Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > Immunosuppresants > Flashcards

Immunosuppresants Flashcards

(52 cards)

Start Studying
1
Q

What is being used more in renal transplants? What is being used less?

A

More: thymoglobulin
Less: ATGAM and muromonab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Immunosuppressive regimen given at time of transplant

A

induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe induction

A

relatively intense; can’t be tolerated long term, may include donor specific transfusion or irradiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe maintenance

A

lower potency than induction and rescue, tolerable in chronic use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe rescue

A

intense and effective, chronically intolerable, applied in response to rejection episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

maintenance therapy usually consists of triple drug therapy using agents that work at different levels of the inflammatory cascade. What are the 3 drugs usually used?

A

Calcineurin inhibitor, anti-proliferative, steroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What 2 antibodies bind parts of the T cell receptor to prevent activation?

A

Anti-CD3 Ab, CTLA-4 Ig

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 2 drugs inhibit T cells at the level of calcineurin?

A

tacrolimus, cyclosporine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is calcineurin

A

a phosphatase in the T cell that controls nuclear access of NFAT. It allows upregulation of IL-2 (for proliferation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What Ab target TCR? And what is the result?

A

Anti-CD3 Ab: binds CD3 component of TCR. No activation

CTLA-4 Ig: binds CD28. anergy, apoptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What happens when drugs bind calcineurin?

A

IL-2 is not upregulated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do glucocorticoids do?

A

inhibit transcription of pro-inflammatory genes and diminish the ability of the T-cell to produce and release IL-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What would Anti-CD25 mAB do?

A

bind to CD25, which is the IL-2 receptor. This inhibits the ability of adjacent T cells to be activated, diminishing clonal expansion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is mTOR?

A

mTOR is activated after IL-2 activates the T cell. this causes initiation of cell cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens when mTOR is inhibited?

A

proliferative signal at IL-2 receptor has no consquences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What drugs inhibit mTOR?

A

serolimus, everolimus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happens when Anti-CD52 mAb binds the CD52 target?

A

identifies cell for lysis via Ab cytotoxicity and complement mediated cytotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

“xi” in a drug means that it is ____.

A

chimeric antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Muronomab class? is it lymphocyte depleting? antigenic target?

A

monoclonal, yes, CD3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Basiliximab class? lymphocyte depleting? antigenic target?

A

monoclonal, no, IL-2 receptor (CD25)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Daclizumab class? lymphocyte depleting? target?

Study These Flashcards
A

monoclonal, no, IL-2 receptor (CD25)

22
Q

Rabbit ATG class? depleting lymphocytes? target?

Study These Flashcards
A

polyclonal, yes, multiple

23
Q

Alemtuzumab class? depleting lymphocytes? target?

Study These Flashcards
A

monoclonal, yes, CD52

24
Q

Belatacept class? depleting lymphocytes? target?

Study These Flashcards
A

monoclonal, yes, CD80 (B7)

25
What black box warning is found only with muromonab?
angiodema, hypovolemia, pulmonary edema, siezures
26
In what patients is belatacept contraindicated? Why?
recipients who are EBV negative. reduce likelihood of PML and PTLD which can ve deadly
27
What is PTLD?
B cell proliferation due to therapeutic immunosuppression after transplantation. These pt may develop mono like lesions or poly- clonal/morphic B cell hyperplasia that can give rise to lymphoma.
28
How is calcineurin activated?
increased cytoplasmic calcium activates calcineurin via calmodulin
29
What are the calcineurin inhibitors?
cyclosporine A and tacrolimus
30
What is the cyclosporine A target? tacrolimus target?
cyclophilin; FKBP12
31
What is the major problem with CNI?
dose/duration dependent nephrotoxicity
32
What are problems with CNI?
renal toxicity, CV, neuro, gingival hyperplasia, hypertrichosis, 2ndary malignancies
33
What do CBPs do?
They have intrinsic HAT activity. Acetylation of core histones and consequent increased expression of multiple inflammatory proteins,
34
What do glucocorticoid receptors do?
bind corticosteroids, inhibit HAT by recruiting HDAC2, suppression of activated inflammatory genes
35
What are the effects of corticosteroids on the immune system?
inhibition of T lymphocyte activity, neutrophilia, eosinopenia, monocytopenia
36
What adverse effects are mediated by the cell-surface steroid receptors?
neurologic issues (insomnia, depression, anxiety)
37
What are some general adverse effects to chronic use of corticosteroids?
protein metabolism dysfunction, reactivation of TB due to increased susceptibility to infection, hyerporticism, hypercholesterolemia, neurologic effects, skin atrophy and impaired wound healing
38
Sirolimus binds ______ and inhibits _____.
FKBP12; 2nd phase of activation
39
Sirolimus is synergistic with _____
cyclosporine
40
What is the effect of sirolimus on B cells?
prevents differentiation into Ab producing cells, decreased IgG, A, M
41
How does the drug target of sirolimus lead to adverse effects?
it is also expressed in non-immune cells
42
adverse effects of sirolimus
life-threatening hepatotoxicity, renal function, opportunisitic infections and secondary malignancies, DVT
43
What does mycophenolate mofetil do?
inhibits ionsine monophosphate dehydrogenase--> interupt DNA synthesis
44
What cell types are most affected by mycophenolate mofetil?
B and T lymphocytes (inhibits T cell proliferation)
45
What are advantages to using mycophenolate mofetil ?
blocks 2ndary antibody responses mediated by memory B cells. selective to lymphocyte proliferation, no chromosomal breaks
46
most common side effect of mycophenolate mofetil involves the ____
GI tract. Myelosuppression occurs infrequently
47
What is azathioprine?
cell cycle disruptor
48
Metabolism of azathioprine leads to what products?
6MP (anti-cancer), 6- tioguanin triphosphate which blocks stimulation of T cell--> apoptosis in IL2 stimulated memory T cells
49
Azathioprine is class ____
D
50
What is cyclophosphamide?
anticancer drug that requires metabolic activation to its pharmacologically active form. It is an alkylating agent that produces cross links
51
What is the dose limiting toxicity of cyclophosphamide?
hematologic
52
Does cyclophosphamide affect B or T cells more?
B cells....lymphopenic: humoral immunity

Pharmacology (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions