immunosurp

all dividing cells (use as a combo)

azathioprine
CCS, S phase
prevent GRAFT rejection, IV hypersent

6-thioinsoic A (nucleotide) inhib purine nuc interconversion

no B & T expansion

- acts like a false substate for purine - no DNA

inhibits PRPP synthe (purine syn pathway)

salvage pathway inhib for purine ((act like analogues)

use small freq does then large
ones

metabolite = thiourate (wont cause gout) , but other purines spilling out will cause gout

Give ALLOPURINOL...uses Xanthine oxidase...

Mercaptopurine ..another immunosuppressent...& using XO, but competes with allo...so reduce the dose of M to prevent toxic levels

lyphotoxic

ALG - from horsey
-Prophlaxis kid rejction, acute rejection, GvH (BMT)
BLOCKS CELL IMMUNITY not Ab formation, binds to T...destroyed by Complment

adverse - IV rnx, type III (jt pain)

Immune globulin (IV) - prep from a pool of donors has no spec ag
- USE AUTOIMMUNE DISEASE
Kawasaki - disease, SLE, hep A,

Rho(D) immune globulin - newborn hemolytic, give Rho + after Rho + baby is born...ok for future

Muromonab- CD3 - Ab to CD3, acute renal allograft rejction, use when rejection ressiant to steriods
- adverse = cytokine release syndrome, avoid by infusion steriods first

Asparaginase
Steroids (glucocorticosteroids)

subpop of immune compt cells

cyclosporine - calcineruin inhibitor
can't dephos NF-AT...can't go into cell and produce IL-2 to make T cells & TNF-B made more impairs proliferation

enters lymphs by DIFFUSION
-organ transplant, GvH, glomerular nephritis (type 1 diabetes

cyclosporine -work on cyclophillin A
tacrolimus (FK506) - works on FKBP-12

USE - GIVE B4 Transplant...but nephrotox..so delay till acceptable renal function reached

adverse - nephro, osteroporis (LT use)

TACROLIMUS - atopic derm too, not as nephrotoxic, 10-100x more potent

Sirolimus (rapomycin) - CHD (reduce stenosis) - binds to FKBP which blocks mTOR not calcineruerin
- no G1-S phanse, not NEPHROtoxic,
increases Cp450 Pa4!....reduces Ab titer

Myophenolate mofetil - prophax of renal, hepatic and ardiac

SLE
inhibts Inosine monophophate Dehydro...stops guanine synthesi
stops B and T!

adverse - Leukopenia/neutropenia
-dont use in PREG, might reduce effective contraceptive pills

target cytokines or receptors for cytokines

etanercept - binds to TNF-A...can't bind to its nml receptor
use in -
RA, methotrexate regments, immnosupress
(not an AB)

infliximab - is an AB (actually binds TNF-alpha-)
- get serum sickness
DO NOT USE IN ANY INFECTION or chronically immunosurpessed pts

dacizuamb - binds to IL-2 receptors....no activation of CD4

corticosteriods - immunosupress/anti-inflam

fackin beevy