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Pharm Exam 2 > Immunpharmacology > Flashcards

Immunpharmacology Flashcards

1
Q

Time for development of primary immune response…

Activation of T cells and AB production takes…

A

8-14d

1-3d

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2
Q

Basophils release…

A
  1. histamine
  2. bradykinin
  3. serotonin
  4. heparin
  5. SRSA
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3
Q

Immunosuppressants generally work better for______

A

primary immune response

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4
Q

Acute rejection is mainly mediated by ____ and ___

A

T cells and cytokines

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5
Q

Three routes of immunosuppression

A
  1. Decrease amount of lymphocyte
  2. Divert lymphocyte traffic
  3. Block pathways involved in lymphocytic response
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6
Q

6 catergories of immunosuppressants

A
  1. regulators of gene expression
  2. alkylating agents
  3. inhibitors of de novo pyrimidine synth
  4. inhibitors of de novo purine synth
  5. Kinase + phosphatase inhibitors
  6. Protein immunosuppressive drugs
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7
Q

Adrenocortical steroid MOA (3)

A
  • reduce levels of lymphocytes
  • Block antigen presentation pathway
  • Inhibit IL-2 gene transcription whih is needed for B and T cell clonal expansion
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8
Q

Example of alkylating agent

A

cyclophosphamide (cytotoxic)

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9
Q

Examples of first and second generation inhibitors of de novo purine synthesis

A

1st gen = AZT + 6-Mercaptopurine

2nd Gen = mizoribine + mycophenolate mofetil

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10
Q

What is MMF

A

inosine 5-MP dehydrogenase inhibitor

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11
Q

Methotrexate and polygentamate derivatives also belong to which class of drugs?

A

Purine synthesis inhibitors

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12
Q

Alkylating agents and Purine synthesis inhibitors – how to they induce/maintain immunosuppression

A

Block DNA/RNA synth

Prevent clonal expansion of B/T cells

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13
Q

Examples of Pyrimidine inhibitors

What is the MOA?

A
  • Brequinar
  • Leflunomide
  • malononitrilomides

inhibit dihydroorotate dehydrogenase

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14
Q

Kinase and phosphatase inhibitor drugs

A

Cyclosporine and tacrolimus

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15
Q

Cyclosporine concentrates in _____

It is given ___ prior to ____

**MOA?**

A

Red/white cells

give 4-24h before transplant

Inhibits the phosphatase activity of calcineurin

= prevents NFAT translocation

**also blocks JNK and p38 signaling

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16
Q

Tacrolimus category and MOA

A

macrolide

binds to FK506-BP 12

= inhibits the phosphatase activity of calcineurin

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17
Q

Sirolimus MOA

What is unique?

A

Binds FKBP12

(same as tacrolimus)

Complex formation with FKBP12 does not inhibit IL-2 production

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18
Q

Antilymphocyte globulins (protein immunosuppressives)

A

muromonab-CD3

Daclizumab

Basiliximab

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19
Q

AntiCD25 mAb’s

A

Daclizumab and Basiliximab

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20
Q

Anti CD3 mAb that binds to TCR-associated CD3 complex and alters T cells

A

Muromonab

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21
Q

RA and Hemolyitc Anemia are diseases that involves overexpression of _____

They would benefit from _____

A

CD20

Anti CD20 mAb’s (which are difficult to make beacuse of CD20’s short extramembrane domain)

22
Q

Belatacept is a _________

Its MOA?

A

“co-stimulatory blocker”

Inhibits CD28-mediated costimulation by binding to CD80 and CD86 –> blocking engagement of CD28 on T cells

23
Q

Use of beletacept is associated with

A

serious side effects in children

24
Q

Selective targeting of ___ rather than ___ may be more effetive to control post-transplant immune responses

A

CD28 rather than CD80/86

25
Q

Rapamycin is a _____ that targets _____

A

macrocyclic lactone

mTOR (regulator of proliferation)

26
Q

Rapamycin is generally replaced by ____

A

everolimus

27
Q

Everolimus is being tried in patients with ______

A

renal insufficiency or neoplasia

28
Q

Fingolimod is structurally related to ____

Function?

A

Myricin (sphingosine analog)

Drives lymphocytes into lymphoid tissue (reducing the number of circulating T cells)

29
Q

TNFa inhibitor

Used for?

A

certolizumab pegol

RA

30
Q

Three antibody mediated diseases

A

AI-mediated Hemolytic Anemia

M.Gravis

Hypoadrenocorticism

31
Q

Two immune complex diseases

A

SLE

RA

32
Q

Antibody/T cell mediated diseases

A

Thyroiditis

AI hypothyroidism

33
Q

AI diseases also arise from deficiencies of

A

Complement enzymes

34
Q

AZT is metabolized to give ___

A

mercaptopurine

35
Q

mercaptopurine is mainly focused on…

A

humoral immunity

36
Q

Leflunomide is a ____ that is used to treat ____

A

prodrug of pyrimidine inhibitor

RA

37
Q

Cyclosporine – important fact in treatment

A

diet must remain consistent without any deviations, blood levels must be closely monitored

38
Q

Systemic allergy treatment now includes

A

Fatty acids (linoleic and gamma linolenic)

39
Q

H1 blockers (common)

Newer gen blockes

A

Common = diphenhydramine, promethazine, chlorpheniramine

New = Rupatadine, cetirizine, fexofenadine

40
Q

In patients with extensive immunnosuppressive therapy, it is important to treat with

A

prophylactic antivirals

41
Q

Possible approach fo GvsHD

A

Adenosine agonists (targeting A2A receptors)

42
Q

Most immunostimulants have _______

A

nonspecific activity toward immune system

43
Q

Echinacea MOA

A

stimulation of phagocytosis

production of interferon and TNF

44
Q

Acemannan MOA

A

induces MQ activity and IL-1 production

45
Q

Beta1,3 Glucan MOA (3 effects)

A

binds B1,3Glucan receptor on MQ

  • Causes nonspecific phagocytosis
  • Causes release of IL1 and IL2 (trigers other cell lines like T cells)
  • Stimulates bone marrow production
46
Q

Beta1,3 glucan for what diseases

A

retroviral, tumors, chemo/radiation

47
Q

QS21 MOA

A

amplifies B and T cell mediated responses

48
Q

Detoxified Freunds Adjuvant is composed of ______ and causes ________

A

monophosphoyl lipid A

induces T cells to secrete IFNg

49
Q

Immunoglobulin therapy results in

A

prevention of virus penetration into cells

for THREE months

50
Q

IVIG used for (6)

A
  1. Hep A
  2. Parvo
  3. Enterovirus
  4. Zoster
  5. Hep B
  6. RSV
51
Q

Cytokines

A

IL-2 and IFNa

Pharm Exam 2 (12 decks)

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