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NURS549 Final Exam Guide With Complete Solution
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NURS549 Final Exam Guide WithComplete Solution
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
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