Week 8A: Immune (Immunosuppressants & NSAIDs)

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Questions and Answers

What are the two most effective immunosuppressants available?

Hydroxychloroquine and Sulfasalazine

Prednisone and Leflunomide

Methotrexate and Azathioprine

Cyclosporine and Tacrolimus (correct)

What is the primary mechanism of action (MOA) of cyclosporine and tacrolimus?

They inhibit calcineurin. (correct)

They block the production of antibodies.

They stimulate T-cell activation.

They enhance the synthesis of inflammatory cytokines.

What role does calcineurin play in the immune response?

It is essential for T-cell activation. (correct)

It promotes antibody synthesis.

It prevents the production of cytokines.

It inhibits T-cell activation.

Which lab tests are especially important to monitor in patients taking cyclosporine and tacrolimus?

Kidney function tests Signup and view all the answers

What symptoms should patients taking cyclosporine and tacrolimus report to their healthcare provider?

Pneumonia-like symptoms Signup and view all the answers

What type of juice should be avoided when taking cyclosporine and tacrolimus?

Grapefruit juice Signup and view all the answers

Why is methotrexate classified as a DMARD?

It alters immune responses. Signup and view all the answers

Which two medications are commonly combined with cyclosporine?

Azathioprine and Methotrexate Signup and view all the answers

Which of the following statements is true regarding the toxicity of tacrolimus and cyclosporine?

Tacrolimus is more toxic than cyclosporine. Signup and view all the answers

Which of the following side effects is commonly associated with tacrolimus and cyclosporine use?

Nephrotoxicity Signup and view all the answers

Which of the following additional medications is often combined with cyclosporine?

Prednisone Signup and view all the answers

What should be monitored to assess nephrotoxicity in patients receiving tacrolimus?

BUN and creatinine levels Signup and view all the answers

Which substance is known to interact negatively with tacrolimus?

Grapefruit juice Signup and view all the answers

Which of the following is NOT a serious side effect associated with tacrolimus and cyclosporine?

Dizziness Signup and view all the answers

Which condition is a contraindication for the use of aspirin?

Peptic ulcer disease Signup and view all the answers

Which of the following side effects is specifically associated with cyclosporine use?

Hirsutism Signup and view all the answers

What general precaution should be taken by patients receiving immunosuppressive therapy?

Avoiding other nephrotoxic agents Signup and view all the answers

Which of the following autoimmune conditions can be treated with methotrexate?

Rheumatoid arthritis Signup and view all the answers

Study Notes

Common Anti-inflammatory Mediators

Cytokines, glucocorticoids (such as cortisol), prostaglandins, nitric oxide, bradykinin, and histamine are key players in inflammation.

Effective Immunosuppressants

Cyclosporine and tacrolimus are the most effective immunosuppressants currently available.

Mechanism of Action (MOA)

Cyclosporine and tacrolimus inhibit calcineurin, an enzyme that triggers the synthesis of Interleukin-2 (IL-2) and various inflammatory cytokines.

Role of Calcineurin

Essential for T-cell activation and transcription of cytokine genes, which are critical for immune response.

Therapeutic Uses

Primarily used to prevent organ rejection in transplant patients and as immunosuppressive agents.

Bone Marrow Suppression

Cyclosporine does not cause bone marrow suppression.

Combination Medications

Often combined with tacrolimus and glucocorticoids such as prednisone to enhance immunosuppression.

Risks Associated

Both cyclosporine and tacrolimus carry a high risk of nephrotoxicity.

Dietary Considerations

Grapefruit juice should be avoided, as it can interact negatively with both medications.

Administration Guidelines

Tacrolimus should not be crushed, and both medications should ideally be taken on an empty stomach.

Toxicity Comparison

Tacrolimus is generally more toxic compared to cyclosporine.

Side Effects

Common side effects include nephrotoxicity, increased risk of infections, and potential carcinogenic effects.

Monitoring Labs

Key labs to monitor include BUN and creatinine (for nephrotoxicity), liver function tests, blood pressure (for hypertension), and blood glucose levels (for hyperglycemia).

Symptoms to Report

Patients should report flu-like symptoms such as fever, chills, and sore throat.

Specific Symptoms for Cyclosporine

Notable specific side effects include hirsutism and gingival hyperplasia.

Patient Education

Patients must be educated to avoid nephrotoxic agents, particularly NSAIDs and aminoglycoside antibiotics.

Therapeutic Ranges

Both cyclosporine and tacrolimus have narrow therapeutic ranges, requiring careful monitoring.

Disease Modifying Anti-Rheumatic Drug (DMARD)

DMARDs, such as methotrexate, are used in the treatment of autoimmune conditions.

Prototype DMARD

Methotrexate is recognized as the prototype DMARD.

Conditions Treated with Methotrexate

Effective in treating autoimmune conditions like psoriasis and rheumatoid arthritis.

Methotrexate Administration Routes

Can be given orally as a tablet or through an autoinjector.

Hepatotoxicity of Methotrexate

Methotrexate is known to be hepatotoxic, requiring monitoring of liver function.

Peptic Ulcer Disease and Aspirin

Peptic ulcer disease is a contraindication for aspirin due to the risk of gastrointestinal bleeding.

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Description

Test your knowledge on immunosuppressants, antihistamines, and NSAIDs with this quiz. Dive deep into the mechanisms of action for medications like Cyclosporine and Tacrolimus and understand their therapeutic uses. Perfect for students looking to solidify their understanding of pharmacology in the immune system.