Immunosuppressants Flashcards
how do calcineurin inhibitors work
block T cell activation
how do cytotoxic drugs work
kill certain cells, more toxic to cells that are actively dividing (where there is an autoimmune response, immune cells are the most dividing cells so immune cells would be targeted
adverse reactions to ALL immunosppuressants
greater risk for infection, cancer (skin cancer)
unique concerns with cyclosporin (calcinerurin inhibitors)
nephrotoxicity
hyperkalemia
HTN
dyslipidemia (increase cholesterol and tris)
unique concerns with cytotoxics
reactions are due to nonspecific of drug
myleosupression (bone), N/V, alopecia, hepatotoxicity
how do monoclonal antibodies differ in the risk of infusion related reactions
more human= less likely to get a reaction
how to prevent infusion related reactions with monoclonal antibodies
premeditate, antihistamines, steroids
for methotrezate what is the difference between RA and cancer doses
cancer does are way larger, RA are very small
what is recommended to minimize some side effects with methotrexate, why?
increase folic acid
methotrexate blocks cells ability to make folic acid
cells that are dividing very rapidly will suck up the drug and cannot leave the cell but cannot hold onto folic acid
what are biosimilars and how do they compare to generic
biosimialrs are not considered identical
cannot do auto substitutions
greater requirements: safety, efficacy, amino acid, folding, turning
add a 4 letter sequence to the end
calcinerurin inhibitors
cyclosporine
cytotoxics
methotrexate
monoclonal antibody
adalimumab (human)
other drug used for this
hydroxychloroquine
hydroxychloroquine
used for RA, Lupus, COVID
N/V/D, neuromuscular toxicity, ataxia, nervousness, visual disturbances
