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transplant drugs.

therapeutics

QuestionAnswer
cyclosporine calcineurin inhibitor (neoral, gengraft, sandimmune, sangcya), reduction of transcription of cytokine genes needed for Tcell activation
tacrolimus calcineuron inhibitor(prograft) , reduction of transcription of cytokine genes needed for Tcell activation
mycophenolate mofetil (cellcept)inhibition of lymphocyte proliferation, inhibits IMPDH which inteferes with purine metabolism required for lymphocyte development
mycophneolic acid (myfortic) inhibition of lymphocyte proliferation, inhibits IMPDH which inteferes with purine metabolism required for lymphocyte development
Sirolimus (Rapamycin) m-TOR inhibitors, IL2 stimulates m-TOR to activate kinase enzymes that promote cell division (G1-S phase), cytokines activate TOR
Everolimus (EVER) m-TOR inhibitors, Zortress for prevention of kidney rejection, Afinitor for cancer advanced- ca and tumors
induction immunosuppression poly/monoclonal antibody, Azathioprine, mycophenolate mofetil, glucocorticoids (methylprdeisolone/prednisone) followed by calcineuron inhibitors or tacrolimus
ATGAM polyclonal antibody from horses, depleting induction, T cells opsonized and then destroyed by complement system
thymoglobin polyclonal antibody from rabbits, depleting induction, T cells opsonized and then destroyed by complement system
alemtuzamab monoclonail antibody (CAMPATH-1 H), depleting induction, acts directly on CD52, given with methylprednisolone
OKT3 mouse monoclonial anti CD3, binds CD3 complex associated w/ TCR and triggers then blocks the TCR and inactivates or kills the T cell, short t1/2, neutralized by AB response, 1st dose cytokine release syndrome
ALG,ATG polyclonal horse/rabbit antilymphoctye/thymocyte globulin, contains AB against protiens on lymphocytes that alter traffic, trigger, kill and sequester the T/B lymphocytes. 1st dose cytokine releasesyndrome, thrombocytopenia, leukopenia
basiliximab non-depleting (simulect) binds to CD25 in IL2 receptor complex, rendering all T cells resistant to IL2, long half life once CD25 is saturated, virtually no toxicity
Azathioprine anti proliferative drug (inhibition of lymphocyte proliferation), anti-metabolite and immunosuppressive effects resulting in inhibition on DNA and RNA and protien synthesis to inhibit lymphocyte prolieferation
glucocorticoids prednisone and methylpredisolone sodium succinate, general immunosuppressive, inhibit IL1 and IL2 which decreases activation and proleiferation of T cells
Belatacept (Nulojix)signal 2 selective co-stimulation blocker, binds co-stimulatory B7 ligands receptors(CD80 or C86) on APC and prevents interaction with CD 28 on t cels to inhibit t cell activation
dacilizumab non depleting(zanapax) binds to CD25 in IL2 receptor complex, rendering all T cells resistant to IL2, long half life once CD25 is saturated, virtually no toxicity
Created by: Kachmiel
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