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mechanism of calcineurin inhibitors?
Inhibit calcineurin by suppressing IL-2
primary use for calcineurin inhibitors?
patients with hx of transplant
action of cyclosporine?
suppresses production of IL-2; inhibits B cells and cytotoxic T cells
adverse effects of cyclosporine?
- nephrotoxicity (up to 75% of patients)
- hepatotoxicity, lymphoma
cyclosporine usually used in combo with what other drug?
glucocorticoids (e.g., Prednisone)
fx of B lymphocytes?
fx of cytolytic T cells?
attack and kill cells directly
fx of helper T cells?
promote proliferation of B cells
sirolimus is used specificially for what?
prevention of renal transplant rejection
side fx of sirolimus?
- increased cholesterol and triglycerides
- increased risk of infection
- increased risk of renal injury
sirolimus given prophylactically for what?
PCP (~1 year) and CMV (~3 mos)
glucocorticoids (prednisone) therapeutic uses?
used for flares of inflammatory diseases, eg asthma, chrons disease, ulcerative colitis, IBD
long-term side fx of prednisone?
- in children: impaired growth
cytotoxic drugs' mechanism of action?
- suppresses immune response
- kills B and T lymphocytes that are undergoing proliferation
cytotoxic drugs' side fx?
- bone marrow suppression
? > ? / ? < ?
- WBC > hgb / Hct < platelets
- 3.5-11 > 120-175 / 31-53 < 140-450
azathropine, cyclophosphamide, methotrexate, CellCept - what class?