Pharmacology Chapter 48: Immunosuppressant Drugs
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Questions and Answers

What is the mechanism of action of immunosuppressant drugs?

  • Macrophages
  • T-lymphocytes (correct)
  • Phagocytes
  • B Cells
  • Which of the following drug(s) are used to prevent rejection of transplanted kidneys?

  • azathioprine (Imuran)
  • basiliximab (Simulect)
  • daclizumab (Zenapax)
  • Both B & C (correct)
  • None of the above
  • What is the purpose of the immune system?

    To distinguish self from nonself and to protect the body from foreign material.

    What are the two types of immunity?

    <p>Humoral immunity and Cellular immunity.</p> Signup and view all the answers

    What are immunosuppressants?

    <p>Drugs that decrease or prevent an immune response.</p> Signup and view all the answers

    What is the mechanism of action of immunosuppressants?

    <p>They suppress certain T-lymphocyte cell lines.</p> Signup and view all the answers

    What are the major classes of immunosuppressants used to prevent organ rejection?

    <p>Glucocorticoids, Calcineurin inhibitors, Antimetabolites, Biologics.</p> Signup and view all the answers

    What is the mechanism of action of corticosteroids?

    <p>They inhibit all stages of T-cell activation.</p> Signup and view all the answers

    What is the mechanism of action of calcineurin inhibitors?

    <p>They inhibit the phosphate required for interleukin 2 production.</p> Signup and view all the answers

    What are examples of immunosuppressant drugs?

    <p>cyclosporine (Sandimmune), azathioprine (Imuran), muromonab-CD3 (Orthoclone), daclizumab (Zenapax), sirolimus (Rapamune), basiliximab (Simulect), glatiramer acetate (Copaxone), tacrolimus (Prograf), mycophenolate mofetil (CellCept).</p> Signup and view all the answers

    What are indications for immunosuppressants?

    <p>Primarily indicated for the prevention of organ rejection.</p> Signup and view all the answers

    What are Muromonab-CD3, mycophenolate, and tacrolimus indicated for?

    <p>Both prevention of rejection and treatment of organ rejection.</p> Signup and view all the answers

    What are Fingolimod and glatiramer indicated for?

    <p>They are indicated for reduction of the frequency of relapses in relapsing-remitting multiple sclerosis.</p> Signup and view all the answers

    What are contraindications for immunosuppressants?

    <p>Known drug allergy, renal or hepatic failure, hypertension, concurrent radiation therapy.</p> Signup and view all the answers

    What are adverse effects of immunosuppressants?

    <p>Increased risk for opportunistic infections and certain types of cancers.</p> Signup and view all the answers

    What is the main adverse effect associated with cyclosporine and tacrolimus?

    <p>Nephrotoxicity.</p> Signup and view all the answers

    What is the main adverse effect associated with corticosteroids, cyclosporine, and tacrolimus?

    <p>Post-transplant diabetes.</p> Signup and view all the answers

    What do patients taking immunosuppressant drugs need to avoid?

    <p>Live vaccines.</p> Signup and view all the answers

    What do immunosuppressant drugs interact with?

    <p>Increased risk for drug interactions and have narrow therapeutic windows.</p> Signup and view all the answers

    Study Notes

    Mechanism of Action

    • Immunosuppressant drugs primarily target and suppress T-lymphocyte cell lines, which are crucial for immune responses.
    • By inhibiting T-lymphocytes, these drugs help prevent immune reactions against transplanted organs.

    Immunosuppressants for Organ Transplantation

    • Basiliximab (Simulect) and daclizumab (Zenapax) are key drugs for preventing kidney transplant rejection, often combined with cyclosporine and corticosteroids.
    • Azathioprine (Imuran) is also used, but basiliximab and daclizumab are specifically highlighted.

    Purpose of the Immune System

    • Protects the body from foreign antigens, including cancers and pathogens.
    • Responsible for transplant rejection and can cause autoimmune diseases by mistakenly attacking self-tissues.

    Types of Immunity

    • Humoral immunity involves B lymphocytes and focuses on antibody production.
    • Cellular immunity involves T lymphocytes, which are vital for direct cellular responses against pathogens.

    Definition of Immunosuppressants

    • These are drugs designed to reduce or prevent immune responses, thus facilitating organ transplant acceptance and treating various autoimmune conditions.

    Classes of Immunosuppressants

    • Major classes include glucocorticoids, calcineurin inhibitors, antimetabolites, and biological agents.

    Specific Mechanisms of Action

    • Corticosteroids inhibit all stages of T-cell activation, offering broad-spectrum immunosuppression.
    • Calcineurin inhibitors block the phosphate necessary for interleukin 2 production, crucial for T-cell activation.

    Examples of Immunosuppressant Drugs

    • Commonly used drugs: cyclosporine (Sandimmune), azathioprine (Imuran), muromonab-CD3 (Orthoclone), daclizumab (Zenapax), sirolimus (Rapamune), basiliximab (Simulect), glatiramer acetate (Copaxone), tacrolimus (Prograf), mycophenolate mofetil (CellCept).

    Indications for Use

    • Immunosuppressants are primarily indicated to prevent organ rejection, though they also treat various immune-mediated disorders.

    Specific Indications

    • Muromonab-CD3, mycophenolate, and tacrolimus are indicated for both organ rejection prevention and treatment.
    • Fingolimod and glatiramer are specifically indicated for reducing relapse frequency in relapsing-remitting multiple sclerosis.

    Contraindications for Immunosuppressants

    • Contraindications include known drug allergies, renal or hepatic failure, hypertension, ongoing radiation therapy, and caution in pregnancy.

    Adverse Effects

    • Increased susceptibility to opportunistic infections and certain cancers, particularly skin cancer.
    • Nephrotoxicity is a significant concern with cyclosporine and tacrolimus.
    • Post-transplant diabetes risk is heightened with corticosteroids, cyclosporine, and tacrolimus.

    Patient Precautions

    • Patients must avoid live vaccines to mitigate the risk of infections due to compromised immunity.

    Drug Interactions

    • Immunosuppressants have narrow therapeutic windows, increasing the potential for drug interactions, necessitating careful monitoring.

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