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PHARMACOLOGY > Immunosuppressants > Flashcards

Immunosuppressants Flashcards

1
Q

Sirolimus is synergistic with ___ and is also used in ___.

A

Cyclosporine

Drug-eluting stents

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2
Q

Mechanism: Epoetin alfa

A

Recombinant EPO

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3
Q

Other uses: Corticosteroids

A

Many autoimmune and inflammatory disorders

Adrenal insufficiency

Asthma

CLL

Non-hodgkin lymphoma

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4
Q

Toxicity: Mycophenolate mofetil

A

GI upset

Pancytopenia

Hypertension

Hyperglycemia

Less nephrotoxic and neurotoxic

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5
Q

Clinical use: IFN-beta

A

Multiple sclerosis

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6
Q

6-MP (azathioprine) degraded by ___; increased toxicity by ___

A

Xanthine oxidase

Allopurinol and febuxostat

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7
Q

Mechanism: Mycophenolate mofetil

A

Reversibly inhibits IMP dehydrogenase → inhibiting purine synthesis of B and T cells

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8
Q

Other use: Cyclosporine

A

Psoriasis

RA

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9
Q

Clinical use: Oprelvekin

A

Thrombocytopenia

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10
Q

Clinical use: IFN-gamma

A

Chronic granulomatous disease

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11
Q

Clinical use: Aldesleukin

A

Renal cell carcinoma

Metastatic melanoma

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12
Q

Mechanism: Sirolimus (rapamycin)

A

Binds FKBP → inhibits mTOR

Blocks T-cell activation and B-cell differentiation by preventing response to IL-2 (blocks G1→S)

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13
Q

Toxicity: Azathioprine

A

Myelosuppression → pancytopenia

Hepatotoxicity

GI distress

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14
Q

Other uses: Basiliximab

A

Kidney transplant rejection prophylaxis specifically

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15
Q

Mechanism: Azathioprine

A

Purine (thiol) analog → decreases de novo purine synthesis

Activated by HGPRT

Metabolized into 6-MP

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16
Q

Mechanism: Eltrombopag

A

Thrombopoetin receptor agonist

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17
Q

Toxicity: Corticosteroids

A

Cushing syndrome-like effects:

Osteoporosis

Hyperglycemia

Diabetes

Amenorrhea

Adrenocortical atrophy

Peptic ulcers

Psychosis

Cataracts

Avascular necrosis (femoral head)

18
Q

Mechanism: Sargramostim

A

Recombinant GM-CSF

19
Q

Mechanism: Oprelvekin

A

Recombinant IL-11

20
Q

Clinical use: Romiplostim

A

Thrombocytopenia

21
Q

Clinical use: IFN-alpha

A

Chronic hepatitis B and C

Kaposia sarcoma

Malignant melanoma

Hairy cell leukemia

Condyloma acuminata

Renal cell carcinoma

22
Q

Mechanism: Basiliximab

A

Monoclonal antibody → blocks IL-2R

23
Q

Clinical use: Epoetin alfa

A

Anemias (especially in renal failure)

24
Q

Mechanism: Tacrolimus

A

Binds FK506 binding protein (FKBP) → inhibits calcineurin

Blocks T-cell activation by preventing IL-2 transcription

25
Q

Mechanism: Cyclosporine

A

Binds cyclophilin → inhibits calcineurin

Blocks T-cell activation by preventing IL-2 transcription

26
Q

Clinical use: Filgrastim

A

Recovery of BM and WBC counts by granulocyte stimulation

27
Q

Clinical use: Eltrombopag

A

Thrombocytopenia

28
Q

Mechanism: Corticosteroids

A

Inhibit NF-kB

Suppress both B- and T-cell function by decreasing transcription of many cytokines

Induce T-cell apoptosis

29
Q

Toxicity: Basiliximab

A

Edema

Hypertension

Tremor

30
Q

Toxicity: Sirolimus

A

Pancytopenia

Insulin resistance

Hyperlipidemia

NOT nephrotoxic

31
Q

Use of ___ causes demargination of WBCs, which causes artificial leukocytosis. ___ may develop if drug is stopped abruptly after chronic use.

A

Corticosteroids

Adrenal insufficiency

32
Q

Mechanism: Aldesleukin

A

Recombinant IL-2

33
Q

Mechanism: Romiplostim

A

Thrombopoetin analog

34
Q

Toxicity: Tacrolimus

A

Similar to cyclosporine, but with increased risk for:

Diabetes (hyperglycemia)

Neurotoxicity

NO:

Gingival hyperplasia

Hirsutism

35
Q

Other use: Sirolimus

A

Kidney transplant rejection prophylaxis specifically

36
Q

Other uses: Azathioprine

A

RA

Crohn disease

Glomerulonephritis

Other autoimmune conditions

37
Q

Toxicity: Cyclosporine

A

Nephrotoxicity

Gingival hyperplasia

Hirsutism

Hypertension

Hyperlipidemia

Neurotoxicity

38
Q

Mycophenolate mofetil is associated with ___

A

Invasive CMV infection

39
Q

Other uses: Mycophenolate mofetil

A

Lupus nephritis

40
Q

Mechanism: Filgrastim

A

Recombinant G-CSF

PHARMACOLOGY (33 decks)

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