W03_11 Immunosuppression

Question 1

what do corticosteroids bind to?

Answer 1

glucocorticoid receptor and other transcription factors, like NF-kB

Question 2

what is dexamethasone?

Answer 2

corticosteroid.

0.75 mg po or IV

Question 3

what is methylprednisolone?

Answer 3

corticosteroid.

4 mg IV

Question 4

what is prednisone?

Answer 4

corticosteroid.

5 mg po

Question 5

what is hydrocortisone?

Answer 5

corticosteroid.

20 mg IV

Question 6

what is cyclophosphamide?

Answer 6

antiproliferative agent.
used in cancers and autoimmune disease.
forms cross links in DNA that causes cell death

Question 7

what’s a general common side effect of antiproliferative agents for immunosuppression?

Answer 7

bone marrow suppression. e.g. neutropenia

Question 8

what’s azathioprine?

Answer 8

antiproliferative agent.

purine analogue that interrupts DNA synthesis

Question 9

what’s mycophenolic acid?

Answer 9

antiproliferative agent.

inhibits purine synthesis

Question 10

what’s leflunomide?

Answer 10

antiproliferative agent.

inhibits pyrimidine synthesis

Question 11

what’s methotrexate?

Answer 11

antiproliferative agent

blocks folic acid action. (DNA issues)

Question 12

side effects of antiproliferative agents?

Answer 12

hepatotoxicity, pancreatitis, GI upset. (also neutropenia)

Question 13

what’s sirolimus?

Answer 13

antiproliferative agent.

Question 14

list three diseases that antiproliferative agents treat

Answer 14

rheumatoid arthritis, inflammatory bowel disease, transplantation

Question 15

what’s calcineurin?

Answer 15

blocks T-cell activation;
prevent IL-2 production;
prevents transcription factors from entering nucleus.

Question 16

indications for calcineurin inhibitors?

Answer 16

transplantation;
some types of glomerulonephritis;
psoriasis;
rheumatoid arthritis;
opthalmic diseases

Question 17

what’s basiliximab?

Answer 17

anti-IL-2;

given before transplantation for acute prevention

Question 18

what’s infliximab?

Answer 18

anti-TNFa; also kills TNFa-producing T cells;

used for IBD, ankylosing spondylitis, psoriasis, others

Question 19

what’s alemtuzumab?

Answer 19

treats lymphoma + transplantation;

depletes T and B cells

Question 20

what’s rituximab?

Answer 20

treats lymphoma, type II HS rejection, glomerulonephritis, vasculitis, others;
depletes B cells

Question 21

what’s eculizumab?

Answer 21

treats antibody-mediated rejection;

mAb against C5 complement

Question 22

what’s thymoglobulin?

Answer 22

polyclonal antibody used to prevent and treat transplant rejection;
depletes T, B, dendritic cells

Question 23

what’s IVIg?

Answer 23

used for autoimmune diseases, like ITP, kawasaki disease, myasthenia gravis, etc.

Question 24

what’s etanercept?

Answer 24

TNFa blocker;

fused protein with TNFa receptor and Fc IgG

Question 25

what’s abatacept/belatacept?

Answer 25

fused protein with Fc IgG and CTLA-4. binds to B7 and prevents CD28 co-stimulation to prevent T cell activation.
used in kidney transplantation and rheumatoid arth.

Question 26

what’s sulfasalazine/5-aminosalicylic acid?

Answer 26

used in IBD; mechanism unknown

Question 27

what’s hydroxychloroquine?

Answer 27

first-line agent in lupus;

also in rheumatoid arthritis and sjogren’s syndrome; may cause macular toxicity