NURS549 Final Exam Latest Update
2 Monoclonal immunosuppressive Antibody Drugs - Answer Daclizumab(zenapax)-
Reduces activated T-cell numbers and activities by binding to interlukin
Muromonab(orthoclone)-Binds to CD3 receptors on T cells and disrupts function.
Depletes circulating T cells
Monoclonal Antibody drug MOA - Answer Clinical application is in TARGETING T-CELLS
AS ANTIGENS, tagging them for attack, disrupting T-Cell ( Cell Mediated Immunity )
function and ultimately providing immunosuppression
Cloned from Bcells
used for transplant rejection
2 antimetabolite drugs for immunosupressant - Answer Azothioprine ( Imuran)- Purine
analog LYMPHOCYTES ( T-CELLS & B-CELLS) ARE PREDOMINATELY AFFECTED BY
THE CYTOTOXIC EFFECTS OF AZATHIOPRINE.!!!!!!! , and this gives immunosupression
Mycophenolate ( Cellcept)- It inhibits the enzyme ( inosine monophosphate
dehydrogenase) that controls the rate of synthesis of the nucleotide ..Guanine
MonoPhosphate (GMP)
Antimetabolite MOA - Answer ( Purine Analogues) are drugs that mimic the structure of
metabolic purines, and do not allow synthesis of DNA.
T-Cells and B-Cells, are rapidly proliferating cells and are cells that are particularly
affected by the inhibition of purine synthesis.
T-Cell and B-Cell production is inhibited and Immunosuppression is accomplished.!!!!!!
generally used in combination with corticosteroids and the Inhibitors of Cytokine
Production
2 Selective Cytokine production inhibitors - Answer Cyclosporine ( Neoral,
Sandimmune)-Cyclosporine complex that binds to the calcineurin does not allow the
normal dephosphorylating of the NFATs to occur, and therefore, they CANNOT enter the
nucleus and promote the cytokine synthesis
Tacrolimus ( Prograf )-exerts its immunosuppressive effect in the same manner as
cyclosporine, except it binds to a different immunophilin in the T-Cell
lowers the risk of organ rejection!!!!!
Selective Cytokine production inhibitor MOA - Answer They both enter the cell....form
complexes within the cell that ultimately inhibit the production of cytokines...specifically
Interleukin-2
,Cold versus Flu onset symptoms - Answer Flu-Sudden chills, severe cough,
aches,fatigue, fever 3-4days, headache
Cold- Gradual, sneezing sore throat common, rarely get a fever ,headache or chills
Viral Neuraminidase - Answer an enzyme found on the surface of influenza viruses that
enables the virus to be released from the host cell after replication
Neraminidase inhibitors - Answer Oseltamivir ( Tamiflu)
Zanamivir ( Relenza)
MOA- Both prevent new viral particles from being released by the infected host cell by
serving as a competitive inhibitor of the enzyme,
nucleoside analog reverse transcriptase inhibitors - Answer It is an ANALOG or
'FAULTY VERSION' of DNA building blocks which is wrongly used by reverse
transcriptase to convert RNA to DNA.When the reverse transcriptase uses these faulty
building blocks, the new DNA cannot be built correctly, and new viral cells are
prevented from being produced.
Inhibits both Hepatitis B Virus and (in a lower doses) HIV Virus Reverse Transcriptase
which is used by the viruses in their replication process. ( note exclusion of Hepatitis C
Virus)
NARTI drugs - Answer Tenofovir ( Viread) - for CHB
Lamivudine( Epivir )- for CHB
excludes Hep C
Interferon free antiviral drugs - Answer Viekira Pak-Ombitasvir - is a NS5A inhibitor with
potent pangenotypic picomolar antiviral activity. ( a zinc-binding and proline-rich
hydrophilic phosphoprotein that plays a key role in Hepatitis C virus RNA replication)
Paritaprevir - is an inhibitor of the NS3/4A serine protease. (The NS3/4A serine protease
is required for self-cleavage during viral replication, but may also inhibit activation of
interferon signalling pathways in infected cells )
Dasabuvir - non-nucleoside NS5B polymerase inhibitor. ( has the key function of
replicating the HCV's viral RNA )
Sofosbuvir - ( Solvadi )
Ledipasvir + Sofosbuvir ( Harvoni )
Simeprevir ( Olysio)
Daclatasvir ( Daklinza )
90% cure rate
,no bone marrow suppression
Zostavax - Answer a live vaccine that has been shown to reduce the incidence of herpes
zoster (known as shingles) by 51.3% in a study of 38,000 adults aged 60 and older who
received the vaccine
shingles (herpes zoster) - Answer painful, blistering skin rash due to the varicella-zoster
virus, the virus that causes chickenpox; the virus remains inactive (becomes dormant)
in certain nerves in the body. Shingles occurs after the virus becomes active again
common groups
older than 60
chickenpox before age 1
Your immune system is weakened by medications or disease
Non-nucleoside reverse transcriptase inhibitors - Answer simply attach themselves to
reverse transcriptase and prevent that enzyme from converting RNA to DNA
Non-nucleoside reverse transcriptase inhibitor drugs - Answer Efavirenz ( Sustiva)
Nevirapine ( Viramune )
Etravirine ( Intelence)
Protease inhibitor - Answer prevents release of viral proteins and subsequent
maturation of infectious particles
Protease inhibitor drugs - Answer RITONAVIR ( NORVIR)
NELFINAVIR (VIRACEPT)
Common side effects of chemo - Answer myelosuppression (decreased production of
blood cells in the bone marrow, hence also immunosuppression via WBC suppression in
the bone marrow ),
mucositis (inflammation of the lining of the digestive tract)
alopecia (hair loss), and
darkening of skin and nails
Antimetabolite Anti-cancer drugs - Answer 6-Mercaptopurine ( 6-MP) -(Purinethol)
6- Thioquanine
MOA Antimetabolite anti-cancer drug - Answer They interfere with the availability of the
normal Purine and Pyrimidine DNA bases in DNA synthesis by competing with them in
rapidly proliferating cells
, Antibiotic "Anthracycline" Anticancer MOA - Answer Inhibits DNA and RNA synthesis by
intercalating into the minor groove between base pairs of the DNA/RNA strand, thus
preventing the replication of rapidly-growing cancer cells.
Inhibits an enzyme needed for DNA transcription.
Antibiotic "Anthracycline" Anticancer Drugs - Answer Doxorubicin
Daunorubicin
Trastuzumab( Herceptin) - Answer Monoclonal Antibody Anticancer drug for breast
cancer
binds to the HER receptor
3-Hydroxy-3-MethylGlutaryl Coenzyme A Inhibitors - Answer AKA- Statins
MOA - ( very straight forward ) - This group of drugs block cholesterol synthesis ( at
3-Hydroxy-3-MethylGlutaryl Coenzyme A ) , and are the first-line and more effective
treatment for patients with elevated LDL cholesterol.
analogs of HMG Co-A Reductase, the precursor of cholesterol, and replace HMG COA ,
and block the second step in cholesterol synthesis
Statin drugs - Answer Simvastatin ( Zocor)
Atorvastatin ( Lipitor)
Lovastatin ( Mevacor)
Rosuvastatin ( Crestor
Niacin ( Nicotinic Acid, Vitamin B3) - Answer Can reduce LDL levels by 10 to 20 %, and is
the MOST EFFECTIVE AGENT FOR INCREASING good HDL LEVELS.
Therefore they are used in combination with statins
MOA for Reduced LDL levels:
inhibits lipolysis in adipose tissue ( the primary producer of circulating free fatty acids).
The liver normally uses these circulating free fatty acids as a major precursor to
Triglycerides, VLDL, and LDL.
Thus, plasma triglycerides, and cholesterol in VLDL and LDL is reduced...!!!!
MOA for Increased HDL levels:
Not well understood, but seems to prevent or inhibit HDL hepatic uptake maintaining
them in circulation
Fibric Acid Derivatives - Answer Significant decrease in Triglycerides, moderate effect
2 Monoclonal immunosuppressive Antibody Drugs - Answer Daclizumab(zenapax)-
Reduces activated T-cell numbers and activities by binding to interlukin
Muromonab(orthoclone)-Binds to CD3 receptors on T cells and disrupts function.
Depletes circulating T cells
Monoclonal Antibody drug MOA - Answer Clinical application is in TARGETING T-CELLS
AS ANTIGENS, tagging them for attack, disrupting T-Cell ( Cell Mediated Immunity )
function and ultimately providing immunosuppression
Cloned from Bcells
used for transplant rejection
2 antimetabolite drugs for immunosupressant - Answer Azothioprine ( Imuran)- Purine
analog LYMPHOCYTES ( T-CELLS & B-CELLS) ARE PREDOMINATELY AFFECTED BY
THE CYTOTOXIC EFFECTS OF AZATHIOPRINE.!!!!!!! , and this gives immunosupression
Mycophenolate ( Cellcept)- It inhibits the enzyme ( inosine monophosphate
dehydrogenase) that controls the rate of synthesis of the nucleotide ..Guanine
MonoPhosphate (GMP)
Antimetabolite MOA - Answer ( Purine Analogues) are drugs that mimic the structure of
metabolic purines, and do not allow synthesis of DNA.
T-Cells and B-Cells, are rapidly proliferating cells and are cells that are particularly
affected by the inhibition of purine synthesis.
T-Cell and B-Cell production is inhibited and Immunosuppression is accomplished.!!!!!!
generally used in combination with corticosteroids and the Inhibitors of Cytokine
Production
2 Selective Cytokine production inhibitors - Answer Cyclosporine ( Neoral,
Sandimmune)-Cyclosporine complex that binds to the calcineurin does not allow the
normal dephosphorylating of the NFATs to occur, and therefore, they CANNOT enter the
nucleus and promote the cytokine synthesis
Tacrolimus ( Prograf )-exerts its immunosuppressive effect in the same manner as
cyclosporine, except it binds to a different immunophilin in the T-Cell
lowers the risk of organ rejection!!!!!
Selective Cytokine production inhibitor MOA - Answer They both enter the cell....form
complexes within the cell that ultimately inhibit the production of cytokines...specifically
Interleukin-2
,Cold versus Flu onset symptoms - Answer Flu-Sudden chills, severe cough,
aches,fatigue, fever 3-4days, headache
Cold- Gradual, sneezing sore throat common, rarely get a fever ,headache or chills
Viral Neuraminidase - Answer an enzyme found on the surface of influenza viruses that
enables the virus to be released from the host cell after replication
Neraminidase inhibitors - Answer Oseltamivir ( Tamiflu)
Zanamivir ( Relenza)
MOA- Both prevent new viral particles from being released by the infected host cell by
serving as a competitive inhibitor of the enzyme,
nucleoside analog reverse transcriptase inhibitors - Answer It is an ANALOG or
'FAULTY VERSION' of DNA building blocks which is wrongly used by reverse
transcriptase to convert RNA to DNA.When the reverse transcriptase uses these faulty
building blocks, the new DNA cannot be built correctly, and new viral cells are
prevented from being produced.
Inhibits both Hepatitis B Virus and (in a lower doses) HIV Virus Reverse Transcriptase
which is used by the viruses in their replication process. ( note exclusion of Hepatitis C
Virus)
NARTI drugs - Answer Tenofovir ( Viread) - for CHB
Lamivudine( Epivir )- for CHB
excludes Hep C
Interferon free antiviral drugs - Answer Viekira Pak-Ombitasvir - is a NS5A inhibitor with
potent pangenotypic picomolar antiviral activity. ( a zinc-binding and proline-rich
hydrophilic phosphoprotein that plays a key role in Hepatitis C virus RNA replication)
Paritaprevir - is an inhibitor of the NS3/4A serine protease. (The NS3/4A serine protease
is required for self-cleavage during viral replication, but may also inhibit activation of
interferon signalling pathways in infected cells )
Dasabuvir - non-nucleoside NS5B polymerase inhibitor. ( has the key function of
replicating the HCV's viral RNA )
Sofosbuvir - ( Solvadi )
Ledipasvir + Sofosbuvir ( Harvoni )
Simeprevir ( Olysio)
Daclatasvir ( Daklinza )
90% cure rate
,no bone marrow suppression
Zostavax - Answer a live vaccine that has been shown to reduce the incidence of herpes
zoster (known as shingles) by 51.3% in a study of 38,000 adults aged 60 and older who
received the vaccine
shingles (herpes zoster) - Answer painful, blistering skin rash due to the varicella-zoster
virus, the virus that causes chickenpox; the virus remains inactive (becomes dormant)
in certain nerves in the body. Shingles occurs after the virus becomes active again
common groups
older than 60
chickenpox before age 1
Your immune system is weakened by medications or disease
Non-nucleoside reverse transcriptase inhibitors - Answer simply attach themselves to
reverse transcriptase and prevent that enzyme from converting RNA to DNA
Non-nucleoside reverse transcriptase inhibitor drugs - Answer Efavirenz ( Sustiva)
Nevirapine ( Viramune )
Etravirine ( Intelence)
Protease inhibitor - Answer prevents release of viral proteins and subsequent
maturation of infectious particles
Protease inhibitor drugs - Answer RITONAVIR ( NORVIR)
NELFINAVIR (VIRACEPT)
Common side effects of chemo - Answer myelosuppression (decreased production of
blood cells in the bone marrow, hence also immunosuppression via WBC suppression in
the bone marrow ),
mucositis (inflammation of the lining of the digestive tract)
alopecia (hair loss), and
darkening of skin and nails
Antimetabolite Anti-cancer drugs - Answer 6-Mercaptopurine ( 6-MP) -(Purinethol)
6- Thioquanine
MOA Antimetabolite anti-cancer drug - Answer They interfere with the availability of the
normal Purine and Pyrimidine DNA bases in DNA synthesis by competing with them in
rapidly proliferating cells
, Antibiotic "Anthracycline" Anticancer MOA - Answer Inhibits DNA and RNA synthesis by
intercalating into the minor groove between base pairs of the DNA/RNA strand, thus
preventing the replication of rapidly-growing cancer cells.
Inhibits an enzyme needed for DNA transcription.
Antibiotic "Anthracycline" Anticancer Drugs - Answer Doxorubicin
Daunorubicin
Trastuzumab( Herceptin) - Answer Monoclonal Antibody Anticancer drug for breast
cancer
binds to the HER receptor
3-Hydroxy-3-MethylGlutaryl Coenzyme A Inhibitors - Answer AKA- Statins
MOA - ( very straight forward ) - This group of drugs block cholesterol synthesis ( at
3-Hydroxy-3-MethylGlutaryl Coenzyme A ) , and are the first-line and more effective
treatment for patients with elevated LDL cholesterol.
analogs of HMG Co-A Reductase, the precursor of cholesterol, and replace HMG COA ,
and block the second step in cholesterol synthesis
Statin drugs - Answer Simvastatin ( Zocor)
Atorvastatin ( Lipitor)
Lovastatin ( Mevacor)
Rosuvastatin ( Crestor
Niacin ( Nicotinic Acid, Vitamin B3) - Answer Can reduce LDL levels by 10 to 20 %, and is
the MOST EFFECTIVE AGENT FOR INCREASING good HDL LEVELS.
Therefore they are used in combination with statins
MOA for Reduced LDL levels:
inhibits lipolysis in adipose tissue ( the primary producer of circulating free fatty acids).
The liver normally uses these circulating free fatty acids as a major precursor to
Triglycerides, VLDL, and LDL.
Thus, plasma triglycerides, and cholesterol in VLDL and LDL is reduced...!!!!
MOA for Increased HDL levels:
Not well understood, but seems to prevent or inhibit HDL hepatic uptake maintaining
them in circulation
Fibric Acid Derivatives - Answer Significant decrease in Triglycerides, moderate effect
