What is the MOA of cyclosporine?
binds to cyclophilins to form a complex that blocks the differentiation and activation of T cells by inhibiting calcineurin. This results in the prevention of production of IL-2 and its receptor
When would you prescribe cyclosporine?
to suppress organ rejection after transplants and in some immunocompromised states
What are the toxic effects associated with Cyclosporine?
predisposes patients to viral infections and lymphomas, and it can precipitate gout, and will be nephrotoxic if not given with mannitol to elicit diuresis
What is the MOA of tacrolimus?
binds to Fk binding protein in order to inhibit the secretion of IL2 and other cytokines
What would you prescribe tacrolimus for?
Potent immunosuppression for post transplantation
What are the 5 significant toxicities of tacrolimus?
What is the MOA of sirolimus (rapamycin)?
Inhibits mTOR to inhibit T cell proliferation in response to IL2
What would you prescribe sirolimus for?
immunosuppression after kidney transplantation in combination with cyclosporine and corticosteroids. Also can be used with drug-eluting stents.
What are the three toxic side effects of sirolimus?
What is the MOA of daclizumab?
monoclonal antibody with high affinity for the IL2 receptor on the activated T cells
What is the MOA of Azathioprine?
Antimetabolite precursor of 6MP that will interfere with the metabolism and synthesis of nucleic acids, therefore making it toxic to proliferating lymphocytes
What three occasions would you prescribe azathioprine?
and autoimmune etiologies of:
What are the toxic effects of azathioprine?
It can cause bone marrow suppression, and it is also metabolized by xanthine oxidase which means the toxicity can be increased in pateints that are concurrently taking allopurinol
What is the MOA of muromonab CD3?
monoclonal antibody that binds to CD3 (which is the epsilon chain) on the surface of T cells. It blocks the cellular interaction with CD3 which is crucial to T cell signal transduction
What are the toxic effects of muromonab CD3?
you can get a cytokine release syndrome or a hypersensitivity reaction
What is aldesleukin?
Interleukin-2 which can be administered in Renal Cell carcinoma or metastatic melanoma
What is filgrastim?
G-CSF to recover bone marrow
What is Sargramostim?
GM-CSF to recover bone marrow
What is Oprelvekin?
interleukin-11 in order to treat a thrombocytopenia
Infliximab targets ________?
TNF-a to treat Crohns disease, RA, ankylosing spondylitis, and psoriatic arthritis
Adalimumab targets _________?
TNF-alpha in order to treat Crohns, RA, or psoriatic arthritis
Abciximab targets ___________?
glycoprotein IIb/IIIa to prevent cardiac ischemia in unstable angina of patients that have been treated with percutaneous coronary interventions.
Rituximab targets __________?
CD20 in order to treat a B cell NHL
Omalizumad targets ______?
IgE and can be used as an additional line in the treatment of severe asthma