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Biologic Response Modifiers BRMs
- used to enhance the body's immune system
- Enhance host immunologic function (immunomodulation)
- Destroy or interfere with tumor activites (cytotoxic/cytostatic effects)
- Promote differentation of stem cells (other biologic effects)
- regulate the immune system to improve resistance to invading micro-organisms
- reduce cell proliferation
- Type 1: Alpha and Beta - bind selectively to either alpha or beta cell surface receptors on effector cells
- Type 2: gamma - binds to different cell surface receptor
- -Produced by B, T cells, macrophages.
- has antiviral antiproliferative, and immunomodulatory effects
- inhibits intracellular replication of viral DNA, interferes with tumor cell groth and enhances natural killer cell activity
- treats: hairy cell leukemia, chronic phase piladelphia chromosome positive chronic myelogenous leukemia, follicular non-Hodgkins lymphoma, AIDS related kaposi sarcoma, non-malignant condition-chronic hepatitis
- SA: flulike syndrom - may progress to rigors.
- Dose limiting: fatigue, anorexia
- enhances the activity of suppressor T cells
- reduces the production of proinflammatory cytokines
- reduces antigen presentation
- inhibits the movement of lymphocytes in the CNS
- treats: multiple sclerosis
- delays time to disease progession of severe malignant osteopetrosis
- reducing the frequency and severity of serious infections related to chronic granulomatous disease
- Enhances oxidative metabolism of pacrophages
- enhances antibody-dependent cell cytotoxicity
- activates natural killer cells
- enhanses the Fc receptors on the antibody and major histocompatibility antigens
Erythropoietin Stimulating Agents
- stimulates red blood cell production
- Monitor hemoglobin closely - should never excede 12g/dl
- SA: hypertension, headache, arthalgias, N&V&D, edema, fatigue, chest pain, injection site skin reaction, asthenia, dizziness, seizures, thrombosis, allergic reactions.
- Contra: uncontrolled hypertension, known hypersensitivity to mammalian cell-derived products, known hypersensitivity to human albumin or polysorbate.