Immunosuppressants

Question 1

Cyclosporine: mechanism and side effects (4).

Answer 1

Binds to cyclophilins. Inhibits calcineurin, which inhibits IL-2 production; this inhibitis the TH1 response.

Side effects: nephrotoxicity; hyperglycemia, gingival hyperplasia, hyperlipidemia.

Question 2

Tacrolimus

Answer 2

Binds to FK-binding protein, inhibits calcineurin.

Question 3

Sirolimus

Answer 3

AKA rapamycin. Inhibits mTOR, which stops T-cell proliferation in response to IL-2 (TH1 only?)

Question 4

Azathioprine

Answer 4

Precursor 5-mercaptopurine. Inhibits purine synthesis, toxic to proliferating lymphocytes. Associated with pancreatitis; more toxic with allopurinol.

Question 5

Muromonab-CD3

Answer 5

Blocks CD3, which inhibits T-cell signal transduction. Transplant.

Question 6

Aldesleukin

Answer 6

IL-2. Used in renal cell carcinoma, metastatic melanoma.

Question 7

Filgrastim, Sargramostim

Answer 7

M-CSF and GM-CSF, respectively

Question 8

alpha-interferon

Answer 8

Inhibits protein synthesis via RNaseL and PKR. Used for Hepatitis B, C.

Question 9

beta-interferon

Answer 9

Inhibits protein synthesis via RNaseL and PKR. Used for MS.

Question 10

Oprelevkin

Answer 10

IL-11. Treats thrombocytopenia.

Question 11

Infliximab, Adalimumab, Etanercept

Answer 11

anti-TNF. Used in RA, Crohn’s, psoriatic arthritis.

Question 12

Trastuzumab

Answer 12

anti-HER2/neu

Question 13

Abciximab

Answer 13

anti-GpIIb/IIIa. Used in unstable angina, cath procedures.

Question 14

Rituximab

Answer 14

anti-CD20. non-Hodgkin’s lymphoma

Question 15

Omalizumab

Answer 15

anti-IgE. Asthma.