pharm2

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Author:
Neda317
ID:
296002
Filename:
pharm2
Updated:
2015-07-26 01:01:06
Tags:
immuno
Folders:
pharm
Description:
immuno pg 218-220
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  1. Cyclosporine MOA
    • Calcineurin inhibitor;binds cyclophilin.
    • Blocks T-cell activation by preventing IL-2 transcription.
  2. Cyclosporine use
    Transplant rejection prophylaxis, psoriasis,rheumatoid arthritis
  3. Cyclosporine toxicity
    Nephrotoxicity,hypertension,hyperlipidemia,neurotoxicity,gingival hyperplasia,hirsutism
  4. Tacrolimus (FK506) MOA
    • Calcineurin inhibitor; nephrotoxic.binds FK506 binding protein (FKBP).
    • Blocks T-cell activation by preventing IL-2 transcription.
  5. Tacrolimus (FK506) use
    Transplant rejection prophylaxis.
  6. Tacrolimus (FK506) toxicity
    Similar to cyclosporine, inc. risk of diabetes and neurotoxicity; no  gingival hyperplasiaor hirsutism.
  7. Sirolimus (Rapamycin) MOA
    mTOR inhibitor; binds FKBP.Blocks T-cell activation and B-cell differentiation by preventing response to IL-2.
  8. Sirolimus (Rapamycin) use
    Kidney transplant rejection prophylaxis .
  9. Sirolimus (Rapamycin) toxicity
    Anemia,thrombocytopenia,leukopenia,insulin resistance,hyperlipidemia;not nephrotoxic.

    Kidney “sir-vives.”Synergistic with cyclosporine. Also used in drug eluting stents
  10. Daclizumab,basiliximab MOA
    Monoclonal antibodies; block IL-2R.
  11. Daclizumab,basiliximab use
    Kidney transplant rejection prophylaxis
  12. Daclizumab,basiliximab toxicity
    Edema, hypertension,tremor.
  13. Azathioprine MOA
    Anti metabolite precursor of 6-mercaptopurine.Inhibits lymphocyte proliferation by blocking nucleotide synthesis.
  14. Azathioprine use
    Transplant rejection prophylaxis,rheumatoid arthritis,Crohn disease,glomerulonephritis,other autoimmune conditions.
  15. Azathioprine toxicity
    Leukopenia, anemia,thrombocytopenia.

    6-MP degraded byxanthine oxidase;toxicity inc. by allopurinol. Pronounce “azathiopurine
  16. Glucocorticoids MOA
    • Inhibit NF-κB.
    • Suppress both B- and T-cell function by transcription of many cytokines.
  17. Glucocorticoids use
    Transplant rejection prophylaxis (immunosuppression), many autoimmune disorders,inflammation.
  18. Glucocorticoids toxicity
    • Hyperglycemia,osteoporosis, central obesity, muscle breakdown, psychosis,acne, hypertension,cataracts, avascular necrosis.
    • Can cause iatrogenic Cushing syndrome
  19. Aldesleukin (IL-2) CC use
    Renal cell carcinoma, metastatic melanoma
  20. Epoetin alfa (erythropoietin) use
    Anemias (especially in renal failure)
  21. Filgrastim (G-CSF)
    Recovery of bone marrow
  22. Sargramostim (GM-CSF)
    Recovery of bone marrow
  23. IFN-α
    Chronic hepatitis B and C, Kaposi sarcoma,malignant melanoma
  24. IFN-β
    Multiple sclerosis
  25. IFN-γ
    Chronic granulomatous disease
  26. Romiplostim, eltrombopag
    Thrombocytopenia
  27. Oprelvekin (IL-11)
    Thrombocytopenia
  28. TARGET CLINICAL USE NOTES
    Alemtuzumab
    • CD52,
    • CLL
    • “Alymtuzumab”—chroniclymphocytic leukemia
  29. TARGET CLINICAL USE NOTES
    Bevacizumab
    • VEGF
    • Colorectal cancer, renal cellcarcinoma
  30. TARGET CLINICAL USE NOTES
    Cetuximab
    • EGFR
    • Stage IV colorectal cancer,head and neck cancer
  31. TARGET CLINICAL USE NOTES
    Rituximab
    • CD20
    • B-cell non-Hodgkinlymphoma, CLL, rheumatoidarthritis, ITP
  32. TARGET CLINICAL USE NOTES
    Trastuzumab
    • HER2/neu
    • Breast cancer HER2—“tras2zumab”
  33. TARGET CLINICAL USE NOTES
    Adalimumab,infliximab
    • Autoimmune disease therapy
    • -Soluble TNF-α IBD, rheumatoid arthritis,ankylosing spondylitis,psoriasis
    • -Etanercept is a decoyTNF-α receptor and not a monoclonal antibody
  34. TARGET CLINICAL USE NOTES
    Eculizumab
    • Autoimmune disease therapy
    • Complement protein C5 Paroxysmal nocturnal hemoglobinuria
  35. TARGET CLINICAL USE NOTES
    Natalizumab
    • Autoimmune disease therapy
    • -α4-integrin Multiple sclerosis, Crohn disease
    • -α4-integrin: WBC adhesion Risk of PML in patients with JC virus
  36. TARGET CLINICAL USE NOTES
    Abciximab
    • -Platelet glycoproteins IIb/IIIa Antiplatelet agent for prevention of ischemic complications in patients undergoing percutaneous coronary intervention
    • -IIb times IIIa equals“absiximab”
  37. TARGET CLINICAL USE NOTES
    Denosumab
    • -RANKL
    • -Osteoporosis; inhibits osteoclast maturation (mimics osteoprotegerin)
    • -Denosumab affects osteoclasts
  38. TARGET CLINICAL USE NOTES
    Digoxin immune Fab
    Digoxin Antidote for digoxin toxicity
  39. TARGET CLINICAL USE NOTES
    Omalizumab
    IgE Allergic asthma; prevents IgE binding to FcεRI
  40. TARGET CLINICAL USE NOTES
    Palivizumab
    • -RSV F protein
    • -RSV prophylaxis for high-risk infants
    • -PaliVIzumab—VIrus
  41. TARGET CLINICAL USE NOTES
    Ranibizumab,bevacizumab
    VEGF Neovascular age-related macular degeneration

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