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