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Mibs and Mabs Flashcards

1
Q

Infliximab

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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2
Q

Adamilumab

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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3
Q

Certoluzimab

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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4
Q

Ertanacept

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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5
Q

Golimumab

A

Anti-TNF alpha

Inflix, Adalim, Certolu, Golim, Ertanacept

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6
Q

What are anti-TNF alpha’s used to treat?

A 
Ank spond
Psoriatic arthritis
RA
IBD
EVERYTHING (anti-rejection for islet cell)
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7
Q

What are the side effects of anti-TNF treatments?

A 
INFECTION
- Candida & TB
Injection site reactions 
Drug induced lupus 
Demyelination 
Malignancy
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8
Q

Tocolizumab

A

Anti-IL6 receptor
Targets the IL17 pathway

Treats GCA and RA

Tocoliz, Sirukum

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9
Q

Sirukumumab

A

Anti-IL6 receptor
Targets the IL17 pathway

Treats GCA and RA
(Same as tocolizumab)

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10
Q

Abatacept

A

Blocks co-stimulation of T cells

Fusion protein - Fc region of IgG1 fused to CTLA-4 - binds to B7 and prevents CD 28 co-stimulation of T-cells from APCs

Acts as CTLA-4!

Treats RA

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11
Q

Secukinamab

A

Anti-IL 17

IL23 is produced by chronic gut inflammation and enthesis in enteropathic arthritis & spondyloarthropathies
IL23 -> Th17 -> IL17 -> new bone formation & synovitis

Treats ank spond and psoriatic arthritis

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12
Q

Ustekinumab

A

Anti-p40 subunit of IL12/23

Blocks the IL interaction with receptor on APCs/NK cells blocking intracellular signalling + production of TNF alpha

Treats: Crohns, psoriasis, psoriatic arthritis

SEs:

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13
Q

Anakinra

A

IL-1 receptor antagonist

Treats: Gout and other inflammasome conditions

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14
Q

Belimumab

A

anti-BAFF/BLyS

Inhibits B cell activating factor AKA B Lymphocyte Stimulator

Treats SLE

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15
Q

Vedolizumab

A

Anti-integrin

Selectively binds alpha4beta7 integrin on T cells & blocks interaction with MAdCam-1 on intestinal endothelium inhibits trafficking of T cells to sites of gut inflammation

Treats IBD, few side effects

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16
Q

Trastuzumab

A

Anti-HER2
Ligand dependent
Treats : HER2 + breast and some gastric ca
SE’s: cardiomyopathy

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17
Q

Pertuzumab

A

Anti-HER 1/3/4
Inhibits dimerisation stopping signalling
Given in combo with Trastuzumab

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18
Q

Olaparib

A

PARP inhibitor
PARP protein repairs single strand breaks in DNA, ss -> ds breaks
BRCA 1/2 (tumour suppressor genes) repair ds breaks through homologous recombination
PARPi + BRCA deficient/mutent cells -> cell death

Treats: Breast, Ovarian, Prostate

SE’s Nausea, fatigue, myelosup

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19
Q

Dabrafenib

A

B-RAF inhibitor
Inhibits RAS-RAF-MEK-ERK signalling
Treats: B-RAF(V600E) mutant melanoma (60% of melanomas)
SEs: Fevers, SCC

combine with MEKi to combat resistance

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20
Q

Vemurafenib

A

B-RAF inhibitor
Inhibits RAS-RAF-MEK-ERK signalling
Treats: B-RAF(V600E) mutant melanoma (60% of melanomas)
SEs: Fevers, SCC

combine with MEKi to combat resistance

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21
Q

Trametinib

A

MEK inhibitor
combine with B-RAFi to combat resistance

SEs: fever, nausea, diarrhoea, fatigue, vomiting, arthralgia, rash, HTN

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22
Q

Cobimetinib

A

MEK inhibitor
combine with B-RAFi to combat resistance

SEs: fever, nausea, diarrhoea, fatigue, vomiting, arthralgia, rash, HTN

23
Q

Ipilimumab

A

Anti-CTLA-4
therefore T-cell can’t turn off/down regulate co-stimulation

SEs: rash, colitis, hepatic toxicity

24
Q

Pembrolizumab

A

PD-1 inhibitor

PDL-1 (tumour cell) + PD-1 (t cell) -> check point to down regulate proliferating T cells
PDL1/PDL2 are commonly over expressed on tumour cells and infiltrating lymphocytes
Thus, tumours ‘tun off’ innate immune response

Melanoma, NSCLC, HL

SEs: Pneumonitis (more PD1), liver toxicity, Uveitis, Myocarditis, Hypophysitis, Thyroiditis (PD1), Colitis
Also rash, pruritis, GI sx

25
Nivolumab
PD-1 inhibitor PDL-1 (tumour cell) + PD-1 (t cell) -> check point to down regulate proliferating T cells PDL1/PDL2 are commonly over expressed on tumour cells and infiltrating lymphocytes Thus, tumours 'tun off' innate immune response Melanoma, NSCLC, HL SEs: Pneumonitis (more PD1), liver toxicity, Uveitis, Myocarditis, Hypophysitis, Thyroiditis (PD1), Colitis Also rash, pruritis, GI sx
26
Ceritinib Crizotinib Alectinib
ALK inhibitor ALK oncogene forms by an inversion of ALK gene on chromosome 2 resulting in an oncogene, ALK mutation --> fusion of EML4-ALK produces chimeric protein that drives growth of cancer Treats: lung adeno (young asian non-smokers) SEs: Hepatitis, pneumonitis, Mild GI, Bradycardia, Visual disturbance – fuzzy lines, flickering lines on gaze shift from dark to light but not assoc with any eye pathology Crazy rich asians get Asian Lung Kancer (ALK)
27
Erlotinib Gefitinib Afatinib Osimertinib
EGFR inhibitor (intracellular) TKI Treats: NSCLC SEs: acneform rash, diarrhoea, N&V, ILD (esp asians)
28
Cetuximab
EGFR inhibitor extracellular Treats: Met CRC (K-Ras wt), NSCLC (K-Ras mut), head and neck. (With chemo) SEs: acne, diarrhoea, pruritis (rash good sign!)
29
Bevacizumab
VEGF-A inhibitor Treats: CRC (with chemo, sensitises) SEs: HTN, clots, poor wound healing, risk of bowel perf
30
Sunitinib, pazopanib, axitinib
VEGF-A inhibitor (TKI) Treats: Renal cell carcinoma (particularly VHL [Von Hipple Lindau] mutations) SEs: Hand/foot syndrome (thick rash on hands and feet) and cardio toxicity
31
Sorafenib
Multiple molecule TKI treats: HCC SEs: hand and foot syndrome
32
Lapatinib
4 - anilokinizone inhibitor - TKI of both EGFR and HER receptors Treats: crosses BBB - met/refractory HER2+ BrCa, brain mets SEs: cutaneous ractions - palmar plantar; SJS; reduce LVEF; ILD
33
Imatinib, dasatinib, nilotinib, ponatinib
BCR-Abl + cKIT inhibitor - t(9:22) Philadelphia chromosome - places a promoter region next to a proliferation gene -> results in a tyrosine kinase that is always switched on - binds and inactivates the tyrosine kinase Treats: BCR-Abl in CML & cKIT in GIST SEs: Resistance
34
Venetoclax
BH3 mimetic/anti Bcl2 Bcl-2 inhibits apoptosis, this is raised in CLL. BH3 mimetics inhibit Bcl2 hence prevents the inhibition of apoptosis Treats: CLL
35
Ibrutinib
Bruton's TKI pathway required for B cell proliferation Treats: Waldensroms, MM, CLL, mantle cell SEs: neutropenia, resp, plt dysfunction, haemorrhage
36
Idelisib
PI3Kdelta required in B cell proliferation Treats: CLL and FL
37
Alemtuzumab
Anti-CD52 Treats: MS, CLL (if high risk features, 17p deletion or p53 mutation) SEs: infections, other longterm autoimmune disease – thyroid especially
38
Blinatumomab
BITE - Bispecific T cell engager Binds CD3 on Tcells to target CD19 on cancer cells Treats: relapsed/refractory ALL SEs: cytokine release syndrome (give steroids with it), encephalopathy
39
Brentuximab
anti-CD30 antibody drug conjugate Treats: HL
40
Ruxolitinib
JAK-1 and 2 inhibitor Treats: myelofibrosis - reduce splenomegaly, improving QoL and mortality SEs: myelosuppression
41
Emicizumab
Activated factor XI + X - antibody that binds to both factor IX and X, thus, crosslinking the two - essentially replaces the function of factor VIII - is NOT inactivated by VIII inhibitors/antibodies thus it is used in patients on long term factor replacement that now have antibodies/inhibitors Treats: Haemophilia A (does not work in B)
42
Elotuzumab
Anti-SLAMF7 Inhibits SLAM5F present on MM and NK cells -must be used in combination with dexamethasome and lenolinomide Multiply refractory MM
43
Natalizumab
Alpha 4 integrin blocker (VCAM) Inhibits lymphocyte migration into the CNS Treats MS SEs JC virus -> PML, hypersensitivity reactions, LFTs
44
Daclizuymab
Anti-IL2 / anti-CD 25 - binds to CD25 which is the alpha subunit of IL-2 receptor Treats: MS, renal transplant induction
45
Basiliximab
Anti-IL2 / anti-CD 25 - binds to CD25 which is the alpha subunit of IL-2 receptor Treats: renal transplant induction
46
Ocrelizumab
IS RITUXUMAB anti-CD20 Treats: PPMS, RRMS SEs infusion rxn
47
Belatacept
Blocks co-stimulation essentially is CTLA4 Treats: renal transplant induction
48
Eculizumab
Anti-C5a Treats: PNH, atypical HUS, C3GN SEs: neisseria infections
49
Omalizumab
Anti-IgE Treats: allergic asthma
50
Mepolizumab
anti-IL5 Treats: eosinophilic asthma
51
Evolocumab | Alirocumab
PCSK9 inhibitor Blocks the degradation of LDL receptors-> increasing the number of LDL Treats: hypercholesterolaemia in combi with statin if high risk
52
Romosozumab
Sclerosin inhibitor Sclerosin in an osteoblast inhibitor therefore romo removes the inhibition -> more oesteoblast activity Treats: osteoporosis
53
Bezlotoxumab
Anti-toxin B from C. Diff Treats: recurrent c diff infection, reduces rate of recurrent infection compared with placebo at 12 weeks, use in combination with antibitoics (NEJM 2017)

FRACP (12 decks)

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