Immunosuppressants - Lymphocyte-signalling inhibitors Flashcards

1
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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2
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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3
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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4
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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5
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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6
Q

Which of the following are the core Lymphocyte-signaling inhibitor we need to be aware of?

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

A

2 - Ciclosporin

Inhibits transcription of proteins and reduces lymphocytic (WBCs) signalling

Also acts as a calcineurin inhibitor that inhibits T cell activation

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7
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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8
Q

All of the following are adverse effects of Ciclosporin, which is the most common?

1 - eye inflammation
2 - GI upset
3 - appetite suppression
4 - fatigue

A

1 - eye inflammation

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9
Q

Which of the following is NOT an indication for the use of Ciclosporin according to the BNF?

1 - severe RA
2 - severe psoriasis
3 - prophylaxis of severe persistent allergic asthma
4 - organ transplantation
5 - severe atopic dermatitis
6 - nephrotic syndrome

A

3 - prophylaxis of severe persistent allergic asthma

Very strong medication

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