Immunosuppressants

Question 1

Classes of Immunosuppressant Agents. Examples of each?

Answer 1

Question 2

MOA of Glucocorticoids?

Answer 2

Enter cell => bind cytosolic glucocorticoid receptor forming a Complex => cell nucleus where one of two events occurs:

• Activation of ani-inflammatory genes (iKB / IL-10)
• Repression of proinflammatory genes (NF-KB / AP1)

Question 3

Glucocorticoid Dosing?

• Low Dose? Used to treat?
• Medium Dose? Used to treat?
• High Dose? Used to treat?

Answer 3

Adrenal gland produces cortisol equivalent to 7.5 mg of prednisone daily

Question 4

Indications for Glucocorticoids?

Answer 4

Question 5

Adverse Effects of Glucocorticoids? How to Manage/Prevent?

Answer 5

Question 6

Cause/Features/Correction of Adrenal Insufficiency

Answer 6

Question 7

Calcineurin Inhibitors Examples/MOA/Use?

Answer 7

Question 8

Calcineurin Inhibitor which inhibits antigen-triggered release of lymphokines (IL-2) by activated T-Cells?

• Indications?
• Side Effects?

Answer 8

Question 9

Calcineurin inhibitor which binds to FKBP12 Protein => Inhibition of T-Cell signal transduction and transcription of IL-2?

• Indications?
• Side Effects?

Answer 9

Question 10

Calcineurin Inhibitor Therapeutic Drug Monitoring?

Answer 10

Question 11

Immunosuppressant which is broken down in vivo => 6-Mercaptopurine (6-MP) => 6-MP inhibits nucleic acid biosynthesis => Prevents B/T Lymphocytes?

• Indications?
• Side Effects?
• Screening?
• Pregnancy?

Answer 11

Question 12

Immunosuppressant which is a prodrug of Mycophenolic Acid (MPA) which inhibits inosine monophosphate dehydrogenases (IMPDH)?

• Indications?
• Side Effects?
• Pregnancy?

Answer 12

Question 13

Immunosuppressant which Inhibits Dihydrofolate Reductase (DHFR) and promotes Adenosine release => reduces inflammation

• Indications?
• Side Effects?
• Pregnancy?

Answer 13

Question 14

Therapeutic Approach to Treating Rheumatoid Arthritis?

Answer 14

Question 15

General Considerations for MABs

• Contraindicated w/ active infection or latent _________
• Increased risk of______________ and ___________________
• Associations w/ _________________ malignancy: Ill-advised to administer in active malignancy (Except _______)

Answer 15

General Considerations for MABs

• Contraindicated w/ active infection or latent TB
• Increased risk of mild infection (URTI) and opportunistic infection/sepsis
• Associations w/ hematological malignancy (Cytopenia Common): Ill-advised to administer in active malignancy (Except Rituximab)

Question 16

Monoclonal Antibodies that function by inhibiting Tumor Necrosis Factor TNF-alpha?

• Indications?
• Risks?
• Contraindications?

Answer 16

Question 17

Monoclonal Antibody that functions by Depleting B-Cells?

• Indications?
• Side Effects?
• Complications?

Answer 17

Question 18

Monoclonal Antibody that functions by inhibiting IL-6 Receptors?

• Indications?
• Side Effects?
• Complications?

Answer 18

Question 19

Fusion protein produced by recombinant DNA that functions as a selective T-cell costimulation blocker?

• Indications
• Risks
• Contraindications?

Answer 19

Question 20

Immune Drugs in Pregnancy?

• Azathioprine?
• Methotrexate?
• Mycophenolate Mofetil?
• Adalimumab?

Answer 20