Immunosuppressants Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
Complications of immunosuppressive therapy ? | * Suppression of immune system .... (lead to infections such as CMV) |
Major classes of immunosuppressive agent classes ? | * Glucocorticoids -- Calcineurin inhibitors -- Cytotoxic agents -- Biologics |
Glucocorticoids = ? | * Prednisone -- methylprednisolone -- dexamethasone |
Gluco. Uses ? | * Prevent rejection - best if given at time of transplant ..... * high doses treat Acute Rejection phases ..... * helps supress/lower GVHD |
Gluco. MOA ? | * Inhibits innate and acquired immunity by inhibiting T cell proliferation and inhibits IL-2 production (which increase T-cells) |
Gluco. SEs ? | * Steroid Man |
Calcineurin inhibitors (antibiotics)= ? | * Cyclosporine and Tacrolimus |
Cyclosporine use ? | * prophylaxis only - not effective in ongoing rejection |
Cyclosporine MOA ? | * Binds to cyclophilin --> Cyclosporin-cyclophilin complex binds calcineurin --> prevents IL-2 from being activated (no T-cells) .... * Prevents transcription factors from being made to activate IL-2 |
Cyclosporine pharmokinetics ? | * Narrow TI ….. Need enough dose to prevent rejection, but have to monitor as to not get toxicity |
Cyclosporine SEs ? | * typical stuff and weird ones --> hirsutism and gingival bleeding ..... * Highly Nephrotoxic (give to prevent rejection, yet it is damaging to an organ you are trying to help) .... * Hyperkalemia - due to decreased K excretion |
Tacrolimus MOA and SEs ? | * Similar MoA and Use as cyclosporine except binds FKBP rather than cyclophilin.... * No side effects like cyclosporine |
Antiproliferative Agent - Sirolimus use and MOA ? | * USE: prophylaxis (usually in combo) - + calcineurin inhibitor + glucocorticoid ...... * Binds to FKBP like tacrolimus but Does NOT block IL-2 production, the Sirolimus-FKBP complex binds to mTOR which blocks kinases needed for genes binds mTOR |
MOA basics ? | * Interrupts T-cell activation downstream of IL-2 receptor --> Inhibits proliferation bc stops cell proliferation at G1-S phase |
Sirolimus SEs ? | * hyperlipidemia and myelosuppression --> (thrombocytopenia, anemia, leukopenia) |
Antiproliferative - Azathioprine uses ? | * Prodrug converted to mercaptopurine..... * Primary cytotoxic agent used for immunosuppression to prevent and maintain transplant.... * CAN use in ongoing Rejection |
Azathioprine MOA ? | * the active metabolite (6-MP) Interferes with purine nucleotide de novo synthesis --> inhibits DNA synthesis ..... acts just like the anti-cancer antimetab purine drugs by (-) TMP/IMP synthesis needed for G and A synthesis |
Azathioprine pharmokinetics ? | * Metabolized (cleared) by the enzyme xanthine oxidase..... * So Azathioprine dose reduction required when allopurinol is being used |
Azathioprine SEs ? | * bone marrow suppression -- leukopenia (most common) |
Immunosupressant - Mycophenolate mofetil MOA and USE? | * Selective, noncompetitive inhibitor of IMPDH --> Stops IMP from being made --> no pureines made ..... * Used w/ glucocorticoid + calcineurin inhibitor --- Has mostly replaced azathioprine for maintenance immunosuppression |
Methotrexate use ? | * Used extensively to treat GVHD and Rheumatoid arthritis |
Immunosuppressive Antibodies purpose ? | * lower/impair T-Cells, while keeping humoral immunity intact |
Immunosuppressive Antibody ALG when to use ? | * is a Polyclonal anti-lymphocyte .... * Major use in kidney transplants after transplant .... * |
ATG ? | * Polyclonal anti-thymocyte also.... *Used during acute rejection episodes...... * also be used in immunosuppression like ALG |
ALG & ATG summary ? | * Used to treat donor BM prior to transplantation to destroy T cells to avoid GVHD |
ALG AND ATG SEs ? | * allergic type reactions from body recognizing foreign particles and mounting a response to them |
Muromonab-CD3 (OKT3) MOA? | * Directed against CD3 on surface of human thymocytes & mature T-cells ......... * Shuts down activation of T-cell proliferation |
Muromonab-CD3 (OKT3) uses and SEs ? | * USES: - Treat acute rejection episodes in combination with other drugs --- Deplete donor BM of T-cells prior to BM transplant ...... * not really used anymore bc SEs...... * SEs: fever, chills,and Cytokine Storm ... * body can develop ABs to it also |
Daclizumab & Basiliximab MOA ? | * Monoclonal antibodies to part of IL-2 receptor (CD25) … IL-2 antagonist ...... * prevents IL-2 from binding to lymphocytes...... ---- * Daclizumab – humanized IgG1 ---- Basiliximab – chimeric mouse-human IgG1 |
Daclizumab & Basiliximab use ? | * Can use long term ..... * Primarily used for prophylaxis against acute rejection of renal transplants in combination with cyclosporine and corticosteroids |
For a renal graft rejection, what Treatment (frequency of use) is most commonly used ? | * High dose corticosteroid pulse (76%) - 1st line therapy in most centers ...... * Anti T-cell antibody therapy -- Thymoglobulin (ALG AND ATG)(28%) |
GVHD Prophylaxis ? | * Methotrexate + cyclosporine and deplete T-Cells |
Created by:
thamrick800
Popular Medical sets