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Pharmacology > Immunotherapy > Flashcards

Immunotherapy Flashcards

1
Q

Corticosteroids MOA

A

Inhibits T cell proliferations, cytokine response, decreases response to antibodies, decreases spleen size/content. Broad spectrum.

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2
Q

Corticosteroid use

A

organ transplants, chronic immunosuppressant, prevent adverse reactions to drugs, topically.

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3
Q

Corticosteroid toxicity

A

cushings syndrome, suppressed pituitary-hypothalamic axis, osteoporosis, ulcers, menstrual and reproductive issues.

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4
Q

Cyclosporine MOA

A

Binds to cyclophilin to inhibit calcineurin/T-cell activation to decrease the formation of IL-2. Selective for T-lymphocytes.

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5
Q

Cyclosporine characteristics

A

No bone marrow suppression, metabolized by CYP3A4 (drug interactions!)

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6
Q

CYP3A4 Inducers

A

Phenobarbitol, phenytoin, Rifampin.

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7
Q

CYP3A4 Inhibitors

A

Grape fruit juice, erythromycin, ketoconazole and verapamil.

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8
Q

Cyclosporine uses

A

Prevents organ rejection (with corticosteroids or azathioprine), organ transplant maintenance, autoimmune diseases.

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9
Q

Cyclosporine toxicity

A

nephrotoxic, gingival hyperplasia (need good oral hygeine, HTN, tremors, hirsutism, hyperlipidemia, hyperglycemia.

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10
Q

Tacrolimus (FK506) MOA

A

Similar to cyclosporine but less toxic. Inhibits T cell activation and decreases IL2 and IL4. Narrow therapeutic range. Metabolized by CYP3A4.

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11
Q

Tacrolimus (FK506) uses

A

Prevent rejection especially in liver and heart transplants.

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12
Q

Tacrolimus (FK506) toxicity

A

nephrotoxic, HTN, hyperglycemia, HA, tremors, insomnia.

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13
Q

Sirolimus MOA

A

Inhibits proliferation of T and B cells.

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14
Q

Sirolimus uses

A

No renal toxicity so used in kidney transplants.

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15
Q

Sirolimus toxicity

A

increased cholesterol and triglycerides.

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16
Q

Pimecrolimus uses

A

Cream for atopic dermatitis that doesn’t cause skin atrophy.

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17
Q

Mycophenolate-Mofetil MOA

A

Decreases DNA synthesis by inhibiting monophosphate dehydrogenase that only T and B cells need for purine synthesis.

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18
Q

Mycophenolate-Mofetil Uses

A

Does NOT suppress bone marrow. Often combined with Tacrolimus to prevent transplant rejection.

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19
Q

Mycophenolate-Mofetil toxicity

A

Rash, GI, very high risk of infections.

20
Q

Thalidomide MOA

A

blocks TNF alpha.

21
Q

Thalidomide uses

A

prevents graft versus host reaction

22
Q

Thalidomide toxicity

A

TERATOGENIC. Drowsiness and neutropenia.

23
Q

Azathioprine MOA

A

Prodrug that is converted into 6-mercaptopurine which inhibits purine synthesis.

24
Q

Azathioprine uses

A

Cancer (high doses), prevents rejection, glomerulonephritis in lupus, severe RA, dentists use in place of steroids.

25
Q

Azathioprine toxicity

A

Myelosuppression, hepatotoxicity, teratogenic, metabolized by xanthine oxidase (allopurinol).

26
Q

Cyclophosphamide MOA

A

Effects T and B cells. Blocks new antigens and can inhibit an established immune response (treat a rejection attack).

27
Q

Cyclophosphamide toxicity

A

hemorrhagic cystitis (treat with MESNA and hydration).

28
Q

Methotrexate MOA

A

Human dihydrofolate reductase inhibitor.

29
Q

Methotrexate uses

A

psoriasis, antineoplastic, severe RA and asthma.

30
Q

Methotrexate toxicity

A

hepatotoxicity and teratogenic.

31
Q

Daclizumab/Basiliximab MOA

A

Binds IL2 receptors on activated T cells to inhibit IL2 activation.

32
Q

Daclizumab/Basiliximab uses

A

great for kidney transplants. No side effects. No general immunosuppression.

33
Q

Bevacizumab/ranibizumab and Degaptanib/aflibercept MOA

A

Bind VEGF-A to inhibit angiogenesis. Used in macular degeneration.

34
Q

Interleukin 2 MOA

A

Immunomodulator that increases the proliferation and differentiation of helper T and cytotoxic T cells.

35
Q

Interleukin 2 Uses

A

renal cell carcinoma and malignant melanoma.

36
Q

Interleukin 2 toxicity

A

pulmonary edema, hypotension, hematological.

37
Q

Filgrastim (neupogen) MOA

A

granulocyte colony stimulation factor for severe neutropenia. Given as subcutaneous depot

38
Q

Filgrastim (neupogen) Toxicity

A

bone pain (making new marrow).

39
Q

Epoetin-alfa (procrit; epogen) MOV

A

EPO for severe anemia caused by zidovudine, interleukin, chemo or kindey disease. subcutaneaous depot.

40
Q

Epogen toxicity

A

HTN and thrombosis/stoke.

41
Q

Interferon alpha and beta

A

respond to viruses

42
Q

Interferon gamma

A

activates T lymphocytes and NK cells. Activates macrophages.

43
Q

interferon alfa-2b

A

Used with Hep C and uveitis

44
Q

Interferon beta-1B

A

multiple sclerosis.

45
Q

Glatiramer

A

Multiple sclerosis. acts as decoy. antibodies bind the drug instead of the nerves.

46
Q

Fingolimod

A

Multiple sclerosis. decreases lymphocytes to reduce the autoimmune response.

47
Q

Dimethyl fumarate

A

Multiple sclerosis. reduces inflammation.

Pharmacology (24 decks)

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