This document summarizes various immunosuppressant drugs used to prevent rejection of organ transplants. It describes several classes of drugs including inhibitors of cytokines like cyclosporine and tacrolimus, inhibitors of cytokine gene expression like corticosteroids, cytotoxic drugs that inhibit DNA synthesis like azathioprine and mycophenolate, and immunosuppressive antibodies. For each drug class and individual drugs, it discusses mechanisms of action, pharmacokinetics, clinical uses, and adverse effects.
Definition: Any messenger that acts on blood vessels, inflammatory cells, or other cells to contribute to an inflammatory response.
Cell derived mediators
Plasma derived mediators
vasoactive amines (serotonin,histamine)
arachidonic acid metabolites
cycloxygenase pathway
lipoxygenase pathway
Lysosomal components
Platelet activating factor
Cytokines (IL-1,TNF-α,TNF-β,IF-γ,Chemokines) f) Nitric oxide and oxygen metabolites
Histamine :-
Stored in granuls of mast cells, basophiles and platelets.
Released by the stimuli of various agents like Heat, Cold, Irradiation, Irritant chemicals, Anaphilatoxins, Interleukins,.. etc.
Actions ; Vasodilation
Vascular permeability Itching and pain
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Immunosuppressants are drugs which inhibit cellular/humoral or both types of immune responses and have their major use in organ transplantation and autoimmune diseases.
Excellent for medical students, pharmacology students, nursing students, and university or college students. Use it to aid in your studying for semester and board exams!
Definition: Any messenger that acts on blood vessels, inflammatory cells, or other cells to contribute to an inflammatory response.
Cell derived mediators
Plasma derived mediators
vasoactive amines (serotonin,histamine)
arachidonic acid metabolites
cycloxygenase pathway
lipoxygenase pathway
Lysosomal components
Platelet activating factor
Cytokines (IL-1,TNF-α,TNF-β,IF-γ,Chemokines) f) Nitric oxide and oxygen metabolites
Histamine :-
Stored in granuls of mast cells, basophiles and platelets.
Released by the stimuli of various agents like Heat, Cold, Irradiation, Irritant chemicals, Anaphilatoxins, Interleukins,.. etc.
Actions ; Vasodilation
Vascular permeability Itching and pain
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Immunosuppressants are drugs which inhibit cellular/humoral or both types of immune responses and have their major use in organ transplantation and autoimmune diseases.
Excellent for medical students, pharmacology students, nursing students, and university or college students. Use it to aid in your studying for semester and board exams!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
2. Immune system
Is designed to protect the host from harmful
foreign molecules.
This system can result into serious problem.
Allograft introduction can elicit a damaging
immune response.
Immune system include two main arms
1) Cell –mediated immunity.
2) Humoral (antibody –mediated immunity).
3.
4. Cytokines
Cytokines are soluble , antigen-nonspecific
signaling proteins that bind to cell surface
receptors on a variety of cells.
Cytokines include
– Interleukins,
– Interferons (IFNs),
– Tumor Necrosis Factors (TNFs),
– Transforming Growth Factors (TGFs)
– Colony-stimulating factors (CSFs).
5. IL-2 stimulates the proliferation of antigen-
primed (helper) T cells.
Cell-mediated Immunity
TH1 produce more IL-2, TNF-β and IFN-γ.
Activate
– NK cells (kill tumor & virus-infected cells).
– Cytotoxic T cells (kill tumor & virus-
infected cells).
– Macrophages (kill bacteria).
9. Mutual regulation of T helper lymphocytes
TH1 interferon-γ:
inhibits TH2 cell proliferation TH2 cells
TH2 IL-10:
inhibits TH1 cytokine production
10. IMMUNOSUPPRESSANT DRUGS
I. inhibitors of cytokine (IL-2) production or
action:
1) Calcineurin inhibitors
Cyclosporine
Tacrolimus (FK506)
2) Sirolimus (rapamycin).
II. Inhibitors of cytokine gene expression
– Corticosteroids
11. III. Cytotoxic drugs
Inhibitors of purine or pyrimidine synthesis
(Antimetabolites):
– Azathioprine
– Myclophenolate Mofetil
– Leflunomide
– Methotrexate
Alkylating agents
Cyclophosphamide
12. IV. Immunosuppressive antibodies
that block T cell surface molecules involved in
signaling immunoglobulins
– antilymphocyte globulins (ALG).
– antithymocyte globulins (ATG).
– Rho (D) immunoglobulin.
– Basiliximab
– Daclizumab
– Muromonab-CD3
V. Interferon
VI. Thalidomide
13. I) Inhibitors of cytokines (IL-2) production or
action
– Inhibitors of cytokines (IL-2) production
Calcineurin inhibitors
Cyclosporine
Tacrolimus (FK506)
– Inhibitors of cytokines (IL-2) action
Sirolimus (rapamycin).
14. CYCLOSPORINE
Chemistry
Cyclosporine is a fungal polypeptide composed
of 11 amino acids.
Mechanism of action:
– Acts by blocking activation of T cells by
inhibiting interleukin-2 production (IL-2).
– Decreases proliferation and differentiation
of T cells.
15. – Cyclosporine binds to cyclophilin
(immunophilin) intracellular protein
receptors .
– Cyclosporine- immunophilin complex
inhibits calcineurin, a phosphatase
necessary for dephosphorylation of
transcription factor (NFATc) required for
interleukins synthesis (IL-2).
– NFATc (Nuclear Fcator of Activated Tcells).
– Suppresses cell-mediated immunity.
16.
17. Pharmacokinetics:
– Can be given orally or i.v. infusion
– orally (25 or 100 mg) soft gelatin capsules,
microemulsion.
– Orally, it is slowly and incompletely
absorbed.
– Peak levels is reached after 1– 4 hours,
elimination half life 24 h.
– Oral absorption is delayed by fatty meal
(gelatin capsule formulation)
– Microemulsion
( has higher bioavailability-is not affected by
food).
18. – 50 – 60% of cyclosporine accumulates in
blood (erythrocytes – lymphocytes).
– metabolized by CYT-P450 system
(CYP3A4).
– excreted mainly through bile into faeces,
about 6% is excreted in urine.
19. Therapeutic Uses:
– Organ transplantation (kidney, liver, heart)
either alone or with other
immunosuppressive agents (Corticosteroids).
– Autoimmune disorders (low dose 7.5
mg/kg/d). e.g. endogenous uveitis,
rheumatoid arthritis, active Crohn’s disease,
psoriasis, psoriasis, nephrotic syndrome,
severe corticosteroid-dependent asthma,
early type I diabetes.
– Graft-versus-host disease after stem cell
transplants
20. Adverse Effects (Dose-dependent)
Therapeutic monitoring is essential
– Nephrotoxicity
(increased by NSAIDs and aminoglycosides).
– Liver dysfunction.
– Hypertension, hyperkalemia.
(K-sparing diuretics should not be used).
– Hyperglycemia.
– Viral infections (Herpes - cytomegalovirus).
21. – Lymphoma (Predispose recipients to
cancer).
– Hirsutism
– Neurotoxicity (tremor).
– Gum hyperplasia.
– Anaphylaxis after I.V.
22. Drug Interactions
Clearance of cyclosporine is enhanced by co-
administration of CYT p 450 inducers
(Phenobarbitone, Phenytoin & Rifampin )
rejection of transplant.
Clearance of cyclosporine is decreased when it
is co-administered with erythromycin or
Ketoconazole, Grapefruit juice cyclosporine
toxicity.
23. TACROLIMUS (FK506)
a fungal macrolide antibiotic.
Chemically not related to cyclosporine
both drugs have similar mechanism of action.
The internal receptor for tacrolimus is
immunophilin ( FK-binding protein, FK-BP).
Tacrolimus-FKBP complex inhibits
calcineurin.
24.
25. Kinetics
Given orally or i.v or topically (ointment).
Oral absorption is variable and incomplete,
reduced by fat and carbohydrate meals.
Half-life after I.V. form is 9-12 hours.
Highly bound with serum proteins and
concentrated in erythrocytes.
metabolized by P450 in liver.
Excreted mainly in bile and minimally in
urine.
26. USES as cyclosporine
Organ and stem cell transplantation
Prevention of rejection of liver and kidney
transplants (with glucocorticoids).
Atopic dermatitis and psoriasis (topically).
27. Toxic effects
Nephrotoxicity (more than CsA)
Neurotoxicity (more than CsA)
Hyperglycemia ( require insulin).
GIT disturbances
Hperkalemia
Hypertension
Anaphylaxis
NO hirsutism or gum hyperplasia
Drug interactions as cyclosporine.
28. What are the differences between CsA and TAC ?
TAC is more favorable than CsA due to:
TAC is 10 – 100 times more potent than CsA in
inhibiting immune responses.
TAC has decreased episodes of rejection.
TAC is combined with lower doses of
glucocorticoids.
But
TAC is more nephrotoxic and neurotoxic.
29. Sirolimus (Rapamycin)
SRL is macrolide antibiotic.
SRL is derived from fungus origin.
It binds to FKBP and the formed complex
binds to mTOR (mammalian Target Of
Rapamycin).
mTOR is serine-threonine kinase essential for
cell cycle progression, DNA repairs, protein
translation.
30. SRL blocks the progression of activated T cells
from G1 to S phase of cell cycle
(Antiproliferative action).
It Does not block the IL-2 production but
blocks T cell response to cytokines.
Inhibits B cell proliferation &
immunoglobulin production.
31.
32. Pharmakinetics
Given orally and topically, reduced by fat
meal.
Extensively bound to plasma proteins
metabolized by CYP3A4 in liver.
Excreted in feces.
Pharmacodynamics
Immunosuppressive effects
Anti- proliferative action.
Equipotent to CsA.
33. USES
Solid organ allograft
Renal transplantation alone or combined with
(CSA, tacrolimus, steroids, mycophenolate).
Heart allografts
In halting graft vascular disease.
Hematopoietic stem cell transplant recipients.
Topically with cyclosporine in uveoretinitis.
Synergistic action with CsA
35. Inhibitors of cytokine gene expression
Corticosteroids
– Prednisone
– Prednisolone
– Methylprednisolone
– Dexamethasone
They have both anti-inflammatory action
and immunosuppressant effects.
36. Mechanism of action
– bind to glucocorticoid receptors and the
complex interacts with DNA to inhibit gene
transcription of inflammatory genes.
– Decrease production of inflammatory
mediators as prostaglandins, leukotrienes,
histamine, PAF, bradykinin.
– Decrease production of cytokines IL-1, IL-2,
interferon, TNF.
– Stabilize lysosomal membranes.
37. – Decrease generation of IgG, nitric oxide and
histamine.
– Inhibit antigen processing by macrophages.
– Suppress T-cell helper function
– decrease T lymphocyte proliferation.
38. Kinetics
Can be given orally or parenterally.
Dynamics
1. Suppression of response to infection
2. anti-inflammatory and immunosuppresant.
3. Metabolic effects.
39. Indications
– are first line therapy for solid organ
allografts & haematopoietic stem cell
transplantation.
– Autoimmune diseases as refractory
rheumatoid arthritis, systemic lupus
erythematosus, asthma
– Acute or chronic rejection of solid organ
allografts.
41. III. Cytotoxic drugs
Inhibitors of purine or pyrimidine synthesis
(Antimetabolites):
– Azathioprine
– Myclophenolate Mofetil
– Leflunomide
– Methotrexate
Alkylating agents
Cyclophosphamide
42. AZATHIOPRINE
CHEMISTRY:
– Derivative of mercaptopurine.
– Prodrug.
– Cleaved to 6-mercaptopurine then to
6-mercaptopurine nucleotide, thioinosinic
acid (nucleotide analog).
– Inhibits de novo synthesis of purines
required for lymphocytes proliferation.
– Prevents clonal expansion of both B and T
lymphocytes.
43.
44. Pharmacokinetics
– orally or intravenously.
– Widely distributed but does not cross BBB.
– Metabolized in the liver to 6-mercaptopurine
or to thiouric acid (inactive metabolite) by
xanthine oxidase.
– excreted primarily in urine.
Drug Interactions:
– Co-administration of allopurinol with
azathioprine may lead to toxicity due to
inhibition of xanthine oxidase by allopurinol.
46. Adverse Effects
Bone marrow depression: leukopenia,
thrombocytopenia.
Gastrointestinal toxicity.
Hepatotoxicity.
Increased risk of infections.
47. MYCOPHENOLATE MOFETIL
– Is a semisynthetic derivative of mycophenolic
acid from fungus source.
– Prodrug; is hydrolyzed to mycophenolic acid.
Mechanism of action:
– Inhibits de novo synthesis of purines.
– mycophenolic acid is a potent inhibitor of
inosine monophosphate dehydrogenase (IMP),
crucial for purine synthesis deprivation of
proliferating T and B cells of nucleic acids.
48.
49. Pharmacokinetics:
– Given orally, i.v. or i.m.
– rapidly and completely absorbed after oral
administration.
– It undergoes first-pass metabolism to give
the active moiety, mycophenolic acid (MPA).
– MPA is extensively bound to plasma protein.
– metabolized in the liver by glucuronidation.
– Excreted in urine as glucuronide conjugate
– Dose : 2-3 g /d
50. CLINICAL USE:
– Solid organ transplants for refractory
rejection.
– Steroid-refractory hematopoietic stem cell
transplant patients.
– Combined with prednisone as alternative to
CSA or tacrolimus.
– Rheumatoid arthritis, & dermatologic
disorders.
52. LEFLUNOMIDE
A prodrug
Active metabolite undergoes enterohepatic
circulation.
Has long duration of action.
Can be given orally
antimetabolite immunosuppressant.
Pyrimidine synthesis inhibitor
Approved only for rheumatoid arthritis
60. Antibodies
preparation
1. by immunization of either horses or rabbits
with human lymphoid cells producing
mixtures of polyclonal antibodies directed
against a number of lymphocyte antigens
(variable, less specific).
61. 2. Hybridoma technology
produce antigen-specific, monoclonal antibody
(homogenous, specific).
produced by fusing mouse antibody-producing
cells with immortal, malignant plasma cells.
Hybrid cells are selected, cloned and
selectivity of the clone can be determined.
62. Recombinant DNA technology can be used to
replace part of the mouse gene sequence with
human genetic material (less antigenicity-
longer half life).
Antibodies from mouse contain Muro in their
names.
Humanized antibodies contain ZU or XI in
their names.
63. Antilymphocyte globulins (ALG)
&Antithymocyte globulins (ATG)
Polyclonal antibodies obtained from plasma or
serum of horses hyper-immunized with human
lymphocytes.
Binds to the surface of circulating T
lymphocytes, which are phagocytosed in the
liver and spleen giving lymphopenia and
impaired T-cell responses & cellular immunity.
64. Kinetics
Given i.m. or slowly infused intravenously.
Half life extends from 3-9 days.
Uses
Combined with cyclosporine for bone marrow
transplantation.
To treat acute allograft rejection.
Steroid-resistant rejection.
66. Muromonab-CD3
Is a murine monoclonal antibody
Prepared by hybridoma technology
Directed against glycoprotein CD3 antigen of
human T cells.
Given I.V.
Metabolized and excreted in the bile.
67. Mechanism of action
The drug binds to CD3 proteins on T
lymphocytes (antigen recognition site) leading
to transient activation and cytokine release
followed by disruption of T-lymphocyte
function, their depletion and decreased
immune response.
Prednisolone, diphenhydramine are given to
reduce cytokine release syndrome.
68. Uses
Used for treatment of acute renal allograft
rejection & steroid-resistant acute allograft
To deplete T cells from bone marrow donor
prior to transplantation.
Adverse effects
Anaphylactic reactions.
Fever
CNS effects (seizures)
Infection
Cytokine release syndrome (Flu-like illness to
shock like reaction).
69. Rho (D) immune globulin
Rho (D) is a concentrated solution of human
IgG containing higher titer of antibodies
against Rho (D) antigen of red cells.
Given to Rh-negative mother within 24-72
hours after delivery of Rh positive baby (2 ml,
I.M.) to prevent hemolytic disease of the next
Rh positive babies (erythroblastosis fetalis).
Adverse Effects
– Local pain
– Fever
70. Monoclonal antibodies
Basiliximab and Daclizumab
Obtained by replacing murine amino acid
sequences with human ones.
Basiliximab is a chimeric human-mouse IgG
(25% murine, 75% human protein).
Daclizumab is a humanized IgG (90% human
protein).
Have less antigenicity & longer half lives than
murine antibodies
71. Mechanism of action
IL-2 receptor antagonists
Are Anti-CD25
Bind to CD25 (α-subunit chain of IL-2
receptor on activated lymphocytes)
Block IL-2 stimulated T cells replication & T-
cell response system
Basiliximab is more potent than Daclizumab.
72. Given I.V.
Half life Basiliximab (7 days )
Daclizumab (20 days)
are well tolerated - only GIT disorders
USES
Given with CsA and corticosteroids for
Prophylaxis of acute rejection in renal
transplantation.
73. Monoclonal antibodies
Infliximab
a chimeric human-mouse IgG
Directed against TNF-α
Is approved for ulcerative colitis, Crohn’s
disease &rheumatoid arhritis
Omalizumab
a humanized monoclonal IgE
Directed against Fc receptor on mast
&basophils
Is approved for asthma in steroid-refractory
patient
74. INTERFERONS
Three families:
Type I IFNs ( IFN-α, β ):
acid-stable proteins; act on same target cell
receptor
induced by viral infections
leukocyte produces IFN-α
Fibroblasts & endothelial cells produce IFN-β
Type II IFN (IFN-γ):
acid-labile; acts on separate target cell
receptors
Produced by Activated T lymphocytes.
75. Interferon Effects:
IFN- γ : Immune Enhancing
– increased antigen presentations with
macrophage, natural killer cell, cytotoxic T
lymphocyte activation
IFN- α, β :
– effective in inhibiting cellular proliferation
(more effective than IFN- γ in this regard)
77. USES:
– Treatment of certain infections e.g.
Hepatitis C (IFN- α ).
– Autoimmune diseases e.g. Rheumatoid
arthritis.
– Certain forms of cancer e.g. melanoma,
renal cell carcinoma.
– Multiple sclerosis (IFN- β): reduced rate of
exacerbation.
– Fever, chills, myelosuppression.
78. THAMLIDOMIDE
A sedative drug.
Teratogenic (Class-X).
Can be given orally.
Has immunomodulatory actions
Inhibits TNF-α
Reduces phagocytosis by neutrophils
Increases IL-10 production