marrow suppression. 4. Active metabolite (mercaptopurine) is metabolized by xanthine oxidase so more toxic when given with allopurinol
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6
Q

Muromonab-CD3 (OKT3)

A
  1. Immunosuppression post-KIDNEY transplant 2. Monoclonal antibody to CD3 on T-cells. Blocks interaction with CD3 responsible for T-cell signal transduction 3. Cytokine release syndrome, hypersensitivity reaction 4. Antibodies= hypersensitivity, hypersensitivity= cytokine release -nab= monocolonal antibody therapy (usually)
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8
Q

Recombinant Cytokines

A

Aldesleukin (interleukin-2) Epoetin alfa (erythropoietin) Filgrastim (CSF-G) Sargramostim (CSF-GM) Alpha-Interferon Beta-Interferon Gamma-Interferon Oprelvekin (interleukin-11) Thrombopoietin

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9
Q

Aldesleukin

A
  1. Renal cell carcinoma Metastatic Melanoma 2. Cytokine: Interleukin-2 MOA: increases helper, cytotoxic, and regulatory T cells
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10
Q

Epoetin alfa

A
  1. Anemias (esp in renal failure) 2. Cytokine: Erythropoietin MOA: Stimulates Erythrocyte replication
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11
Q

Filgrastim

A
  1. Recovery of bone marrow 2. GM-CSF (Granulocyte Colony Stimulating Factor)
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12
Q

Sargramostim (CSF-GM)

A
  1. Recovery of bone marrow 2. GM-CSF (Granulocyte-Macrophage Colony Stimulating Factor)
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13
Q

Alpha-Interferon

A
  1. Hepatitis B and C Kaposi’s Sarcoma Leukemia Malignant Melanoma 2. Inhibit viral protein synthesis and activates NK cells to kill virally infected cells
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14
Q

Beta-Interferon

A

Multiple Sclerosis

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15
Q

Gamma-Interferon

A
  1. Chronic Granulomatous disease 2. Activates macrophages and Th1 cells Suppresses Th2 cells. 4. (G)amma = (G)ranulomatous
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16
Q

Oprelvekin

A
  1. Thrombocytopenia 2. IL-11
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17
Q

Thrombopoietin

A

Thrombocytopenia

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19
Q

Theraputic Antibodies

A

Muromonab-CD3 (OKT3 Digoxin Immune Fab Infliximab Adalimumab Abciximab Trastuzumab (Herceptin) Rituximab Omalizumab

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20
Q

Muromonab-CD3 (OKT3)

A
  1. Immunosuppression post-KIDNEY transplant 2. Monoclonal antibody to CD3 on T-cells. Blocks interaction with CD3 responsible for T-cell signal transduction 3. Cytokine release syndrome, hypersensitivity reaction 4. Antibodies= hypersensitivity, hypersensitivity= cytokine release -nab= monocolonal antibody therapy (usually)
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21
Q

Digoxin Immune Fab

A

Target: Digoxin Use: Antidote for Digoxin toxicity

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22
Q

Infliximab

A

Target: TNF-alpha Use: Crohn’s Disease, Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis

23
Q

Adalimumab

A

Target: TNF-alpha Use: Crohn’s Disease, Rheumatoid arthritis, psoriatic arthritis

24
Q

Abciximab

A

Target: Glycoprotien IIb/IIIa Use: Prevent cardiac ischemia in unstable angina and patients treated with percutaneous coronary intervention MOA: Prevents platelet aggregation by inhibiting the platelet-GIIb/IIIa-fibrinogen bonds

25
Q

Trastuzumab (Herceptin)

A

Target: HER2 Use: HER2 overexpressing breast cancer

26
Q

Rituximab

A

Target: CD20 Use: B-cell non-Hodgkin’s lymphoma

27
Q

Omalizumab

A

Target: IgE Use: Additional treatment for severe asthma

30
Q

-azole

A

Antifungal Ex: Ketoconazole

31
Q

-cillin

A

Penicillin Ex: Methicillin

32
Q

-cycline

A

Antibiotic, protein synthesis inhibitor Ex: Tetracycline

33
Q

-navir

A

Antibiotic, protease inhibitor Ex: Saqyubavir

35
Q

-triptan

A

5-HT 1B/1D agonists (for migranes) Ex: Sumatriptan

36
Q

-ane

A

Inhalational general anesthetic Ex: Halothane

37
Q

-caine

A

Local anesthetic Ex: Lidocaine

38
Q

-operidol

A

Butyrophenone (neuroleptic) Ex: Haloperidol

39
Q

-azine

A

Phenothiazine (neuroleptic, antiemetic) Ex: Chlorpromazine, compazine

40
Q

-barbital

A

Barbituate Ex: Phenobarbital

41
Q

-zolam

A

Benzodiazepine Ex: Alprazolam

42
Q

-azepam

A

Benzodiazepine Ex: Diazepam

43
Q

-etine

A

SSRI Ex: Fluoxetine

44
Q

-ipramine

A

TCA Ex: Imipramine

45
Q

-triptyline

A

TCA Ex: Amitriptyline

47
Q

-olol

A

B-antagonist Ex: Propranolol

48
Q

-terol

A

B2-agonist Ex: Albuterol

49
Q

-zosin

A

Alpha1-antagonist Ex: Prazosin

51
Q

-oxin

A

Cardiac glycoside (inotropic agent) Ex: Digoxin

52
Q

-pril

A

ACE inhibitor Ex: Captopril

53
Q

-afil

A

Erectile Dysfunction Ex: Sildenafil

55
Q

-tropin

A

Pituitary hormone Ex: Somatotropin

56
Q

-tidine

A

H2 antagonist Ex: Cimetidine