Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm 7 > immunotherapy > Flashcards

immunotherapy Flashcards

1
Q

MOA of glucocorticoids

A

substitute for cortisol -> inhibits production of inflammatory mediators and MF release of inflammatory cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ADR of glucocorticoids

A

Cushing syndrome, including DM, reduced resistance to infection, osteoporosis, cataracts, inc appetite -> wt gain, HTN
*abrupt cessation -> adrenal insufficiency = must taper!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

azathioprine MOA and use

A

prodrug of 6-MP
inhibits lymphocyte proliferation by blocking nucleotide synthesis
first drug for post-transplant immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

methotrexate MOA and use

A

folate analog, irreversibly binds and inhibits DHF reductase, halting purine and pyrimidine synthesis in rapidly proliferating cells
used to treat malignancies, among other conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ADR methotrexate

A

oral and GI ulcers, pancytopenia, alopecia, hepatotoxicity (inc fibrosis, cirrhosis, hepatitis), pulmonary fibrosis, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

mycophenolic acid MOA

A

inhibits inosine monophosphate dehydrogenase (IMPDH) (rate limiting step in guanosine synth)
acts 1’ on lymphocytes (dependent on de novo purine synth)
*better efficacy vs AZA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

leflunomide MOA and use

A

prodrug of teriflunomide, blocks synthesis of UMP by inhibiting dihydroorotate dehydrogenase (DHOD), preventing DNA/RNA synth for proliferation and cytokine production in lymphocytes
used for RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

cyclophosphamide MOA, use, ADR

A

alkylating agent, cross-links DNA at guanine N7
used in SLE, Wegener’s; often combined with corticosteroids
ADR: hemorrhagic cystitis, prevented with mesna (mercapto-ethane sulfonate, neutralizes toxic metabolites)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MOA cyclosporine

A

complexes with cyclophilin, binds calcineurin and inhibits Ca-stimulated de-P of cytosolic part of NFAT, blocking T-cell activation by preventing IL-2 transcription

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

uses of cyclosporine

A

kidney, liver, heart, other organ transplants
RA
psoriasis
GVHD: cyclosporine + MTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ADRs of cyclosporine

A

renal dysfunction/ nephrotoxicity
tremor - neurotoxicity
hirsutism, HTN, hyperlipidemia, gum hyperplasia
*little BM suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cyclosporine drug interactions

A

CYP 3A4 metabolism, so interacts with both CYP inhibitors (macrolides, azoles, grapefruit juice) and inducers (phenytoin, carbamazepine, abx, rifampin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MOA tacrolimus

A

complexes with FKBP-12, binds calcineurin and inhibits Ca-stimulated de-P of cytosolic part of NFAT, blocking T-cell activation by preventing IL-2 transcription

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

uses of tacrolimus

A

prophylaxis of solid-organ allograft rejection
eczematous conditions
GVHD: tacrolimus + MTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ADR of tacrolimus

A

same as cyclosporine but no gum hyperplasia or hirsutism

*hyperglycemia, diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MOA sirolimus and everolimus

A

inhibits T-lymph activation and proliferation downstream of IL-2
complexes with FKBP-12 and inhibits mTOR, blocking cell-cycle progression at G1->S phase transition

17
Q

uses of sirolimus

A

prophylaxis of organ transplant rejection in combination with calcineurin inhibitor and glucocorticoids

18
Q

ADRs of sirolimus

A

dose-dependent inc in serum cholesterol and TGs
anemia, leukopenia, thrombocytopenia
*no nephrotoxicity

19
Q

specific ADR everolimus

A

hypersensitivity pneumonitis

20
Q

role of TNF-a

A

cytokine secreted by MFs, mast cells, activated Th cells
stimulates MFs to produce cytotoxic metabolites and inc phagocytic killing activity
a/w autoimmune dz like RA, psoriasis, Crohn’s dz

21
Q

etanercept

A

TNF-a blocker

fusion protein of Fc portion of IgG1 and TNF-R2

22
Q

infliximab

A

TNF-a blocker

partially humanized mouse mab

23
Q

adalimumab

A

TNF-a blocker

fully human IgG1 mab

24
Q

uses of TNF-a blockers

A

RA, juvenile idiopathic arthritis

Crohn’s dz, ulcerative colitis

25
Q

ADRs of TNF-a blockers

A

infection (inhibits MFs)

reactivation of latent TB infection (TNF-a sequesters TB in granulomas)

26
Q

role of IL-1 and IL-6

A

IL-1 stimulates IL-6 production, enhances adhesion molecule expression, and stimulates cell proliferation

27
Q

anakinra

A

recombinant IL-1 receptor antagonist

used in RA

28
Q

tocilizumab

A

IL-6 receptor antagonist

used in RA and giant cell arteritis

29
Q

OKT3/ muromonab MOA and ADR

A

mouse mab against human CD3 (co-receptor for activation of T-cell) -> profound immunosuppression
*cytokine release syndrome: fever, myalgia, nausea, diarrhea

30
Q

rituximab MOA, uses, ADRs

A

partially humanized anti-CD20 mab, causes profound depletion of circulating B cells
used in RA refractory to TNF-a inhibitors, transplant rejection, leukemias, lymphomas
ADR: risk of progressive multifocal leukoencephalopathy (viral)

31
Q

levamisole

A

“restores” depressed immune function of B and T cells, monocytes, MFs
used only as adjuvant therapy with 5-FU after surgical resection of colon cancer
*originally introduced as antihelminthic

32
Q

thalidomide

A

extremely restricted availability
used for erythema nodosum leprosum (hypersensitivty rxn to anti-leprosy tx) by decreasing TNF-a; can also give clofazimine
*increases TNF-a in HIV patients!
*teratogenic

33
Q

bacillus Calmette-Guerin (BCG)

A

attenuated live culture of Calmette and Guerin strains of Mycobacterium bovis
used for tx and prophylaxis of carcinoma in situ of urinary bladder
unclear MOA

34
Q

Rho(D) immune globulin MOA and use

A

binds Rho antigen, preventing sensitization
used in Rh- women who may be sensitized to Rh antigen on fetus, prevents hydrops in future Rh+ pregnancies
injections at 28 weeks and w/i 72 h of delivery/ ruptured membranes

35
Q

Kleihauer-Betke test

A

postmaternal blood sample analyzed to see how much fetal blood has entered maternal circulation to determine dose of RhoD immune globulin to give

Pharm 7 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions