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Pharm 45 Immunosuppr

Pharm

QuestionAnswer
Inhibit inosine monophosphate dehydrogenase (IMPDH)->no guanosine for solid organ transplant, Lupus nephritis, RA. SE: HTN, periph edema. Don't take w iron (reduces bioavailability). Mycophenolic acid, Mycophenolate mofetil
Inhibit dihydroorotate dehydrogenase (DHOD)->no pyrimidine for RA. SE: HTN, hepatotox, alopecia. Contra: Preg Leflunomide
Inhibit phosphatase activity of calcineurin (mediates T-cell activation) also inhibits IL-2 production from T-cells for Keratoconjunctivitis sicca (topical). SE: Nephrotox, HTN, neurotox, hepatotox, infx, gingival hyperplasia, hyperlipid, hirsutism Cyclosporine
Complex w FK-binding prot inhibits calcineurin for organ transplant, atopic dermatitis (topical). SE: nephrotox, HTN, prolong QT, hypergly, alopecia Tacrolimus
Complex w FK-binding prot inhibits mTOR for prophylax of renal transplant rejection, cardiac stents. SE: HTN, periph edema, infx, alopecia Sirolimus (Rapamycin)
TNF receptor dimer (inhibits both TNF-Alpha and Beta) for RA, Juvenile Idiopathic Arthritis, plaque psoriasis, Ankylosing spondylitis. SE: Myelosuppress, heart fail, optic neuritis, REACTIVATE TB. Contra: Sepsis, heart fail. Etanercept
Monoclonal antibod that binds to TNF-Alpha selectively for RA, Crohn's, UC, Anklylosing spondylitis. SE: myelosuppress, heart fail, optic neuritis, REACTIVATE TB. Infliximab - partially human mouse antibod Adalimumab - also for JIA, not for UC. Golimumab - not for UC or Crohn's. also fully human IgG1 antibod w longer half-life than adalim Certolizumab - only Crohn's. pegylated anti-TNF-Alpha antibod fr
IL-12 and IL-23 p40 inhibitor for Plaque psoriasis. SE: infx, URI. Ustekinumab
IL-1 receptor antagonist for RA (reduces bony erosions). SE: neutropenia, infx. Anakinra
IL-1 inhibitor for Cryopyrin-asso periodic fever synds (familial cold autoinflamm synd and Muckle-Wells synd). SE: infx. Rilonacept: soluble IL-1 receptor FC fusion prot Canakinumab: IgG1 monoclonal antibod to IL-1Beta
Antibod to IL-6 receptor for RA. SE: infx, GI perforation. Contra: live vaccines. Tocilizumab
Polyclonal bunny/horse antibod against T-cell epitopes for Renal transplant, aplastic anemia. SE: cytokine release synd (cytokine storm=fever, shaking, chills, myalgia, HA), infx. Antithymocyte globulin (ATG)
Mouse monoclonal antibod against CD3 for Organ transplants. SE: Cytokine release synd(cytokine storm=fever, shaking, chills, myalgia, HA), infx. Contra: heart fail, seizure, Preg/breastfeed OKT3
Anti-CD20 antibod for B-cell NHL, CLL, RA. SE: immunosuppress, progressive multifocal leukoencephalopathy (PML), tumor lysis synd. Rituximab
Antibod to CD25 (high affinity IL-2 receptor) for organ transplant. SE: immunosuppress, progressive multifocal leukoencephalopathy (PML), tumor lysis synd. Daclizumab
Antibod to CD52 (campath-1) for CLL. SE: immunosuppress, progressive multifocal leukoencephalopathy (PML), tumor lysis synd. contra: active infx Alemtuzumab
inhibit T-cell activation by binding to CD2 for Psoriasis. SE: immunosuppress, progressive multifocal leukoencephalopathy (PML), tumor lysis synd. Contra: HIV. Alefacept
Prevents co-stimulatory signal->T-cell anergy and apoptosis for RA refractory to methotrexate or TNF-Alpha inhibitors. SE: COPD Abatacept
Monoclonal antibod against alpha-4 integrin for MS, Crohn's. SE: PML. Contra: PML. Natalizumab
Monoclonal antibod against C5 (part of MAC) for Paroxysmal Nocturnal Hemoglobinuria. SE: infx. Contra: N. meningitidis. Monitor pts for intravasc hemolysis and elevated LDH after discontinuing tx. Eculizumab
Created by: Jakphooey
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