MOA and toxicities of chemo and immunosuppressive agents

Question 1

What type of chemo drug is Cyclophosphamide and is it an MOA?

Answer 1

it inhibits DNA Replication by alkylating guanine bases, crosslinks DNA; cell-cycle independent; can cause SIADH and hemorrhagic cystit

Question 2

What type of chemo drug is Azathioprine and is it an MOA?

Answer 2

interferes with synthesis of nucleic acids; pro-drug that is converted into a purine (adenine or guanine) antagonist

Question 3

What type of chemo drug is Doxorubicin and is it an MOA?

Answer 3

an anthracycline; causes dilated cardiomyopathy (increase in LV volume with impaired contractile function and decreased CO)

Question 4

What type of chemo drug is Paclitaxel and is it an MOA?

Answer 4

it inhibits microtubule depolymerization/disassembly; mitosis halted after metaphase and decreased cell functions; mitosis-specific

Question 5

What type of chemo drug is Vinca alkaloids (Vinblastine, Vincristine) and is it an MOA?

Answer 5

inhibit microtubule formation/assembly

Question 6

What type of chemo drug is Methotrexate and is it an MOA?

Answer 6

Leucvorin=folinic acid—used to treat myelosuppression due to MTX

Question 7

What type of immunosuppressant is Cyclosporine and is it an MOA?

Answer 7

• It inhibits calcineurin and inhibiting transcription of IL-2🡪decreases T-cell activation; used to treat psoriasis and rheumatoid arthritis
• Can cause HTN, hyperlipidemia nephrotoxicity, gingival hyperplasia, neurotoxicity, hirsutism

Question 8

What type of immunosuppressant is Tacrolimus and is it an MOA?

Answer 8

It Iinhibits calcineurin, which is needed for IL-2 transcription

Question 9

What type of immunosuppressant is Sirolimus and is it an MOA?

Answer 9

It Inhibits MTOR, which is needed for IL-2 transcriptoin

Question 10

What type of immunosuppressant is Azathioprine and is it an MOA?

Answer 10

Antimetabolite precursor of 6-mercaptopurine; Inhibits lymphocyte proliferation by blocking nucleotide synthesis; can cause pancytopenia; b/c it is degraded by xanthine oxidase, increased risk of toxicity in pt’s on allopurinol for gout, etc.

Question 11

What type of immunosuppressant is Basiliximab and is it an MOA?

Answer 11

• It blocks IL-2 Receptor

- –Can cause edema, HTN, tremor

Question 12

What type of immunosuppressant is Glucocorticoids and is it an MOA?

Answer 12

It inhibits Nfkb->suppress transcription of many cytokines (like IL-2) by phospholipase A2🡪 suppress both B and t cell function and activation, and Induce T cell apoptosis (FA 2018 P120); inhibits histamine release from mast cells

Question 13

What type of immunosuppressants are Infliximab and adalimumab and are they MOAs?

Answer 13

TNF-alpha inhibitors (used in IBD)