Immunosuppressive Agents

Question 1

Immunosuppressants that affect t cell activation

Answer 1

atgam
antithymocyte globulin
-poly-clonal, renal transplant rejection, likely to produce allergic reaction.
abatacept
-treats RA, inhibits CD 80 & 86
belatacept
-for renal transplants, binds CD80 & 86, associated with INCREASED MALIGNANCIES.

Question 2

IS: monoclonal Ab

Answer 2

-mab ending
GIVEN BY INJECTION–absorbed too quickly orally
IL: immune, TU: tumor
XI: chimeric, ZU: humanized, U: fully human

Question 3

Name the monoclonal Ab

Answer 3

natalizumab

• chrohns & MS
• humanized, attacks immune cell (alpha integrains on T cell)
• linked to progressive multifocal leukoencephalopathe

tocilizumab

• treats RA
• humanized, binds IL-6 receptor

ustekinumab
-treats psoriasis & is fully human, binds interleukeins.

Question 4

Agents that bind TNF

Answer 4

etanercept: treats RA, subcutaneously given, binds TNF
infliximab: monoclonal Ab, binds TNF, given IV, chimeric so can induce immune response
adalimumab: fully human
certolizumab
golimumab

Question 5

IL-1 blockers

Answer 5

anakinra

• block receptor of IL-1
• subQ, treats RA
• dont use with TNF inhibitors

rilonacept
-binds IL-1 molecule

Question 6

blockers of internal t cell processes

Answer 6

cyclosporine

• inhibits enzyme calcineurin phosphatase
• SE: nephrotoxicity, hypertrichosis, gingival hyperplasia

tacrolimus

• binds FK binding protein–inhibiting the enzyme
• more efficacious than cyclosporine
• SE: alopecia

glucocorticoids: inhibits immune processes

sirolimus
-binds FK binding protein–inhibits a KINASE.

Everolimus

Question 7

blocker of IL-2 receptor

Answer 7

basiliximab
-monoclonal Ab, chimeric so antigenic
SE: hypersensitivity

Question 8

janus kinase inhibitor

Answer 8

tofacitinib

-kinase inhibitor

Question 9

inhibits t cell replication

Answer 9

azathioprine: prodrug, inhibits synthesis of purines
- SE: megaloblastic anemia, thrombocytopenia

mycophenolate mofetil
-inhibits enzyme: inosine monphosphate deydrogenase

methotrexate

• DOC early RA treatment
• inhibits dihydrofolate reductase=no cell division

leflunomide
Terifluonomide
-inhibits pyrimidine synthesis
-inhibits enzyme

Question 10

hydroxychloroquine

Answer 10

malaria treatment
interferes with macrophage processing of antigens
SE: retinal damage & visual disturbances.