Term
| prednisone mechanism of action |
|
Definition
inhibit gene expression
suppresses activation of innate/adaptive immune cells
downregulates expression of inflamm mediators (TNF & IL)
inhibits PLA2
continued ues can decrease primary and secondary immune repsonse |
|
|
Term
| uses of glucocorticoids (prednisone) |
|
Definition
| solid organ transplant, HSC transplantation, certain autoimmune diseases, attenuates allergic reactions |
|
|
Term
| What are the adverse effects of prednisone |
|
Definition
| adrenal suppression, cushingoid reactions, mood swings, diabetes, decreased resistance to infection, osteoporosis, HT, wt gain, cataracts |
|
|
Term
| What is the mechanism of action of Belatacept? |
|
Definition
| It consists of CTL4 linked to IgG, and it competes w/CD28 to bind B7 on the APC (blocks co-stimulation by T-cells) |
|
|
Term
| What is the mechanism of action for Azathioprine (Mercaptopurine)? |
|
Definition
| It interferes w/purine nucleic acid synthesis, therefore preventing clonal expansion |
|
|
Term
| What are the adverse effects of Azathioprine (Mercaptopurine) |
|
Definition
BM suppression (leucopenia), rash, interaction w/allopurinol
at high doses: GI distrubances, hepatotoxicity |
|
|
Term
| What is Azathioprine/Mercaptopurine used for? |
|
Definition
| kidney transplants and autoimmune diseases |
|
|
Term
| What is the mechanism of action of Mycophenolic Acid? |
|
Definition
| inhibits IMPDH II, so it blocks guanosine synthesis in lymphocytes (cytostatic effect- prevents clonal expansion) |
|
|
Term
|
Definition
|
|
Term
| What are the adverse effects of MMF? |
|
Definition
| GI disturbances, headache, hypertension |
|
|
Term
| What is methotrexate used for and what is its MOA? |
|
Definition
RA and psoriasis
prevents clonal expansion |
|
|
Term
| What is cyclophosphamide used for? |
|
Definition
|
|
Term
| What is the mechanism of action of cyclosporine? |
|
Definition
| Inhibits T cell activation: inhibits calcineurin, which normally dephosphorylates a transcription factor for IL2 |
|
|
Term
| What is cyclosporine used for? |
|
Definition
| organ transplantation, G v H preparation, psoriasis, RA, rare autoimmune diseases not response to anything else |
|
|
Term
| What are the adverse effects of cyclosporine A? |
|
Definition
| dose-dep nephrotoxicity, HT, hyperlipidemia, neurotoxicity, hepatotox, predisposition to viral infection & lymphoma |
|
|
Term
| What is the MOA of tacrolimus? |
|
Definition
| binds FKBP & inhibits calcineurin (10-100x more potent than cyclosporine A); also inhibits IL3, IL 4, IFN Y, & T cells |
|
|
Term
| Which drugs inhibit calcineurin, and which is more potent? |
|
Definition
| tacrolimus (more potent) & cyclosporine A |
|
|
Term
| What is the MOA of sirolimus, and what is special about it? |
|
Definition
Inhibition of mTOR, which inhibits IL2-stimulated protein synthesis (lymphocytes are arrested in G1)
It is NOT nephrotoxic |
|
|
Term
|
Definition
| it is an antibody against CD3 on T-cells, so it suppresses T-cell response to transplantation |
|
|
Term
| Which drug can cause cytokine release syndrome? |
|
Definition
|
|
Term
| What is the MOA of ATG/ATL? |
|
Definition
| polyclonal antibodies against long-lived peripheral lymphocytes |
|
|
Term
|
Definition
| antibodies against CD25 (the IL2 Receptor on activated T cells) |
|
|
Term
| Drugs used to prepare for transplantation |
|
Definition
| T-cell depleters: Daclizumab, ATG, or OKT3 |
|
|
Term
| Drugs used for acute rejection: |
|
Definition
| calcineurin inhib (cyclosporine or tacrolimus) + cell cycle inhib (MMF or sirolimus) +/- steroids |
|
|
Term
| Which drug has an AE of BM suppression? |
|
Definition
|
|
Term
| What are the symptoms of cytokine release syndrome? |
|
Definition
| fever, myalgia, nausea, diarrhea |
|
|
Term
|
Definition
| at low doses for humoral deficiency, high doses for: severe asthma, some AI disorders, Kawasaki syndrome |
|
|
Term
| How is Rho Immuno Globulin used? |
|
Definition
it is a concentrated solution of human IgG containing antibodies to Rho(D) Ag of the red cell
prevents sensitization of Rh-negative mother
administered within 24-72 hours after birth of an RH + infant |
|
|
