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Microbial Pharmacology > Imunosuppressants > Flashcards

Imunosuppressants Flashcards

1
Q

What are the uses of Immunosupressant drugs?

A 
Transplantation
-prophylactic
-acute rejection
Autoimmune diseases
-lupus or RA
Inflamatory diseases
-UC or CD
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2
Q

What are the major classes of immunosupressive agents?

A

GLucocorticoids
Calcineurinn inh.
Anti-proliferative/Anti Metabolic
Biologicals (Ab)

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3
Q

Steroids

A

A common multiple ring structure

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4
Q

Why is Corticosteroid an incorrect term for Immunosupressive drugs

A

Adrenal cortex secretes Glucocorticoids and mineralocorticoids

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5
Q

How do glucocorticoids cause Genomic effects?

A

Bind to cytosolic receptors > Nucleus > Bind to DNA

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6
Q

How do glucocorticoids cause Non-Genomic effects?

A

Can influence cell signaling pathways and intercalate into the cell membraneto alter ion transport. RAPID immunosupression

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7
Q

What are the effects of Glucocorticoids?

A

Dec. in peripheral blood lymphocytes
DR key pro-inflammatory cytokines
Inhibit IL-2 production by T cells
Reduce Neutrophil chemotaxis

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8
Q

What are the Theraputic uses of Glucocorticoids?

A

Prevent and Treat transplant rejection
Treat GVHD
Block first dose Cytokine storm
Treat AI disorders such as RA, SLE, etc

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9
Q

WHat are the Adverse effects of Glucocorticoids

A

Potential Disabling and LT effects including growth retardation in children
poor wound healing
HTN
Avascular Necrosis
Cataracts
Hyperglycemia
Adrenal Crisis upon rapid discontinuation

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10
Q

What is the Standard prototype Glucocoirticoid?

A

Prednisone

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11
Q

What is the Standard Low dose GLC?

A
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12
Q

What is the Standard Med dose GLC?

A

> 7.5mg but

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13
Q

What is the Standard High dose GLC?

A

> 30mg but

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14
Q

What is the Standard Very High dose GLC?

A

> 100 mg prednisone eq/day

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15
Q

What is the Standard Pulse Therapy dose GLC?

A

> 250 mg prednisone eq/day

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16
Q

What is the best drug for Preventing transplant rejection?

A

Cyclosporine

17
Q

What is the MOA of Cyclosporine?

A

Suppresses T-Cell mediated immunity

Prevents IL-2 Production

18
Q

What is the utilization for cyclosporines?

A

Prophylaxis for Organ transplant
RA
Psoriasis
Combined with other agents, esp glucocorticoids
Not usually given to renal transplant Pts bc of nephrotox

19
Q

What are the adverse rxns of Cyclosporine?

A

Renal Dysfunction, Htn…

CSN can be increased with Grapefruit juice ingestion

20
Q

What is the prefered Calcineurin inhibitor for transplantation?

A

Tacrolimus. Easier to monitor blood levels

21
Q

What type of rejection is treatable by immunosupressants?

A

Acute Rejection!

22
Q

What type of Immunosupressant is Azathioprine?

A

Anti-proliferative and anti-metabolic agent

23
Q

What is the MOA of Azathioprene?

A

Inhibits lymphocyte proliferation and blocks the de novo pathway of purine synth is blocked

24
Q

What is the theraputic use of Azathioprene?

A

Prevent Organ transplant rejection

Crohns, RA, MS, TPurpura, Hemolytic anemia

25
Q

What is the MOA of Mycophenolate Mofetil?

A

Inhibits inosine monophosphate dehydrogenase(inhibits lymphocytes

26
Q

Whao should not take Mycophenolate Mofetil?

A

Pregnant women!

27
Q

What is the MOA of Sirolimus?

A

Inhibits T lymphocyte Proliferation via inhibition of mTOR. In. of G1-S phase

28
Q

What is the Theraputic use of Sirolimus

A

Prevents Organ transpplant rejection w/ GCC

In renal transplant recipients that can’t tolerate calcineurin

29
Q

What is the adverse effect of Sirolimus

A 
Anemia, Leukopenia, thrombocytopenia
Hypokalemia, 
GI 
Delayed Wound healing
Inc. Cancer risk
30
Q

What suface marker do all T cells have?

31
Q

What is the MOA of anti-thymocyte Globulin?

A

Depletes circulating lymphocytes

  • Complement
  • Binding to cell and inhibiting lymph functions
32
Q

What are the theraputic uses of A-Thymocyte Globulin?

A

Induction immunosupression

Tx of acute rejection of solid organ transplants

33
Q

What are the Adverse rxns to A-thymocyte globulins

A

Serum sickness, etc…

34
Q

What is the MOA of Muromonab?

A

T cell depletion through complement or bind to CD3

35
Q

Pros/cons of Muromonab.

A

Very fast!

Can only use once bc the body can make Abs toward this Ab.

36
Q

Adverse Rxns to muromonab?

A

Cytokine Storm

Serum sickness

37
Q

What are the Anti TNF-alpha Reagents and MOA?

A

Infliximab-human constant region and murine var region
Adalimumab-recombinant human IgG1 monoclonal
Etancercept-ligand binding portion of TNF-alpha receptor fused to the Fc portion of human IgG1

38
Q

What are the Theraputic uses of Anti TNF-alpha Reagents?

A

RA, Crohns, UC, Ankylosing Spondylitis, plaque psoriasis, psoriatic arthritis

39
Q

What are the Adverse Rxns to Anti TNF-alpha Reagents?

A

Risk for serious infections

Risk for lymphomas and other malignancies

Microbial Pharmacology (13 decks)

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