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Matt's Path REVERSE > Modulating Drugs > Flashcards

Modulating Drugs Flashcards

1
Q

Anti-CTLA4

A

Iplimumab

Advanced melanoma

Increase T cell response

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2
Q

Anti-PD1

A

Pembrolizumab
Nivolumab

Advanced Melanoma

Increase T cell response

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3
Q

Alkylates guanine base of DNA

A

Cyclophosphamide

Affects B cells > T cells

Indications
Multisystem connective tissue disease or vasculitis with severe end-organ involvement
eg GPA (Wegener’s granulomatosis), SLE
Anti-cancer agent
HAEMORRHAGIC CYSTITIS

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4
Q

Blocks de novo purine (eg adenine, guanine) synthesis

A

Azathioprine

Indications
Transplantation
Auto-immune disease
Auto-inflammatory diseases, eg Crohn’s, ulcerative colitis
CHECK TPMT LEVELS PRIOR

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5
Q

Blocks de novo nucleotide synthesis

A

Mycophenolate mofetil

Prevents T>B cell proliferation

Major Indications
Widely used in transplantation as alternative to azathioprine
Also used in auto-immune diseases and vasculitis as alternative to cyclophosphamide

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6
Q

Side effect of Progressive multifocal leukoencephalopathy (JC virus)

A

Mycophenolate Mofetil
Natalizumab
Rituximab

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7
Q

Indications for plasmapheresis

A

Severe antibody-mediated disease

Goodpastures syndrome

Severe acute myasthenia gravis

Severe vascular rejection

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8
Q

Calcineurin inhibitors

A

Cyclosporin

Tacrolimus

Prevents IL-2 upregulation

Use post-transplant

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9
Q

Dysmorphism

A

Cyclosporin

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10
Q

JAK inhibitor antibody

A

Tofacitinib (inhibits cell signalling)

Rheumatoid Arthritis

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11
Q

PDEF 4 inhibitor antibody

A

Apremilast (inhibits cell signalling)

Psoriasis

Psoriatic arthritis

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12
Q

Neutropenia particularly if TPMT low

A

Azathioprine

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13
Q

Infertility

A

Cyclophosphamide

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14
Q

Inhibits T cell migration but may only be used in highly active remitting/relapsing MS

A

Natalizumab (Anti-a4 integrin

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15
Q

Inhibits T cell activation and is effective in rheumatoid arthritis

A

Abatacept (CTLA4-Ig fusion protein)

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16
Q

Depletes B cells and is effective in treatment of B cell lymphomas and rheumatoid arthritis

A

Rituximab (Anti-CD20)

17
Q

Inhibits function of lymphoid and myeloid cells and used in management of rheumatoid arthritis

A

Tocilizumab (Anti-IL6 receptor)

18
Q

Antibody specific for CD25 which inhibits T cell activation and is used to prevent rejection

A

Basiliximab (Anti-IL2 receptor)

19
Q

Anti-Thymocyte globulin

A

Anti-CD3
Removes T cells
Allograft rejection
Daily IV infusion
Infusion reaction, leucopaenia

20
Q

Anti-CD25

A

Basiliximab

Inhibits T cell proliferation

Prophylaxis in organ transplant

IV pre and post surgery

21
Q

CTLA4-Ig fusion

A

Abatacept

Prevents T cell activation

Rheumatoid arthritis

IV 4 weekly
Subcut weekly

22
Q

Anti-CD20

A

Rituximab

Removes mature B cells

Lymphoma
SLE
Rheumatoid arthritis

2 doses every 6 months IV

23
Q

Anti-alpha4 integrin

A

Natalizumab

Reduce T cell migration

Highly active relapsing MS
Crohn’s
IV every 4 weeks

24
Q

Anti-CD11a

A

Efalizumab

Inhibits T cell migration

Psoriasis

causes PML, now withdrawn

25
Q

Anti-IL-6R

A

Tocilizumab

Reduces activation of:
Macrophages
T cells
B cells
Neutrophils

Castleman’s
Rheumatoid arthritis

26
Q

Anti-TNFa Antibodies

A

Infliximab
Adalimumab
Certolizumab
Golimumab

Indications and dosing

  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Psoriasis and psoriatic arthritis
  • Inflammatory bowel disease

Subcutaneous or intravenous

27
Q

TNFa antagonist = TNF receptor p75-IgG fusion protein

A

Etanercept

Indications and dosing

  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Psoriasis and psoriatic arthritis
  • Subcutaneous weekly

Action
- Inhibits TNFa and TNFb

28
Q

Antibody to p40 subunit of IL-12 and IL-23

A

Ustekinumab

Indications and dosing

  • Psoriasis, psoriatic arthritis
  • Subcutaneous every 12 weeks

Action
Inhibits IL-12 and IL-23

29
Q

Antibody to IL17 A

A

Secukinumab

Indications and dosing
Psoriasis and psoriatic arthritis
Ankylosing spondylitis
SC load and then monthly

Action
Inhibits IL-17A

30
Q

Antibody directed at RANK ligand

A

Denosumab

Indications and dosing
Osteoporosis
Subcutaneous every 6 months

Action
Inhibits RANK mediated osteoclast
differentiation and function

Toxicity
Infection
- Avascular necrosis of jaw

31
Q

Treatment options include inhibition of IL6, TNF alpha and depletion B cells

A

Rheumatoid arthritis

32
Q

Treatment options include inhibition of IL12/23, TNF alpha and IL17A

A

Psoriasis

33
Q

Treatment options include inhibition of RANK ligand

A

Osteoporosis

Matt's Path REVERSE (18 decks)

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