Immunosuppressants Flashcards
Immunosuppressants that Block T-cell activation by preventing IL-2 transcription
Cyclosporine and Tacrolimus
Calcinuerin inhibitor that bind FK506
Tacrolimus
Calcinuerin inhibitor that binds cyclophilin
Cyclosporine
mTOR inhibitor that binds FKBP
Sirolimus (Rapamycin)
Immunosuppresant that blocks T-cell activation and differentiation of B-cells by preventing response to IL-2
Sirolimus (Rapamycin)
Sirolimus (Rapamycin) mechanism
Blocks T-cell activation and B-cell differentiation by preventing response to IL-2
Tacrolimus mechanism
Calcineurin inhibitor that binds FK506 preventing IL-2 transcription which blocks T-cell activation
Cyclosporine mechanism
Calcineurin inhibitor that binds cyclophilin preventing IL-2 transcription which blocks T-cell activation
Nephrotoxic immunosuppressant
Both calcineurin inhibitors are nephrotoxic but cyclosporine > tacrolimus
Tacrolimus inhibits what
Calcineurin
Cyclosporine inhibits what
Calcinuerin
Sirolimus (Rapamycin) inhibits what
mTOR
Sirolimus
mTOR inhibitor that binds FKBP preventing IL-2 response and blocking T-cell activation and B-cell differentiation
Indications for Sirolimus (Rapamycin)
Kidney transplant rejection prophylaxis
Immunosuppressant given to synergistically with cyclosporine
Sirolimus (Rapamycin)
Immunosuppressant used in drug-eluding stents
Sirolimus (Rapamycin)
Immunosuppresant that spares the kidney
Sirolimus (Rapamycin)
Other indications for cyclosporine
Psoriasis, rheumatoid arthritis
Toxicities associated with cyclosporine
Nephrotoxicity, hypertension, hyperlipidemia, neurotoxicity, gingival hyperplasia, hirsutism
Toxicities associated with tacrolimus
Increased risk of diabetes and neurotoxicity; NO gingival hyperplasia or hirsutism
Nephrotoxic immunosuppressant that does not cause gingival hyperplasia or hirsutism
Tacrolimus
Nephrotoxic immunosuppressant that causes gingival hyperplasia and hirsutism
Cyclosporine
Monoclonal antibody that blocks IL-2R
Basiliximab
Monoclonal antibody that causes edema, hypertension and tremors
Basiliximab
Toxicity associated with azathioprine (6-MP)
Pancytopenia
Immunosuppressant contraindicated with allopurinol
Azathioprine
Enzyme responsible for azathiprine degradation
Xanthine oxidase
Immunosuppressant that inhibits lymphocyte proliferation by blocking nucleotide synthesis
Azathioprine
Other indications for azathioprine
Rheumatoid arthritis, Crohn disease, glomerulonephritis, and other immune conditions
Antimetabolite precursor of 6-mercaptopurine
Azathioprine
Mechanism of azathioprine
Blocks nucleotide synthesis inhibiting lymphocyte proliferation
Mycophenolate mofetil other indications
Lupus nephritis
Mycophenolate mofetil toxicities
GI upset, pancytopenia, hypertension, hyperglycemia
Immunosuppressant associated with invasive CMV infection
Mycophenolate mofetil
Mycophenolate mofetil is associated with what infection
CMV
Mycophenolate mofetil mechanism
Reversibly inhibits IMP dehydrogensase preventing purine synthesis of B and T cells
Immunosuppressant that reversibly inhibits IMP dehydrogenase
Mycophenolate mofetil
Immunosuppressant that prevents purine synthesis of B and T cells and is associated with invasive CMV infections
Mycophenolate mofetil
Immunosuppressant that is less nephrotoxic and neurotoxic and reversibly inhibits IMP dehydrogenase
Mycophenolate mofetil
Reversible inhibitor of IMP dehydrogenase also indicated for lupus nephritis
Mycophenolate mofetil
Immunosuppressant that inhibits NF-kB
Corticosteroids
Immunosuppressant that suppresses B and T cell function by decreasing transcription of many cytokines
Corticosteroids
Corticosteroid mechanism
Inhibits NF-kB decreasing transcription of many cytokines suppressinb B and T-cell function
Corticosteroids induce apoptosis in what cells
T-cells
T-cell apoptosis is induced by which immunosuppressant
Corticosteroids
Indications for corticosteroids
Many autoimmune and inflammatory disorders, adrenal insufficiency, asthma, CLL, non-Hodgkin lymphoma
Immunosuppressant that causes artificial leukocytosis
Corticosteroids
Adrenal insufficiency may develop if this immunosuppresant is stopped abruptly
Corticosteroids
Cushing syndrome, osteoporosis, hyperglycemia are complications of which immunosuppressant
Corticosteroids
Avascular necrosis, peptic ulcers, and adrenocoritcal atrophy are complications of which immunosuppressant
Corticosteroids
Diabetes, amenorrhea and demargination of WBCs is seen with which immunosuppressant
Corticosteroids