34 topics with concise breakdowns: definitions, key facts, and class questions.
This section focuses on the pharmacology of drugs capable of selectively suppressing, stimulating, or modulating the immune response. Graft survival, the treatment of autoimmune pathologies, and the management of severe allergies are all within the purview of immunotropic agents.
The material is structurally divided into three main blocks. Immunosuppressants include basic glucocorticoids, calcineurin inhibitors (cyclosporine, tacrolimus), and targeted monoclonal antibodies (muromonab-CD3, daclizumab). The immunostimulants section covers cytokine preparations (interferons, interleukins, colony-stimulating factors), interferon inducers (tylron, cycloferon), as well as thymic, microbial, and synthetic drugs (polyoxidonium, levamisole). The third block is antiallergic agents, with the main focus on H1-histamine receptor blockers and antileukotriene drugs.
What is most frequently asked in class? Classic exam topics include the detailed molecular mechanism of action of cyclosporine and tacrolimus, the pharmacodynamic differences between generations of H1-antihistamines (effects on the CNS), and the strict indications for monoclonal antibodies.
What is the role of calcineurin in the immune response?
This enzyme binds to the nuclear factor NFAT and dephosphorylates it. This allows the factor to enter the T-lymphocyte nucleus and trigger the synthesis of interleukin-2.
Why does mycophenolic acid suppress lymphocytes specifically rather than all cells in the body?
T and B lymphocytes depend critically on de novo purine synthesis, which is blocked by the drug. Other cells are able to use alternative salvage pathways for nucleotide synthesis and thus suffer significantly less.
Which drug is considered the reference standard among glucocorticoid immunosuppressants?
The reference representative of this group of pharmacological agents is prednisolone.
Why does cyclosporine therapy require regular blood sampling for analysis?
The drug has a narrow therapeutic index, and its toxic effects are directly dose-dependent. Mandatory blood concentration monitoring helps avoid overdose and severe complications.
To which pharmacological group does tacrolimus belong?
This is an immunosuppressant that belongs chemically to the macrolide group of fungal origin.
What is the main difference in the mechanism of action between sirolimus and tacrolimus?
Both drugs bind to the intracellular protein FKBP-12. However, the complex with tacrolimus blocks calcineurin, while the complex with sirolimus blocks the mTOR protein, leading to cell cycle arrest.
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