Term
| Aldesleukin, IFNs and BCG are immune... |
|
Definition
|
|
Term
| immunophilin ligands, like _____, are immune _____s |
|
Definition
| cyclosporin, suppressants |
|
|
Term
| enzyme inhibitors like _________ _______ are immune _______s |
|
Definition
| mycophenolate mofetil, suppressants |
|
|
Term
| cytotoxic drugs like ______ are immune ______s |
|
Definition
| azathioprine, suppressants |
|
|
Term
| Anti-TNFa agents like _______ are immune ______s |
|
Definition
|
|
Term
| _______s like RhoGAM are immune ______s |
|
Definition
|
|
Term
| Activated Th cells secrete _____, a cytokine that causes proliferation and activation of ____ and ____ |
|
Definition
|
|
Term
| Th1 cells orchestrate _______ immunity and _______ _______ reactions |
|
Definition
| cell-mediated, delayed hypersensitivity reacions |
|
|
Term
| Th1 cells produce what? What does it do? |
|
Definition
| Th1 -> IFNy, IL-2, TNF-b -> activate macs, CTLs, and NK cells |
|
|
Term
| When T-cell receptors on Th2 cells are activated by MHC2-peptide complex, they release which ILs? What does that do? |
|
Definition
| IL-4, 5, and 6 -> B cell proliferation and differentiation into memory B cells and plasma cells |
|
|
Term
| ____ downregulates Th1 responses |
|
Definition
|
|
Term
| ____ downregulates Th2 responses |
|
Definition
|
|
Term
| corticosteroids have a greater affect on _______ than humoral immunity, but continuous therapy lowers IgG levels |
|
Definition
| cell-mediated (T-lymphocyte proliferation) |
|
|
Term
| Glucocorticoids can induce ___ in immune cells, making them useful for ___ |
|
Definition
|
|
Term
| Cyclosporine, tacrolimus and sirolimus bind ________, which play critical roles in ____-cell function |
|
Definition
|
|
Term
| Name the drugs that bind immunophilins and affect T cell function |
|
Definition
| cyclosporine, tacrolimus, sirolimus |
|
|
Term
|
Definition
|
|
Term
| which drug binds cyclophilin? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Which drug binds FK-binding protein? |
|
Definition
|
|
Term
| Both cyclosporin-cyclophilin and tacrolimus-FKBP complexes inhibit... |
|
Definition
|
|
Term
| which drugs inhibit calcineurin? |
|
Definition
| cyclosporin-cyclophilin, and tacrolimus-FKBP |
|
|
Term
| Calcineurin regulates the ability of the nuclear factor of activated T cells (NF-AT) to... |
|
Definition
| translocate to the nucleus and increase production of cytokines |
|
|
Term
| What regulates the ability of NF-AT to translocate to the nucleus and increase production of cytokines? |
|
Definition
|
|
Term
|
Definition
| binds FKBP, inhibits the response of T cells to cytokines without affecting cytokine production |
|
|
Term
| Which drug binds FKBP and inhibits the response of T cells to cytokines without affecting cytokine production? |
|
Definition
|
|
Term
| Sirolimus is a potent inhibitor of... |
|
Definition
| B-cell prolif, Ab production, mononuclear cell responses to CSF |
|
|
Term
| Cyclosporine is used in... |
|
Definition
| solid organ transplants, GVHD |
|
|
Term
|
Definition
| solid organ and stem cell transplants, and GVHD |
|
|
Term
| Sirolimus is used alone or with cyclosporine in... |
|
Definition
| solid organ transplant, investigation for GVHD |
|
|
Term
| cyclosporine, tacrolimus and sirolimus are used in some autoimmune diseases, like... |
|
Definition
| RA, uveitis, psoriasis, asthma, T1 DM |
|
|
Term
| Cyclosporine and tacrolimus are available as oral or IV, but sirolimus is only available for ___ use |
|
Definition
|
|
Term
| ______ exhibits erratic bioavailability and serum levels should be monitored |
|
Definition
|
|
Term
| cyclosporine is metabolized by... |
|
Definition
|
|
Term
| Toxicity of cyclosporine and tacrolimus? |
|
Definition
| renal dysfunction, HTN, neurotox, hyperglycemia, hyperlipidemia, cholelithiasis |
|
|
Term
| sirolimus is more likely than cyclosporine or tacrolimus to cause... |
|
Definition
| hypertriglyceridemia, hepatotoxicity, diarrhea, myelosuppression |
|
|
Term
| mycophenolate mofetil - MOA and effects? |
|
Definition
| -> mycophenolic acid, inhibits IMP dehydrogenase (purine synthesis), suppresses both B and T cell activation |
|
|
Term
| which drug inhibits IMP dehydrogenase (purine synthesis), suppresses both B and T cell activation? |
|
Definition
|
|
Term
| mycophenolate has been used for... |
|
Definition
| kidney, liver, heart transplants |
|
|
Term
|
Definition
| GI disturbance, myelosuppression, neutropenia |
|
|
Term
| Which drug causes GI disturbance, myelosuppression, neutropenia? |
|
Definition
|
|
Term
|
Definition
| -->mercaptopurine, inhibits enzymes involved with purine metabolism |
|
|
Term
| which drug is metabolized to mercaptopurine, inhibits enzymes involved with purine metabolism? |
|
Definition
|
|
Term
| azathioprine is cytotoxic in the ____ phase of lymphoid cell prolif and has greater effect on activity of ___ cells |
|
Definition
|
|
Term
| which drug is cytotoxic in the early phase of lymphoid cell prolif and has a greater effect on the activity of T cells than B cells? |
|
Definition
|
|
Term
| what is azathioprine used for? |
|
Definition
| autoimmune diseases, immunosuppression in renal homografts, minimal effect on established graft rejection |
|
|
Term
| which drug is used in autoimmune diseases, immunosuppression in renal homografts, and has minimal effect on established graft rejection? |
|
Definition
|
|
Term
| Toxicity of azathioprine? |
|
Definition
| major: bone marrow suppression, also GI irritation, rashes, liver dysfunction. |
|
|
Term
| tox: major- bone marrow suppression, also GI irritation, rashes, liver dysfunction. NAME THE DRUG. |
|
Definition
|
|
Term
| the use of ____ is associated with an increased risk of cancer |
|
Definition
|
|
Term
| azathioprine is assoc with an increased risk of... |
|
Definition
|
|
Term
| Azathioprine's metabolite is metabolized by ____ ____, which can cause toxic effects when administered with ______ |
|
Definition
| xanthine oxidase, allopurinol |
|
|
Term
| allopurinol can cause toxic effects with the administration of ______, because its metabolite is metabolized by xanthine oxidase |
|
Definition
|
|
Term
|
Definition
| orally active prodrug is transformed by liver enzymes to alkylating agent that is cytotoxic to proliferating lymphoid cells |
|
|
Term
| which drug is an orally active prodrug that is transformed by liver enzymes to alkylating agent that is cytotoxic to proliferating lymphoid cells? |
|
Definition
|
|
Term
| effects of cyclophosphamide? |
|
Definition
| greater effect on B than T, will inhibit an established immune response |
|
|
Term
| which drug has a greater effect on B than T cells and will inhibit an established immune response? |
|
Definition
|
|
Term
| Other than cyclophosphamide, cytotoxic drugs that similarly suppress proliferating lymphoid cells and are sometimes used as immunosuppressants include... |
|
Definition
| cytarabine, dactinomycin, methotrexate, vincristine |
|
|
Term
| cyclophosphamide is effective for... |
|
Definition
| autoimmune diseases (including hemolytic anemia), Ab-induced red cell aplasia, BMTs, and possibly other organ transplant procedures |
|
|
Term
| which drug is used for autoimmune diseases (including hemolytic anemia), Ab-induced red cell aplasia, BMTs, and possibly other organ transplant procedures? |
|
Definition
|
|
Term
| the large doses of cyclophosphamide usually needed for immunosuppression cause... |
|
Definition
| pancytopenia, GI distress, hemorrhagic cystitis, alopecia, may cause sterility |
|
|
Term
| tox of large doses: pancytopenia, GI distress, hemorrhagic cystitis, alopecia, may cause sterility. NAME THE DRUG |
|
Definition
|
|
Term
|
Definition
|
|
Term
| which drug is a recombinant TNFa receptor? |
|
Definition
|
|
Term
| which drug sequesters TNFa, reducing formation of ILs and adhesion molecules involved in leukocyte activation |
|
Definition
|
|
Term
| What is etanercept used for? |
|
Definition
| RA, psoriatic arthritis, other inflam diseases |
|
|
Term
|
Definition
| injection site rxns and hypersensitivity |
|
|
Term
| etanercept, infliximab and adalimumab increase the risk of... |
|
Definition
| serious infections and lymphoma |
|
|
Term
|
Definition
| inhibits pyrimidine synthesis and arrests lymphocytes in G1 phase |
|
|
Term
| which drug inhibits pyrimidine synthesis and arrests lymphocytes in G1 phase? |
|
Definition
|
|
Term
| leflunomide is used in... |
|
Definition
|
|
Term
|
Definition
| liver dmg, renal impairement, teratogenic effects, and may cause cardiovascular effects (angina, tachy) |
|
|
Term
| Toxicity of which drug includes liver dmg, renal impairement, teratogenic effects, and may cause cardiovascular effects (angina, tachy)? |
|
Definition
|
|
Term
| Thalidomide is a ____ drug |
|
Definition
|
|
Term
| thalidomide's complex immune effects include... |
|
Definition
| suppress TNF production, ^ IL-10, reduced neutrophil phagocytosis, altered adhesion molecule expression, enhanced cell-mediated immunity |
|
|
Term
| Which drug has complex immune effects that include the following: suppress TNF production, ^ IL-10, reduced neutrophil phagocytosis, altered adhesion molecule expression, enhanced cell-mediated immunity |
|
Definition
|
|
Term
| Thalidomide is used for... |
|
Definition
| some forms of leprosy reactions, immunologic disease, anticancer drug, aphthous ulcers and wasting syndrome in AIDS |
|
|
Term
| which drug is used for some forms of leprosy reactions, immunologic disease, anticancer drug, aphthous ulcers and wasting syndrome in AIDS? |
|
Definition
|
|
Term
|
Definition
| an engineered protein that blocks CD2 on T cells |
|
|
Term
| which drug is an engineered protein that blocks CD2 on T cells? |
|
Definition
|
|
Term
| alefacept contains the CD2-binding region of ____ fused to a human _______. |
|
Definition
|
|
Term
| What is the effect of alefacept? |
|
Definition
| inhibits T cell activation |
|
|
Term
| alefacept is approved for tx of... |
|
Definition
|
|
Term
| You have to monitor _____ counts when using alefacept |
|
Definition
|
|
Term
| What types of antisera directed against lymphocytes are available? |
|
Definition
|
|
Term
|
Definition
| antisera - antilymphocyte globulin and antithymocyte globulin |
|
|
Term
|
Definition
| bind T cells, destroyed by complement, block cellular immunity, suppress organ graft rejection (cell mediated process) |
|
|
Term
| Which drugs bind T cells, destroyed by complement, block cellular immunity, and suppress organ graft rejection (cell mediated process)? |
|
Definition
|
|
Term
| What are ALG and ATG used for? |
|
Definition
| used before BMT to prevent GVHD |
|
|
Term
| because humor immunity can remain intact, injection of ALG and ATG can cause... |
|
Definition
| hypersensitivity reactions, serum sickness, anaphylaxis. also pain and erythema at injection site, lymphoma has been noted as late complication |
|
|
Term
| Which drugs can cause hypersensitivity reactions, serum sickness, anaphylaxis (mediated by humoral immunity), and also pain and erythema at injection site, and lymphoma as late complication? |
|
Definition
|
|
Term
|
Definition
| human IgG, Abs against Rho(D) antigens on RBCs |
|
|
Term
| Which drug contains human IgG, Abs against Rho(D) antigens on RBCs? |
|
Definition
|
|
Term
|
Definition
| Rho(D)-negative moms at time of antigen exposure (birth of RhoD positive baby), to block the primary immune response to the foreign cells |
|
|
Term
| What does RhoGAM prevent? |
|
Definition
| hemolytic disease of the newborn, production of maternal antibodies to Rh-positive cells in subsequent pregnancies |
|
|
Term
|
Definition
| MAb that binds CD3 on T cells |
|
|
Term
| Which drug is a MAb that binds CD3 on T cells? |
|
Definition
|
|
Term
| What is muromonab used for? |
|
Definition
| renal transplant rejection crises |
|
|
Term
| which drug is used for renal transplant rejection crises? |
|
Definition
|
|
Term
| First dose effects of muromonab include... |
|
Definition
| fever, chills, dyspnea, pulm edema, hypersensitivity rxns may occur |
|
|
Term
| The first dose effects of _____ include, fever, chills, dyspnea, pulm edema, and possible hypersensitivity rxns |
|
Definition
|
|
Term
|
Definition
| MAb that binds alpha subunit of IL-2 receptor on T cells and prevents activation by IL-2 |
|
|
Term
| Which drug is a MAb that binds alpha subunit of IL-2 receptor on T cells and prevents activation by IL-2? |
|
Definition
|
|
Term
| What is daclizumab used for? What are its toxicities? |
|
Definition
| prevent renal transplant rejection, toxicity equal to placebo! |
|
|
Term
| Which drug is used to prevent renal transplant rejection and has toxicity equal to placebo (!)? |
|
Definition
|
|
Term
|
Definition
| chimeric human mouse IgG with an action equivalent to daclizumab |
|
|
Term
| Which drug is A chimeric human mouse IgG with an action equivalent to daclizumab? |
|
Definition
|
|
Term
|
Definition
| humanized MAb, targeted against TNFa (like etanercept) |
|
|
Term
| Which drug is a humanized MAb, targeted against TNFa (like etanercept)? |
|
Definition
|
|
Term
| What is infliximab used for? |
|
Definition
| Crohn's, RA, UC, ankylosing spondylitis, psoriatic arthritis |
|
|
Term
| Which drug is used for Crohn's, RA, UC, ankylosing spondylitis, psoriatic arthritis? |
|
Definition
|
|
Term
| What side/adverse effects may occur with infliximab? |
|
Definition
| infusion reactions and increased rate of infection |
|
|
Term
|
Definition
| completely human IgG MAb that binds TNFa |
|
|
Term
| Which drug is a completely human IgG MAb that binds TNFa? |
|
Definition
|
|
Term
| Adalimumab is approved for the treatment of... |
|
Definition
|
|
Term
| Aldesleukin is a recombinant form of which IL? What does that IL do? |
|
Definition
| IL-2, promotes production of CTLs and activates NK cells |
|
|
Term
| What is aldesleukin indicated for? |
|
Definition
| adjunctive tx of renal cell carcinoma and melanoma |
|
|
Term
| which drug is approved for adjunctive tx of renal cell carcinoma and melanoma? |
|
Definition
|
|
Term
| IFNa-2a inhibits ________ and is used in ______________________. |
|
Definition
| cell proliferation, HCL, CML, MM, Kaposi's, Hep B and C |
|
|
Term
| Which IFN inhibits cell proliferation and is used in HCL, CML, MM, Kaposi's, Hep B and C? |
|
Definition
|
|
Term
| IFNb-1b has beneficial effects in... |
|
Definition
|
|
Term
| Which IFN has beneficial effects in relapsing MS? |
|
Definition
|
|
Term
| IFNy-1b has greater _____ actions than the others and appears to act by _____________. Recombinant form is used in pts with ________. |
|
Definition
| immune-enhancing, increasing synthesis of TNF, CGD |
|
|
Term
| Which IFN seems to have greater immune-enhancing actions than the others, may work by increasing synthesis of TNF, and is used in pts with CGD? |
|
Definition
|
|
Term
|
Definition
| immunization against TB and as an immunostimulant in the tx of superficial bladder cancer |
|
|
Term
| Which drug is used for immunization against TB and as an immunostimulant in the tx of superficial bladder cancer? |
|
Definition
|
|
Term
| The efficacy of BCG may be due to... |
|
Definition
| activation of macs and enhancement of immune response |
|
|
Term
| Which drug may work by activating macs and enhancement of immune response? |
|
Definition
|
|
Term
| Type 1 (immediate) hypersensitivity involves... |
|
Definition
| IgE, animal and plant stings, pollens, drugs, anaphylaxis, urticaria, angioedema, haptens linked to carrier proteins, B cell prolif -> IgE Abs, mast cells, basophils, histamine, kinins, PGs, LTs, PCNs, sulfonamides |
|
|
Term
| Name the type of hypersensitivity: IgE, animal and plant stings, pollens, drugs, anaphylaxis, urticaria, angioedema, haptens linked to carrier proteins, B cell prolif -> IgE Abs, mast cells, basophils, histamine, kinins, PGs, LTs, PCNs, sulfonamides |
|
Definition
|
|
Term
| Type II allergy involves... |
|
Definition
| IgG or IgM bound to circulating RBCs, reexposure -> complement-dependent lysis, autoimmune syndromes, hemolytic anemia from methyldopa, SLE from hydralazine or procainamide, thrombocytopenic purpura from quinidine, and agranulocytosis from exposure to many drugs |
|
|
Term
| Name the type of hypersensitivity response: IgG or IgM bound to circulating RBCs, reexposure -> complement-dependent lysis, autoimmune syndromes, hemolytic anemia from methyldopa, SLE from hydralazine or procainamide, thrombocytopenic purpura from quinidine, and agranulocytosis from exposure to many drugs |
|
Definition
|
|
Term
| Type III hypersensitivity involves... |
|
Definition
| complement-fixing IgM or IgG Abs and possibly IgE Abs, serum sickness, vasculitis, maybe SJ syndrome (sulfonamides) |
|
|
Term
| Name the type of hypersensitivity: complement-fixing IgM or IgG Abs and possibly IgE Abs, serum sickness, vasculitis, SJ syndrome (sulfonamides) |
|
Definition
|
|
Term
| Type IV allergy involves... |
|
Definition
| cell-mediated reaction, from topical application of drugs, contact dermatitis |
|
|
Term
| name the type of hypersensitivity response: cell-mediated reaction, from topical application of drugs, contact dermatitis |
|
Definition
|
|
