Immunosuppressants

Question 1

What are the T-cell inhibitors

Answer 1

Cyclosporine
Tacrolimus
Sirolimus

Question 2

What is the Glucocorticoid

Answer 2

Prednisone

Question 3

What are the Cytotoxic drugs

Answer 3

Mycophenolate mofetil
Cyclophosphamide
Azathioprine
MTX

Question 4

What are the Immunosuppresive Abs

Answer 4

Muromonab
Daclizumab
Basiliximab
Antithymocyte globulin
RhoD Immunoglobulin

Question 5

How do T-cell inhibitors work

Answer 5

Immunophilin ligands

Prevent activation, differentiation and cytokine release

Question 6

What is Cyclosporine’s MOA

Answer 6

Bind cyclophilin and inhibit calcineurin

Decreased cytokine production

Question 7

How does grapefruit juice increase the absorption of Cyclosporine

Answer 7

Inhibit P-glycoprotein

Question 8

What metabolizes Cyclosporine

Answer 8

3A4

Question 9

What does Cyclosporine interact with

Answer 9

Aminoglycosides (Amikacin)

Spironolactone

Question 10

What are the main Cyclosporine AE

Answer 10

Gum hyperplasia

Hirsuitism

Question 11

What are the other Cyclosporine AE

Answer 11

Nephrotoxicity
Hyperkalemia
Increased Lymphoma risk

Question 12

Which T-cell inhibitor is a macrolide, 100x more potent than Cyclosporine

Answer 12

Tacrolimus

Question 13

How does Tacrolimus act

Answer 13

Bind FK-506 inhibiting calcineurin

Question 14

What does Tacrolimus absorption depend on

Answer 14

Bile

Question 15

What is the main Tacrolimus AE

Answer 15

Neurologic effects

Question 16

Does Tacrolimus cause gum hyperplasia and hirsutism

Answer 16

No

Question 17

How does Sirolimus act

Answer 17

Inhibit mTOR and IL-2 action

Question 18

What is Sirolimus used for

Answer 18

Prevent re-stenosis after angioplasty

Question 19

What happens if you combine Sirolimus with Cyclosporine

Answer 19

Nephrotoxicity

Question 20

What is the Sirolimus AE

Answer 20

Hyperlipidemia

Question 21

How does Prednisone act

Answer 21

Inhibit cell cycle
Induce apoptosis in activated T-cells
Decrease cellular and humoral response

Question 22

What are the Prednisone AE

Answer 22

Adrenal suppression, Cushing features
Ostoporosis
HTN, Peptic ulcer, Muscle wasting

Question 23

What does Mycophenolate mofetil do

Answer 23

Inhibit IMP dehydrogenase
Blocks PURINE synthesis
Suppress B and T cell activation

Question 24

What are the Mycophenolate mofetil AE

Answer 24

Diarrhea

Myelosuppression (neutropenia)

Question 25

What is Azathioprine used for

Answer 25

Renal transplant

Autoimmune disease

Question 26

What is Azathioprine converted to

Answer 26

6-MP

Question 27

How does Allopurinol affect Azathioprine

Answer 27

Increases its concentration by inhibiting Xanthine oxidase

Question 28

What is the Alkylating agent

Answer 28

Cyclophosphamide

Question 29

What is Cyclophosphamide used for

Answer 29

Wegener’s
SLE
Autoimmune

Question 30

What are the Cyclophosphamide AE

Answer 30

Hemorrhagic Cystitis

BM suppression

Question 31

Tx for Cyclophosphamide Hemorrhagic Cystitis

Answer 31

Mesna

Question 32

What is useful in RA

Answer 32

MTX

Question 33

How does MTX act

Answer 33

Inhibit AICAR transformylase

Question 34

What are the MTX AE

Answer 34

BM suppression
Mucositis
Hepatic fibrosis

Question 35

What is the Anti-CD3 Ab

Answer 35

Muromonab

Question 36

What is Muromonab used for

Answer 36

Acute graft rejection

Question 37

What does Muromonab kill

Answer 37

T-cells

Question 38

What are the Muromonab AE

Answer 38

HS

Question 39

IL-2r antagonist used pre-op for transplantation

Answer 39

Daclizumab

Basiliximab

Question 40

Human IgG Ab against Rh Ag

Answer 40

RhoD Immunoglobulin

Question 41

What is RhoD Immunoglobulin used for

Answer 41

Prevent hemolytic disease of the newborn