Immunosuppressants - Anti-IgE monoclonal antibody Flashcards

1
Q
A
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2
Q

Biological DMARDs can be used to treat patients in rheumatology. When should biological DMARDs be used?

1 - failure to achieve remission or low disease severity in 3-6 months followingmethotrexateor other conventional DMARD therapy with max, non-toxic range
2 - chronic use of glucocorticoid alongside a DMARD with a dose of 5mg/day ofprednisoneor equivalent to achieve or maintain remission
3 - multiple courses of treatment with glucocorticoids
4 - continued progression of erosive disease or structural damage that is not accounted for by prior joint damage
5 - all of the above

A

5 - all of the above

It can be any of these and does not need to be all of them

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3
Q

What does mab relate to at the end of a drug name?

1 - indicates a chimeric mAb
2 -indicates a monoclonal antibody
3 - indicates a humanized
4 - indicates a fully human mAb

A

2 -indicates a monoclonal antibody

B cells are immortalised and selected to create clones capable of producing homogenous antibodies against specific epitopes of target proteins

They are adapted to ensure they are not immunogenic in humans

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4
Q

What does ximab relate to at the end of a drug name?

1 - indicates a chimeric mAb
2 -indicates a monoclonal antibody
3 - indicates a humanized mAb
4 - indicates a fully human mAb

A

1 - indicates a chimeric mAb

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5
Q

What does zumab relate to at the end of a drug name?

1 - indicates a chimeric mAb
2 -indicates a monoclonal antibody
3 - indicates a fully human mAb
4 - indicates a humanized

A

4 - indicates a humanized mAb

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6
Q

What does umab relate to at the end of a drug name?

1 - indicates a chimeric mAb
2 -indicates a monoclonal antibody
3 - indicates a fully human mAb
4 - indicates a humanized mAb

A

3 - indicates a fully human mAb

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7
Q

Which 2 of the following are the core Anti-IgE monoclonal antibody that we need to be aware of?

1 - Infliximab
2 - Mesalazine
3 - Adalimumab
4 - Omalizumab

A

4 - Omalizumab

These drugs suppress excessive immune response through targeting specific aspects of the immune system

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8
Q

What is one core adverse event that are caused by ALL monoclonal antibodies?

1 - seizures
2 - immediate/delayed hypersensitivity
3 - leukopenia
4 - hearing loss

A

2 - immediate/delayed hypersensitivity

Includes urticaria, fever, systemic symptoms and even anaphylaxis

Drugs are typically monitored for 1h after administration and monitored after this

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9
Q

Monoclonal antibodies are effective by targeting and suppressing aspects of the immune system. What can this increase the risk of?

1 - seizures
2 - autoimmune development
3 - leukopenia
4 - infection

A

4 - infection

Immune system is reduced so dangerous infections are more likely as well

Important to ensure latent and active infection is treated before commencing Monoclonal antibodies

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10
Q

Typically are monoclonal antibody medications such as Omalizumab have an impact on the immune system and are large stable molecules. Are these typically given on a weekly or daily basis?

A
  • weekly for treating RA
  • Adalimumab = SC 40 mg every 2 weeks
  • Infliximab = intravenous infusion 3 mg/kg, then 3 mg/kg, to be taken at week 2 and 6 after initial dose

MUST BE PRESCRIBED BY SPECIALISTS

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11
Q

What is the mechanism of action of Omalizumab?

1 - binds IgE and inhibits neutrophils
2 - binds IgE and inhibits mast cell activation
3 - binds IgE and inhibits B cell activation
4 - binds IgE and inhibits T cell activation

A

2 - binds IgE and inhibits mast cell activation

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12
Q

Which of the following are indications for the use of Omalizumab according to the BNF?

1 - RA
2 - urticaria
3 - Prophylaxis of severe persistent allergic asthma
4 - Non-Hodgkin’s lymphoma

A

2 - urticaria
3 - Prophylaxis of severe persistent allergic asthma

Both are immune and IgE related

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