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immunosuppressants Flashcards

1
Q

do glucocorticoids have any effect on humoral immunity?

A

no, but they decr cytokines, lymphocytes, and T cell activation

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2
Q

do glucocorticoids have any effect on humoral immunity?

A

no, but they decr cytokines, lymphocytes, and T cell activation

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3
Q

which immunosuppressant is used for GVHD?

A

glucocorticoids, calcineurin inhibitors

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4
Q

what is recommended to block 1st dose cytokine storm in transplant recipeients after muromonab-CD3 admin?

A

glucocorticoids can be given prophylactically

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5
Q

what is an issue with rapid discontinuation of glucocorticoisd?

A

adrenal crisis

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6
Q

what glucocorticoid is the reference standard?

A

prednisone

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7
Q
A

low dose

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8
Q

> 7.5 mg, but

A

medium dose

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9
Q

> 30 mg, but

A

high dose

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10
Q

greater than 250 mg prednisone eq per day for 1 day or a few days

A

pulse therapy

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11
Q

> 250 mg prednisone eq per day for 1 day or a few days

A

pulse therapy

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12
Q

for what diseases does cyclosporine work after tx failure

A
  1. RA (after methorexate)

2. psoriasis (after failed tx)

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13
Q

what is recommended to block 1st dose cytokine storm in transplant recipeients after muromonab-CD3 admin?

A

glucocorticoids can be given prophylactically

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14
Q

grapefruit juice incr which drug concentrations?

A

cyclosporine + tacrolimus

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15
Q

AE: nephrotoxicity, HTN, DM, neurotoxicity?

A

cyclosporine + tacrolimus

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16
Q

less than 7.5 mg prednisone eq per day?

A

low dose

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17
Q

what anti-proliferative immunosuppr is a tx option for crohns disease?

A

aziothioprine or anti-TNFalpha reagents

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18
Q

what sort of tests need to be monitored with aziothioprine admin?

A

CBC & liver tests

19
Q

AE: bone marrow suppression, incr susceptibility to viral infxns, incr risk of lymphoma

A

azathioprine

20
Q

MOA: prodrug metabolized into NPA–>inhibs inosine monophosphate dehydrogenase req’d for de novo synthesis of guanine NT?

A

mycophenolate mofetil

21
Q

does mycophenolate mofetil act in the stomach?

A

NO, not soluble in low pH

22
Q

for what diseases does cyclosporine work after tx failure

A
  1. RA (after methorexate)

2. psoriasis (after failed tx)

23
Q

major AE assc’d with cyclosporine?

A

nephrotoxicity

24
Q

grapefruit juice incr which drug concentrations?

A

cyclosporine + tacrolimus

25
Q

AE: nephrotoxicity, HTN, DM, neurotoxicity?

A

cyclosporine + tacrolimus

26
Q

MOA: purine antimetabolite used to inhibit lymphocyte proliferation–>metabolized into 6 MP and integrated into DNA–>blocking lymphocyte proliferation

A

aziothioprine

27
Q

which immunosuppr would you use for intense immunosuppression in the 1st days-weeks post transplant?

A

antithymocyte globulin

28
Q

what dort of tests need to be monitored with aziothioprine admin?

A

CBC & liver tests

29
Q

AE: bone marrow suppression, incr susceptibility to viral infxns, incr risk of lymphoma

A

azathioprine

30
Q

wat can be used to reverse glucocorticoid resistant organ transplant rejection episodes?

A

muromonab-CD3

31
Q

does mycophenolate mofetil act in the stomach?

A

NO, not soluble in low pH

32
Q

AE: hematologic, GI, incr infxns with CMV, teratogenic

A

mycophenolate mofetil

33
Q

contains the ligand-binding portion of a human TNF-α receptor fused to the Fc portion of human IgG1

A

Etanercept

34
Q

what is the immunosuppressant that can ONLY be administereed orally?

A

sirolimus

35
Q

MOA: blocks mTOR–>cannot remove inhibitory protein that normally initiates cell cycle proliferation–>cell cycle proliferation blocked

A

sirolimus

36
Q

what is sirolimus used for?

A

prophylaxis of organ transplant rejection.

used in combo with glucocorticoids + calcineurin inhib

37
Q

which immunosuppr would you use for intense immunosuppression in the 1st days-weeks post transplant?

A

antithymocyte globulin

38
Q

MOA: bind CD and HLA 1/2–>complement mediated cytotox and inhib of lymphocyte fxn

A

antithymocyte globulin

39
Q

MOA: mouse Ab directed at CD3

A

muromonab-CD3

40
Q

wat can be used to reverse glucocorticoid resistant organ transplant rejection episodes?

A

muromonab-CD3

41
Q

chimeric monoclonal antibody containing a human constant region and a murine variable region

A

Inflixamab

42
Q

recombinant human IgG1 monoclonal

A

Adalimumab

43
Q

contains the ligand-binding portion of a human TNF-α receptor fused to the Fc portion of human IgG1

A

Etanercept

44
Q

how to inflixamab, Adalimumab, etanercept act?

A

prevent TNF-alpha from binding receptor

Pharm (20 decks)

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