Immunosupressant Drugs

Question 1

mechanism of cyclosporine

Answer 1

binds cyclophilin and inhibits T cell activation by inhibiting calcineurin and preventing IL-2 transcription

Question 2

SEs of cyclosporine

Answer 2

nephrotoxicity, HTN, HLD, neurotoxicity, gingival hyperplasia, hirsutism

Question 3

mechanism of tacrolimus

Answer 3

binds FK506 and inhibits T cell activation by inhibiting calcineurin and preventing IL-2 transcription

Question 4

SEs of tacrolimus

Answer 4

nephrotoxicity, neurotoxicity

Question 5

mechanism of sirolimus/rapamycin

Answer 5

binds FKBP and inhibits B and T cell activation by inhibiting mTOR and preventing IL-2 transcription

Question 6

mechanism of azathioprine

Answer 6

precursor of 6-mercaptopurine –> inhibits lymphocyte proliferation by blocking nucleotide synthesis

Question 7

never give azathioprine/6-MP with ______ because _____

Answer 7

• allopurinol

- toxicity increases when XO inhibitied (XO breaks down the drug)

Question 8

SEs of azathioprine

Answer 8

BM suppression

Question 9

glucocorticoids

Answer 9

inhibition of NF-kB –> suppression of B and T cell function by suppressing transcription of many cytokines

Question 10

-sone vs -solone

Answer 10

• sone: prodrug absorbed better in GI tract

- solone: active form (topical, inhaled)

Question 11

cromolyn

Answer 11

inhibition of mast cell degranulation

Question 12

adalimumab

Answer 12

MAB vs TNFa

Question 13

etanercept

Answer 13

soluble TNFa receptor

Question 14

H1 antagonists that enter CNS:

Answer 14

• diphenhydramine

- promethazine

Question 15

H1 antagonists that do NOT enter CNS:

Answer 15

• fexofenadine

- loratidine

Question 16

filagrastim

Answer 16

G-CSF to recover BM (granulocytes)

Question 17

sargramostim

Answer 17

GM-CSF to recover BM (granulocytes, monocytes)

Question 18

IFNa used for:

Answer 18

HepB, HepC, Kaposi sarcoma, malignant melanoma, hairy cell leukemia, condyloma acuminata, RCC

Question 19

IFNb used for:

Answer 19

MS

Question 20

IFNy used for:

Answer 20

CGD

Question 21

bevacizumab, ranibizumab

Answer 21

VEGF MAB

Question 22

cetuximab, erlotinib, gefitinib

Answer 22

EGFR MAB

Question 23

rituximab

Answer 23

CD20 MAB

Question 24

trastuzumab

Answer 24

Her2 MAB

Question 25

abciximab

Answer 25

platelet GP IIb/IIIa MAB used in pts undergoing percutaneous coronary intervention

Question 26

denosumab

Answer 26

RANKL MAB (mimics osteoprotegrin)

Question 27

omalizumab

Answer 27

IgE MAB

Question 28

palivizumab

Answer 28

RSV F protein MAB - prophylaxis for high risk infants

Question 29

SEs of sirolimus

Answer 29

insulin resistance, HLD

Question 30

Sirolimus does not cause _____ so it is drug of choice for ____ transplants.

Answer 30

nephrotoxicity, kidney

Question 31

basiliximab

Answer 31

IL-2 receptor ab (prevents T cell activation)

Question 32

mechanism of mycophenolate mofetil

Answer 32

reversibly inhibits IMP dehydrogenase to prevent purine synthesis in lymphocytes (used in SLE)

Question 33

SEs of CSTs include:

Answer 33

• Cushing syndrome:osteoporosis, muscle atrophy, hyperglycemia, adrenocortical atrophy
• peptic ulcers
• psychosis
• avascular necrosis of the femoral head

Question 34

WBCs go ____ with CSTs because the cells ____.

Answer 34

up, demargination from vessel walls

Question 35

aldesleukin

Answer 35

IL-2 agent used for RCC, melanoma

Question 36

romiplostim

Answer 36

TPO analogue

Question 37

eltrombopag

Answer 37

TPO receptor agonist

Question 38

oprelvekin

Answer 38

IL-11 analogue used for thrombocytopenia

Question 39

alemtuzumab

Answer 39

CD52 mab, CLL

Question 40

adalimumab, infliximab

Answer 40

TNFa MAB

Question 41

etanercept

Answer 41

TNFa soluble decoy receptor

Question 42

eculizumab

Answer 42

C5 ab, used in PNH to prevent complement destruction of RBCs