Pharmacolcogy Immunopharm

• 1st hormonla agent with lympholytic properties
• reduces size and lymphoid content of LN and spleen
• interfere with lymphocyte cell division
• No effect on myeloid and erythroid stem cells
• Effect on CMI>HMI
• Prednisone!!!!: idiopathic thrombocytopenic pupura, rheumatoid arthritis, autoimmune hemolytic anemia, asthma, organ and bone marrow transplant

• calcineurin inhibitors
• peptide antibiotic
• oral, IV, used alone or in combo
• used for organ transplant, evere dry eye syndrome

binds to cyclophilin for form complex, which inhibits calcineurin, which is responsible for T cell transcription factor for synthesis of IL2

• NEPHROTOXIC
• hypertension
• hyperglycemia
• liver dysfunction
• seizure
• metastiasis

• calcineurin inhibitor
• macrolide antibiotic
• not related to CSA but mech is same (binds with FK binding protein that inhibits calcineurin)
• 10-100 times more potent than CSA
• organ transplant
• Metabolized by CYP450
• T1/2 9-12 h
• NEPHROTOXIC

• Proliferation signal inhibitors
• binds with FKBP and targets mTOR --> inhibits T cell proliferation
• metabolized through CYP450(drug interaction with CSA)
• Sirolimus t1/2: 60 hr
• Everolimus t1/2: 43 hr
• prevents graft rejection
• uveoretnitis with CSA
• Toxicity: myelosupression, hepatotoxicity, diarrhea, NO NEPHROTOXICITY (good alternative to CSA)

• semi synthetic derivative of mycophenolic acid
• Inhibits T and B cell proliferation in tissue culture (purine synthesis inhibition (adenine and quanine))
• Oral and IV
• for solid organ transplant, RA, and IBD
• Toxic: gi problems, ha, hypertension, reversible myelosuppression

• sedative drug, teratogenicity in pregnant women
• immunomodulator
• inhibits angiogenesis, antiinflammatory, multiple myeloma, solid tumor, lupus erythematosus
• Inhibits TNF-alpha, reduce phagocytosis by neutrophils, increase IL10, enhanced CMI
• Toxic: tertogenesis, peripheral neuropathy, rash, constipation, fatigue, deep vein thrombosis

• cytotoxic agent
• percaptopurine prodrug
• GI absoption
• Xanthine oxidase converts active compound into 6-thiouric acid-excreted through urine
• interferes with purine metabolism
• good for renal allografts, RA, crohn disease, MS
• Toxic: bone marrow suppression, thrombocytopenia, rash, fever, nausea, hepatic dysfunction

• cytotoxic agents
• One of most efficacious immunosuppressive drugs
• destoys dividing lymphoid cells , but also effects resting cells
• Good for SLE, autoimmune hemolytic anemia
• Toxic: n/v, cardiac, electrolyte imbalance

• cytotoxic agents
• Inhibitor of pyrimidine synthesis
• long half life
• orally active
• good for RA
• Toxic: liver enzyme, renal impairment, teratogenic

• cytotoxic agent
• antimalarial
• affects intracellular antigen processing and loading of epitope on MHC classII
• Used for RA and SLE

• oral drug for relapsing MS
• Sphingosine 1-phosphate receptor modulator
• reduces lymphocyte migration from lymph node to brain
• reduces counts 20-30%
• Side effects: decrease heart rate, slight increase in bp, fetal harm

• anti lymphocyte or thymocyte antibodies
• used in transplants

• antilymphocyte or thymocyte antibodies
• used for bone marrow transplant

local pain, erythema, type3 hypersensitivity

• IGIV prepared form healthy volunteers
• Kawasaki disease: prevents coronary artery aneurysm
• Helps in SLE, and ITP (idiopathic thromocytopenic purpura
• Mech of action unclear

• Target: TNF-alpha
• Disease: auto-immune

• Target: CD25
• Disease: transplant rejection

• CD25
• Transplant rejection

• CD11a
• psoriasis

• TNF-alpha
• arthritis and crohns

• IL-5
• hypereosinophilic syndrome

• a4 integrin
• MS
• crohns disease

• IgE
• allergy

• VEGF-A
• macular degeneration

• phagocytosis
• activation of bact mech
• antigen presenting

• antigen uptake in periphery
• antigen presenting in lymph node

• phagocytosis
• activation of bact mech