Immune System Pharmacology Study Guide 1 Immunosuppressants a Corticosteroids Prototype Prednisone Mechanism of Action Suppresses inflammatory and immune responses by inhibiting cytokine production Uses Organ transplantation autoimmune disorders Drug Interactions Increased risk of gastrointestinal bleeding with NSAIDs Side Effects Adrenal suppression osteoporosis immunosuppression b Calcineurin Inhibitors Prototype Cyclosporine Mechanism of Action Inhibits calcineurin preventing T cell activation Uses Organ transplantation autoimmune disorders Drug Interactions Numerous including drugs affecting cytochrome P450 Side Effects Nephrotoxicity hypertension hyperlipidemia c mTOR Inhibitors Prototype Sirolimus Rapamycin Mechanism of Action Inhibits mTOR interfering with T cell proliferation Uses Organ transplantation Drug Interactions Metabolized by CYP3A4 interactions with CYP3A4 inhibitors Side Effects Hyperlipidemia delayed wound healing d Antimetabolites Prototype Azathioprine Mechanism of Action Inhibits DNA synthesis affecting rapidly dividing cells Uses Organ transplantation autoimmune disorders Drug Interactions Allopurinol increases azathioprine levels Side Effects Myelosuppression hepatotoxicity 2 Immunomodulators a Tumor Necrosis Factor TNF Inhibitors Prototype Infliximab Mechanism of Action Blocks TNF reducing inflammation Uses Rheumatoid arthritis Crohn s disease Drug Interactions Concurrent use with other immunosuppressants Side Effects Increased risk of infections infusion reactions b Interleukin Inhibitors Prototype Anakinra Mechanism of Action Inhibits interleukin 1 reducing inflammation Uses Rheumatoid arthritis Drug Interactions Limited interactions Side Effects Injection site reactions increased risk of infections c B Cell Depleting Agents Prototype Rituximab Mechanism of Action Depletes B cells by targeting CD20 Uses Non Hodgkin s lymphoma rheumatoid arthritis Side Effects Infusion reactions increased risk of infections Drug Interactions May enhance immunosuppressive effects of other agents 3 Immunostimulants a Interferons Prototype Interferon alpha Mechanism of Action Modulates the immune response inhibiting viral replication Uses Viral infections Hepatitis B and C certain cancers Drug Interactions Limited interactions Side Effects Flu like symptoms fatigue depression b Colony Stimulating Factors Prototype Filgrastim Mechanism of Action Stimulates the production of neutrophils Uses Neutropenia associated with chemotherapy Drug Interactions Limited interactions Side Effects Bone pain leukocytosis c Vaccines Examples Influenza vaccine Hepatitis B vaccine Mechanism of Action Stimulate the immune system to produce an immune response Uses Prevent infectious diseases Drug Interactions Limited interactions Side Effects Local reactions at injection site fever 4 Antibodies a Monoclonal Antibodies Prototype Trastuzumab Mechanism of Action Targets specific proteins on cancer cells Uses Breast cancer gastric cancer Drug Interactions Limited interactions Side Effects Cardiotoxicity infusion reactions