Term
| What was wrong with early immunosuppressants? |
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Definition
were nonselective w/ general suppression of the entire immune system leading to death from infection
(opportunistic infection) |
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Term
| T Cell inhibitor (non-specific) |
|
Definition
| adrenocorticoids (prednisone) |
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Term
|
Definition
|
|
Term
| T-cell activation blockers |
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Definition
|
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Term
|
Definition
|
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Term
|
Definition
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Term
|
Definition
azathioprine
mycophenolate mofetil |
|
|
Term
What were the early anti-cancer drugs targeted at inhibiting cell proliferation of inflammatory/immunological cells?
very non-specific |
|
Definition
methotraxate
cyclophosphamide
azathioprine
prednisone |
|
|
Term
| Adverse effects of prednisone |
|
Definition
diabetogenic (hyperglycemia)
cataracts
osteoporosis
hypertension
hypercholesterolemia |
|
|
Term
???MOA- T-cells most affect probably by lysis
suppression of DNA translation of genes involved w/ inflmmatory process |
|
Definition
Adrenocorticoids/glucocorticoids
prednisone |
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Term
| Mainstay for preventing rejection in transplantation and auto-immune disorders (RA, SLE, arthritis, asthma) |
|
Definition
prednisone
adrenocorticoids/glucocorticoids |
|
|
Term
| Antithymocyte antibodys, what are the types mentioned? |
|
Definition
antilymphocyte globulin
antithymocyte globulin (thymoglobulin) |
|
|
Term
| Binds to surface of circulating T lymphocytes, phagocytized --> lymphopenia & impaired T-cell responses |
|
Definition
| Antithymocyte globulin (thymoglobulin) |
|
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Term
| Which antibody has an acute phase of allograft rejection |
|
Definition
antithymocyte antibody
antithymocyte globulin |
|
|
Term
| What is the half-life of antithymocyte globulin? |
|
Definition
|
|
Term
| Antibodies against these can be formed |
|
Definition
|
|
Term
| What are the adverse effects of antithymocyte antibodies |
|
Definition
chills/fever
decreased WBC
decreased platelets
skin rashes |
|
|
Term
| Murine monoclonal antibody against glycoprotein CD3 antigen on human T cells |
|
Definition
|
|
Term
|
Definition
acute allograft rejection- renal, cardiac, & hepatic transplants
deplete T cells from donor bone marrow prior to transplant
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|
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Term
| Initial treatment cytokine storm therefore pre-medicate with prenisolone, diphenhydramine, and acetaminophen |
|
Definition
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|
Term
| Adverse effects - mild flu to anaphylactic rxn due to cytokine release, headache, fever, encephalopathy |
|
Definition
|
|
Term
| What are the contraindications of Muronomab-CD3? |
|
Definition
pregnant
seizure
CHF patient |
|
|
Term
| ____ is on human T-cells and it is the antibody that links to antigen presented to it. First step in inflammatory process |
|
Definition
|
|
Term
Humanized monoclonal antibody against CD 52
Depletes T cells |
|
Definition
|
|
Term
|
Definition
| experimental in replacement of steriod |
|
|
Term
Adverse effects: initial treatment "cytokine storm" therefore premedicate with prenisolone, diphenhydramine, and acetaminophen
(other one) |
|
Definition
|
|
Term
| Adverse effects : anemia, neutropenia, pancytopenia |
|
Definition
|
|
Term
| Caution: increased B cell rejection/autoimmune disorders |
|
Definition
|
|
Term
|
Definition
peptide isolated from fungus
inhibits cell mediated immune rxns
humoral immunity less effected |
|
|
Term
|
Definition
prevents de-phosphorylation of NFATc (cytoplasmic nuclear factor of activated T cells)
Thus inhibits production & subsequent release of IL-2 & induces activation of resting T cells |
|
|
Term
| usually administed (oral or IV) in combination with glucocorticoids to increase effectiveness |
|
Definition
|
|
Term
|
Definition
prevention of rejection of allogenic transplanted (kidney, liver, heart)
severe, active RA
recalcitrant psoriasis that does not response to other therapies |
|
|
Term
| what does allogenic mean? |
|
Definition
|
|
Term
| Adverse effects: reversible nephrotoxity, viral infections (CMV) hirusitism, gingival hyperplasia, anaphylaxis, lymphoma |
|
Definition
|
|
Term
| Why does cyclosporine have an adverse effect of reversible nephrotoxicity? |
|
Definition
|
|
Term
| Same MOA & uses as cyclosporine |
|
Definition
|
|
Term
| Routes of administration of tacrolimus |
|
Definition
|
|
Term
| Why is tacrolimus favored over cyclosporine? |
|
Definition
decreased episodes of rejection
lower doses of glucorticoids can be used, reducing likelihood of infection |
|
|
Term
| Adverse effects: Nephrotoxicity, neurotoxicity, insulin dependent diabetes, anaphylaxis to vehicle |
|
Definition
tacrolimus
more severe than cyclosporine |
|
|
Term
Is tacrolimus or cyclosporine?
Much better immunosuppresent but comes with much bigger toxicity |
|
Definition
|
|
Term
| Which IL-2 receptor blocker is chimerized? |
|
Definition
|
|
Term
| Which IL-2 receptor blocker is humanized? |
|
Definition
|
|
Term
| IL-2 receptor blockers MOA |
|
Definition
anti CD-25 (IL-2 receptor)
IV only, long half lives (7 and 20 days)
renal transplantation |
|
|
Term
| Adverse effects of IL-2 blockers |
|
Definition
mainly GI
malignancy not a problem |
|
|
Term
| IL-2 response blockers are used for? |
|
Definition
|
|
Term
| IL-2 response blocker MOA |
|
Definition
prevent IL-2 induced cell proliferation
acts synergistally w/ cyclosporine
SRL coated stents
Immunosuppresent effect can persist up to 6 months after cessation of therapy |
|
|
Term
| Adverse effects: hyperlipidemia, nephrotoxicity, headache, nausea, diarrhea |
|
Definition
IL-2 response blockers
sirolimus
everolimus |
|
|
Term
| What is the "me too" drug to sirolimus? |
|
Definition
|
|
Term
IL-2 response blockers
instead of inhibiting synthesis of IL-2 they inhibit.. |
|
Definition
|
|
Term
| 6 mercaptopurine, fradulent nucleotide |
|
Definition
|
|
Term
| Lymphocytes predominatently are affected due to their rapid proliferation and dependence on de novo synthesis of purines required for cell division |
|
Definition
|
|
Term
| Little effect on chronic immune response |
|
Definition
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|
Term
| Therapeutic uses for azathioprine |
|
Definition
adjust w/ other agents in prevention of rejection of solid organ transplants
severe RA unresponsive to other agents
Other autoimmune diseases: ITP, SLE, MS, Chrohns |
|
|
Term
| Routes of admin for azathioprine |
|
Definition
|
|
Term
Adverse effects: fever, chills, N/V, anorexia, diarrhea, pancytpenia, secondry infection
|
|
Definition
|
|
Term
| Which drug has increased toxicity w/ allopurinol |
|
Definition
azathioprine
reduce dose of azathioprine |
|
|
Term
| Azathioprine is contraindicated |
|
Definition
|
|
Term
| Warning/Precautions of using Azathioprine for chronic immunosuppresion |
|
Definition
increases risk of neoplasia
mutagenic potential
possible hematologic toxicities
caution in pts w/ liver disease, renal impairment
monitor hematologic fxn closely |
|
|
Term
| Azathioprine is not to be given with... |
|
Definition
|
|
Term
| Potent reversible inhibitor of inosine monophosphate dehydrogenase thus blocking de novo synthesis of guanosine phosphate (GMP) |
|
Definition
|
|
Term
| Deprives rapidly proliferating T and B cells of GMP |
|
Definition
|
|
Term
Mycophenolate mofetil
mycophenolic acid |
|
Definition
rapidly absorbed in gut
glucuronidated and excreted in urine |
|
|
Term
| Adverse effects: pain, diarrhea, sepsis, lymphoma |
|
Definition
|
|
Term
| Concomitant administration w/ antacids of Mg/Al or cholestyramine decrease the absorption |
|
Definition
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