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Pharmcology > Immunosuppressants > Flashcards

Immunosuppressants Flashcards

1
Q

MOA of action of corticosteroids?

A

Immunosuppressive by inhibiting transcription and therefore gene expression.

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2
Q

Examples of corticosteroids?

A 
Prednisolone
Beclomethasone
Fluticasone
Dipropionate
Budenoside
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3
Q

ADRs of corticosteroids?

A

Cushingoid, suppression HPA axis, osteoporosis, at high concentration will act on mineralocorticoid receptors (salt retention), stunted growth in children

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4
Q

Indications of corticosteroids?

A

Immunosuppressive, anti inflammatory, replacement of endogenous corticosteroids

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5
Q

Azathioprine indication of use?

A

RA, IBD, transplant and leukaemia

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6
Q

MOA: Azathioprine

A

Inhibition of purine metabolism reduces DNA and RNA production. Cytotoxic action of rapidly diving cells

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7
Q

ADRs of azathioprine?

A

Myelosuppression (bone marrow suppression!) causing thrombocytopenia and anaemia . Increased infection risk, GI disturbance

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8
Q

Give an example of a cytotoxic alkylating agent?

A

cyclophosphamide

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9
Q

MOA: cyclophosphamide?

A

Creates cross links between DNA thus preventing replication. It targets cells with a high mitotic rate

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10
Q

ADRs of cyclophosphamide?

A

Bladder cancer risk due to increase of acrolein metabolite in urine
Lymphoma and leukaemia
Infertility and teratogenic

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11
Q

DDIs of cyclophosphamide?

A

It is activated by CYP450 so consider CYP inducers and inhibitors

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12
Q

What is the agent of choice for transplant immunosuppression?

A

Mycophenolate Mofetil

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13
Q

MOA of mycophenolate mofetil?

A

Inhibition of guanosine synthesis leading to impaired B cell and T cell proliferation

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14
Q

ADRs of mycophenolate mofetil?

A

My loud suppression leading to leukopenia and neutropenia

Increased risk of infection, especially viral

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15
Q

Calcineurin inhibitors are indicated for..?

A

Prevention of graft and transplant rejection
Atopic dermatitis
Psoriasis

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16
Q

MOA of calcineurin?

A

Reduction in IL2 synthesis suppressing the cell mediated and antibody specific adaptive immune response. Active against t helper cells

17
Q

Examples of calcineurin inhibitors?

Where do they bind?

A

Cyclosporin binds to cyclophilin

Tacrolimus binds to Tacrolimus-binding-protein

18
Q

ADRs of calcineurin inhibitors.

A

Nephrotoxic. Effect in PCT.

DOESN’T CAUSE MYELOSUPPRESSION

Pharmcology (2 decks)

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