immunosupressant pharmacology Flashcards

1
Q

what are the calcineurin inhibitors and what is their mechanism of immunosupression after transplant?

A

cyclosporine and tacrolimus

block T-cell activation by preventing IL-2 gene transcirption

cause dose dependent rise in BUN and creatinine

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2
Q

what is the major adverse drug effect from cyclosporine and tacrolimus?

A

Highly nephrotoxic

cause dose dependent rise in BUN and creatinine from renal alrteriolar vascocronsitction ==> hypertension and can lead to oblertative vasculopathy

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3
Q

what is the mechanism for sirolumus?

A

aka rapamycin - mTOR inhibitor
blocks T-cell activation and B-cell differentiation by preventing a response (blocked mTOR signal cascade) from binding of IL-2 to its receptor

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4
Q

what are daclizumab and basilizimab?

A

monoclonal antibidies against IL2

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5
Q

what drug using in transplant immunospression/rejection prevention works by inhibiting lymphocyte proliferation by blocking nucleotide synthesis?

A

azathioprine

antimetabolite pre-cursor of 6-mercaptopurine

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6
Q

what drug should azathioprine not be given with?

A

allopurinol - 6-MP metabolite is also degraded by xanthine oxidase — so increases marrow suprpession when given with allopurinol

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7
Q

which immunosupressant works by inhibiting NF-kB and thereby supresses both B and T cell function by decreasing transciption of cytokiness / induces apoptosis

A

corticosteroids

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8
Q

pt with kidney transplant develops avascular necrosis of the femoral head. What was the drug?

A

prednisone

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9
Q

what drug revsrsibly inhibits IMP dehydrogenase, thereby preventing purine synthesis of B and T cells?

A

mycophenolate mofetil

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10
Q

pt received kidney tansplans and took immunosupressant that was associated with an invasive CMV injection - what was the drug?

A

mycophenolate mofetil

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11
Q

pt received kidney tansplans and took immunosupressant developed gingival hyperplasia. what was the drug?

A

cyclosporine

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12
Q

what is anakinra?

A

IL-1 receptor blocker

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13
Q

does rutuximav affect pre-B lymphocytes or plasma cells?

A

NO only CD20+ mature B cells in the ciruclation

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14
Q

which drug inhibits calcineurin, thereby decreasing transcirption of the IL-2 gene in T cells

A

cyclosporine

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