Immunosuppressants & Therapeutic Abs

Question 1

Precursor to 6-Mercaptopurine

Answer 1

Azthioprine - inhibits lymphocyte proliferation by blocking nucleotide synthesis

Question 2

Inhibits IMP dehydrogenase

Answer 2

Mycophenolate mofetil - inhibits guanine synthesis - prevents lymphocyte proliferation

Question 3

Binds to cyclophilins and inhibits calicineurin resulting in the loss of IL-2 production

Answer 3

Cyclosporin

Question 4

Binds FK-binding protein leading to loss of IL-2 production

Answer 4

Tacrolimus

Question 5

Binds FKBP-12 leading to inhibition of mTRO and inhibition of T-cell proliferation

Answer 5

Sirolimus

Question 6

Used for lupus nephritis

Answer 6

Azathioprine

Question 7

Metabolized by xanthine oxidase, therefore allopurinal increases its toxicity

Answer 7

Azathioprine

Question 8

Immunosuppressants that are highly nephrotoxic?

Answer 8

Cyclosporin

Tacrolimus

Question 9

Glucocorticoids

Answer 9

Inhibits NF-KB

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

Question 10

Use to be used as sedative during pregnancy but causes phocomelia

Answer 10

Thalidomide

Phocomelia = hypolasia of limbs

Question 11

Adalimumab

Infliximab

Answer 11

Targets soluble TNF-alpha

**used for seronegative spondyloarthropathies

*Check for latent TB

Question 12

Etanercept

Answer 12

*NOT a monoclonal Ab
BUT
Is a decoy TNF alpha receptor so it binds up all the TNF- alpha

Question 13

Rituximab

Answer 13

Binds CD20 on B-cells and induces complement to lyse B-cells

*B-cell non-hodgkin lymphoma, CLL

Question 14

Trastuzumab

Answer 14

Binds to HER2/neu in treatment of breast cancer

Question 15

Digoxin immune Fab

Answer 15

Binds to digoxin

Antidote for digoxin toxicity

Question 16

Omalizumab

Answer 16

Binds IgE
Used in allergic asthma
Very expensive

Question 17

Bevacizumab

Ranibizumab

Answer 17

Binds to VEGF

*Colorectal cancer, renal cell carcinoma