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Nephro
ImmunoPharmacology
28
Pharmacology
Graduate
11/03/2010

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Cards

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
What is MMF used for?
Definition
kidney transplants
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
cancers and SLE
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
What is the MOA of OKT3?
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
OKT3
Term
What is the MOA of ATG/ATL?
Definition
polyclonal antibodies against long-lived peripheral lymphocytes
Term
Daclizumab/Basiliximab
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
Azathiprine
Term
What are the symptoms of cytokine release syndrome?
Definition
fever, myalgia, nausea, diarrhea
Term
What is IGIV used for?
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
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