immunosuppressants Flashcards
cyclosporine MOA?
calcineurin inhibitor, binds cyclophilin
prevents IL2 transcription
cyclosporine use?
txp rejection ppx
psoriasis
RA
cyclosporine toxicity?
NEPHROTOXIC
HTN
hyperlipidemia
neurotoxicity
** gingival hyperplasia, hirsutism
tacrolimus MOA?
calcineurin inhibitor, binds FKBP
prevents IL2 transcription
tac use?
txp rejection ppx
tac toxicity?
like cyclosporine but w/o gingival hyperplasia/hirsutism
** increased risk of diabetes and neurotoxicity
sirolimus (rapamycin) MOA?
mTOR inhibitor
prevents response to IL2
sirolimus use?
kidney txp rejection ppx
synergistic with cyclosporine
sirolimus toxicity?
anemia TCP leukopenia insulin resistance hyperlipidemia
daclizumab, basiliximab?
monoclonal Abs that block IL2R
azathioprine MOA?
6MP precursor, blocks nucleotide synthesis
azathioprine use?
txp rejection ppx RA Crohn glomerulonephritis autoimmune
azathioprine toxicity?
leukopenia
anemia
TCP
** toxicity increased by allopurinol
glucocorticoid MOA?
inhibit NFKB - decreases transcription of many cytokines
aldesleukin?
IL 2
used in renal cell carcinoma
metastatic melanoma
filgrastim
G-CSF
sargramostim
GM-CSF
romiplostim, eltrombopag
used in TCP
oprelvekin
IL 11
used in TCP
alemtuzumab?
–>CD52
used in CLL
bevacizumab?
–>VEGF
used in CRC, renal cell carcinoma
cetuximab?
–> EGFR
used in stage IV CRC, head/neck ca
rituximab?
–> CD20
used in BCell NHL, CLL, RA, ITP
trastuzumab?
–>HER2neu
used in brca
adalimumab, infliximab?
–>TNF-a
used in IBD, RA, ankylosing spondylitis, psoriasis
eculizumab?
–>C5 (complement)
used in PNH
natalizumab?
–>alpha 4 integrin
used in MS, Crohn
** risk of PML in pts with JC virus
abciximab?
–> IIb/IIIa
used in patients getting PCI
denosumab?
–> RANKL
used in osteoporosis
digoxin immune Fab?
antidote for dig toxicity
palivizumab?
–> RSV F protein
used for RXV ppx in high risk infants
ranibizumab?
–> VEGF
used in neovascular macular degeneration
