Immunosuppressive drugs Flashcards
How do corticosteroids work at low doeses?
At low doses they predominantly act on antigen-presenting cells, preventing some of the early stages of graft rejection
How do corticosteroids work at higher doeses?
Higher doses of corticosteroids have direct effects on T cells and are used to treat episodes of rejection.
What type of drugs are Cyclosporine and tacrolimus?
T-Cell Signalling Blockade- they work by interacting with proteins in the intracellular T-cell signalling cascade.
Give examples of drugs that work on IL-2 Blockade
- Basiliximab
- Daclizumab
- Rapamycin
How do basiliximab and daclizumab work?
- They are Monoclonal antibodies against the IL-2 receptor
- Completely block IL-2 and have potent immunosuppressive effects
- Only used to treat episodes of acute graft rejection
How does Rapamycin work?
- It can be given orally and interacts with signalling events downstream of the IL-2 receptor
- Rapamycin is less potent and easier to take than the monoclonal antibodies, so it is used to prevent graft rejection.
What are examples of antiproliferates?
- Azathioprine
- Mycophenolate mofetil
- Methotrexate
How do antiproliferates work?
- Inhibit DNA production
- These drugs prevent lymphocyte proliferation, but they are not specific for T cells -> can cause myelotoxicity (bone marrow suppression)
Side effects of Cyclosporin: x5
- Viral, fungal and bacterial infections
- Increased risk of getting certain cancers
- Nephrotoxic properties
- Diabetes
- Hypertension
What might be causing cyclosporin side effects?
The side effects of cyclosporin are thought to be largely due to its mode of action in inhibiting calcineurin
Side effects of Rapamycin: x8
- Raised lipid and cholesterol levels
- Hypertension
- Anaemia
- Diarrhoea
- Rash
- Acne
- Thrombocytopenia
- Decreases in platelets and haemoglobin
