Immunosupressors Flashcards
Calcineurin inhibitor that binds to FK506
Tacrolimus
> potent Calcinuerin inhibitor
Tacrolimus
MOA of Calcineurin inhibitors
inhibition of NFAT activation → ↓IL-2
Inhibits phosphatase activity
Main side effect of Calcineurin inhibitors
Nephrotoxicity
Calcinuerin inhibitor that can cause CNS side effects
Tacrolimus
Calcinuerin inhibitor that causes:
hyperlipidemia
hyperuricemia
hyperglicemia
Cyclosporine
Gum hyperplasia
Cyclosporine
Calcinuerin inhibitor related to hyperkalemia as side effect
Tacrolimus
Contraindications of Calcinuerin inhibitors
Diabetes
CYPA4 inhibitors or inducers
These two immunosuppressors have a synergistic effect, and can cause:
- ↑ Renal dysfunction of cylosporine
- ↑ Hyperlipidemia and myelosupression
Cyclosporin + Sirolimus
T or F: Antiarrythmics have an interaction with Calcineurin inhibitors
T
mTOR inhibitor
Sirolimus
Binds to FKBP
Sirolimus
Cyclosporine binds to….
Cyclophilin
Used to coat stents
Sirolimus
T or F: Sirolimus is Nephrotoxic
F
Immunomodulator that causes insulin resistance
Sirolimus
Adverse Effects of Sirolimus
Pancytopenia
Insulin resistance
Hyperlipidemia
Mouth ulcer
Antimetabolites: Purine Ana
Purine Analogue
Azathioprine
Antimetabolite used to tx Leukemias
Azathioprine
Coadmin with Allopurinol causes toxic accumulation of this drug
Azathioprine
Common side effect of antimetabolites
Bone Marrow suppression
Antimetabolite that can cause liver toxicity (cholestasis)
Azathioprine
T or F: Azathioprine, Mycophenolate Moefetil and Methotrexate are CONTRAINDICATED @Pregnancy
T
Prophylaxis vs Kidney transplant
Sirolimus
Side effect: infection by CMV
Mycophenolate Moefetil
Folic acid antagonist/analogue
Methotrexate
Inhibition of DHFR
Methotrexate
Reversible inhibition of IMDH
Mycophenolate Moefetil
Antimetabolite that can be administered Intrathecally
Methotrexate
Medical abortion
Methotrexate
immunosuppressant that can cause Pulmonary Fibrosis
Methotrexate
Leukovorin rescue
@Methotrxate overdose
Is a reduced form of folic acid
Displaces Methotrexate from binding site
Intermediate acting Glucocorticoids
Predinosone
Predisolone
Methilpredisolone
Glucocorticoid that acts for 12-36 hrs
Intermediate:
Predinosone
Prednisolone
Methilprednisolone
T or F = Dexamethasone is 25x > potent than short acting
T
Glucocorticoid for speed up lung maturation @fetus during pregnancy
Bethamethasone (long acting)
How long does Long Acting Glucocorticoids last?
36-72 hrs
Inhibition of NF-kB → suppression of B and T cells
Glucocorticoids
T or F: Long term effect (hours) have a direct influence on gene expression → ↑ Tcell apoptosis
@Glucorticoids
T
Type of glucocorticoid for Atopy and asthma tx
Intermediate
Adrenal Insufficiency is Tx with _____ acting Glucocorticoids
Short
Immunosuppressor used to relief cerebral edema in brain tumors
Dexamethasone
Overnight Dexathasone Suppression Test
Cushing
Intermediate acting Glucocorticoid with TOPICAL admin
Predinisolone
Intermediate acting Glucocorticoid with IV, IM and Intraarticular admin
Methylpredinosolone
Glucocorticoid used in px with liver disease or not able to swallow pills
Prednisolone
bc of peroral admin
Abrupt discontinuation of Glucocorticoids cuases
Flare-up of underling disease
Can cause diminished growth @children
Glucocorticoids
Peptic ulcers
Glucocorticoids
Contraindications of Glucocorticoids
Fungal infections
Live vaccines
Premature infants
Cushing
Diabetes
Osteoporosis
Peptic ulcers
Causes “demmargination” of Neutrophils, causing ↑Neutrophils @blood
Glucocorticoids
Chimeric Monoclonal antibodies
Infliximab
Rituximab
Anti-CD20 monoclonal antibody
Rituximab
Monoclonal antibodies that bind to TNFa
Infliximab
Adalimumab
Needs screening for TB
Infliximab
Adalimumab
Monoclonal antibodies used to tx IBD
Infliximab
Adalimumab
= Anti-TNFa
Contraindications in Monoclonal antibodies
Congestive heart failure
Active infections
Must be screened for HBV before starting tx
Rituximab
Monoclonal antibody used to tx Multiple Sclerosis
Rituximab
T or F: Monoclonal antibody anti-TNFa are indicated for MS tx
F
Its contraindicated
Lupus like syndrome
Infliximab
Adalimumab
Acts as decoy for T cells instead of attacking neural myelin
Glatiramer
Lipoatrophy
Glatiramer
Best safety profile for pregnant women with mild Multiple Sclerosis disease
Glatiramer
Glatiramer is a…
synthetic polypeptide
Used for enzyme replacement therapy
Elapegmedasa
Acts as exogenous adenosine deaminase (ADA)
Elpegmedasa
Used to tx Sevre combined immunodeficiencies
Elapegmedasa
CDK4/6 inhibitor
Trilaciclib
Immunomodulator that slows down cell cycle by ↓ proliferation of cancer cells
Trilaciclib
Chemotherapy induced myelosuppresion @Px with extensive-stage cell lung cancer
Trilaciclib
Injection site reactions: Phlebitis, Thrombophlebitis
Trilaciclib
T or F: Trilaciclib is safe during pregnancy
F
Hematopoietic Stem Cell Mobilizer
Plerixaflor
Blocks binding of CXC12 to CXC4
Plerixaflor