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Pharm: Immuno-drugs

Terms in this set (33)

Glucocorticoids
•first line immunosuppressive therapy
•interrupts cell cycle of activated lymphoid cells, inhibits NF-kappaB
•decrease synthesis of PG, LT, cytokines that participate in immune responses
•increased use causes diminished humoral immunity, IgG catabolism increases
•Use: Transplant PPx, autoimmune disorders, inflammation
•Tox: Hyperglycemia, osteoporosis, central obesity, muscle breakdown, psychosis, acne, HTN, cataracts, avascular necrosis
Prednisone
• glucocorticoid used for hypersensitivities or allergic reactions
Cyclosporine
•inhibits calcineurinn* and therefore blocks T cell activation by preventing IL-2 transcription
•ORAL or IV
•used in organ transplants, GVH disease, psoriasis, Rheumatoid Arthritis
•Tox: Nephrotoxicity (constricts aff. and eff. vessels), HTN, hyperlipidemia, neurotoxicity, gingival hyperplasia, hirsutism;
Tacrolimus
•inhibits calcineurin - binds NK506 binding protein; blocks Tcell actiation by preventing IL2 transcription
•effective at inhibiting transplant rejection
•Similar to cyclosporine, but inc risk of diabetes and neurtoxicity and NO gingival hyperplasia or hirsutism
Sirolimus (Rapamycin)
•Inhibits mTOR - binds FKBP; prevents T cell activation and B cell differentiation by inhibiting response to IL2
•KIDNEYY* transplant PPx
•similar to tacrolimus and cyclosporin except it inhibits mTOR instead of calcineurin; synergistic with cyclosporine
•Tox: anemia, thrombocytopenia, leukopenia, insulin resistance, hyperlipidemia - NOT nephrotoxic
MMF (mycophenolate mofetil)
•inhibits T and B cells response by inhibiting de novo synthesis of purines (lymphocytes have no salvage pathway to make GTP)
•isolated from penicillin
*1st choice for reducing chronic allograft vasculopathy in heart transplants, GVH, SLE, RA, IBD and dermatology disorders
•not specific for one cell type; patient is left severely IMMUNOCOMPROMISED, GI problems
Azathioprine (6-mercaptopurine)
•Prodrug for 6-MP
•Inhibits lymphocytes proliferation
•interferes with purine nucleic acid metabolism
•Used in renal transplant, lupus, rheumatoid arthritis, Crohn disease, glomerulonephritis, and other AI diseases
•Tox: Bone marrow suppression - leukopenia, anemia, thrombocytopenia; increased when used with ALLOPURINOL: 6-MP degraded by xanthine oxidase
Cyclophosphamide
•DNA alkylating agent that slows or stops cell growth
•chemotherapy drug that destroys lymphoid cells
•Used in lymphomas, organ transplants and rheumatic diseases
•Adverse effects: bone marrow suppression, bladder cancer
Luflunomide
•blocks pyrimidine synthesis
•transplant immunity and RA
Vincristine
•tubulin polymerization
Pentostatin
•adenosine deaminase inhibitor
•prevents allograft rejection
Methotrexate
•anti cancer drug that inhibits dihydrofolate reductase
•used to treat cancers, RA, psoriasis
Muromonab
•blocks CD3 on all T cells
•blocks killing action of cytotoxic T cells
•used to manage renal, cardiac, and liver transplant rejection crises
Abatacept (orencia)
•Binds to B7 on APC and blocks its interaction with CD28 on T Cell; no co-stimulatory response to activate T cells
•used for severe rheumatoid arthritis
Ipilimumab
•Anti-CTLA4 Ab that prolongs T cell activation
•used to treat patients with RA, SLE, MELANOMA
Rituximab
•blocks CD20 on B cell and recruits immune effector functions to mediate lysis
•no co-stimulatory response which would normally cause B cells to differentiate into plasma cells "B cell depletion"
•used for B cell non-Hodgkins lymphoma
Alefacept
•mAb binds to CD2 on T cell
•can't bind to LFA3 on APC
•used to treat psoriasis
Efalizumab
•binds to LFA-1 on T cell
•can't bind to ICAM-1 on APC
•used to treat psoriasis
Adalimumab and infiximab
•anti-TNF alpha monoclonal antibodies
•Infiximab is humanized mAb, Adalimumab is a completely human IgG mAb
Etanercept
•soluble TNF alpha receptor that sequesters TNF alpha with high affinity
•used in arthritis, psoriasis, ankylosing spondylitis
Basiliximab and Daclizumab
•blocks IL2 from binding, prevents T cell proliferation
•used to prevent renal transplant rejection
*Basiliximab is a chimeric human-mouse IgG
Omalizumab
•Anti-IgE mAb that blocks binding of IgE to mast cells
•used to treat severe allergic asthma
Tocilizumab
•inhibits IL6 mediated signaling
Ustekinumab
•blocks IL12 and IL23 from binding to receptors
•used to treat severe plaque psoriasis
Ofatumumab
•binds to CD20 on B cells (different epitope than Rituximab)
•used to treat non-Hodgkin's lymphoma
Bevacizumab and Ranibizumab
•anti-ANGIOGEN drug binds VEGF and prevents vaculogenesis
Cetuximab and Panitumumab
•binds epidermal GF to INHIBIT TUMOR cell growth
•used for colorectal, head and neck cancers
Trastuzumab
•binds extracellular domain of HEGF receptor HER1/neu on tumor cells; cytoxic for breast tumors
•approved for breast cancer
Thalidomide
•sedative drug with TERATOGENIC effects
•suppresses TNF alpha, reduces neutrophil phagocytosis, increases IL-10, alters adhesion molecule expression
•Used to treat SLE, some forms of leprosy, and is an Anti-Cancer drug
Brodalumumab
IL-17 RC- recombinant receptor that binds IL-17 and inhibits its cellular interactions, used for psoriasis
Ixekizumab
a humanized anti-interleukin-17 monoclonal antibody, for psoriasis or IBS treatment
Aldesleukin
recombinant IL-2 and used to stimulate T cell proliferation and cytotoxicity, used to treat metastatic kidney cancer and melanoma.
Alemtuzumab
Alemtuzumab-anti-CD52, (expressed on many cells) used for CLL
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