Medical Pharmacology: Immunopharmacology Practice Questions
Calcineurin Inhibitors III (Cyclosporin,
Tacrolimus)
Click on the correct answer.
Cyclosporine toxicity/toxicities:
Renal insufficiency
High blood pressure
Both
Neither
Cyclosporine toxicity/toxicities:
Elevated potassium (hyperkalemia)
Elevated uric acid (hyperuricemia)
Both
Neither
Patients being treated with cyclosporine for either rheumatoid arthritis or psoriasis should have creatinine
levels and blood pressure carefully monitored both at the beginning of
treatment and subsequently every 1-3 months during extended cyclosporine
therapy.
True
False
Tacrolimus (Envarsus):
Binds to T-cell immunophilin FK-binding protein 12 (FKBP-12)
Inhibits calcineurin activation
Both
Neither
Tacrolimus metabolism:
Metabolized by the cytochrome P450 hepatic drug metabolizing system isoform CYP3A.
Mostly (greater than 90%) excreted in feces.
Both
Neither
Tacrolimus:
Classified as the macrolide antibiotic (fungal origin).
Exhibits higher potency relative to cyclosporine with the main difference between the two drugs is different internal receptors [FK-binding protein for tacrolimus; cyclophilin for cyclosporine]
Both
Neither
Tacrolimus side effects are comparable to those seen with cyclosporine but tend to be more severe.
True
False
The likelihood of drug-induced nephrotoxicity in neurotoxicity is elevated with tacrolimus compared to cyclosporine.
True
False
Tacrolimus administration may cause new-onset diabetes mellitus in post-transplant patients.
True
False
In addition to tacrolimus use as an immunosuppressent in the context of transplantation, the topical formulation may be used in the treatment of atopic dermatitis.
Rothlin C Gutkind J Chapter 39
Immunosuppressants, Immunomodulation and Tolerance In
Goodman & Gilman's The Pharmacological Basis of Therapeutics
(Brunton LL Knollman BC eds) McGraw Hill LLC (2023).
Lake D & Briggs A Ch 55 Immunopharmacology
in Katzung's Basic & Clinical Pharmacology (Vanderah TW, ed)
16e McGraw Hill 2023.
Chrouos G Ch 39 Adrenocorticosteroids &
Adrenocortical Antagonists in Katzung's Basic & Clinical
Pharmacology (Vanderah TW, ed) 16e McGraw Hill 2023
Brezinski E Klickstein L Armstrong A Ch 46
Pharmacology of Immunosuppression in Principles of
Pharmacology: The Pathophysiologic Basis of Drug Therapy.
(Golan DE Armstrong EJ Armstrong AW, eds) 4e 2017 ls) 4e
2017
Ritter JM Flower R Henderson G Loke YK
MacEwan D Robinson E Fullerton J Ch 54 Anti-inflammatory and
Immunosuppressant Drugs Rang & Dale's Pharmacology 10e
Elsevier 2024.
Burchum J Rosenthal L Lehne's Pharmacology
for Nursing Care Ch 72 Immunosuppressants Elsevier 2022.
Burchum J Rosenthal L Lehne's Pharmacology
for Nursing Care Ch 75 Glucocorticoids in Nonendrocrine
Disorders Elsevier 2022.
Bass A Rogatsky Ch 32 Immunomodulatory Drugs
in Goldman-Cecil Medicine (Goldman L Schafer, eds) Elsevier
26e 2020
Leiva M Takemoto Ch 238 Immunosuppressants in
Lippincott Illustrated Reviews: Pharmacology 8e ((Walen et
al, eds) Wolters Kluwer 2023.
Hall J Hall M Ch 78 Adrenocortical
Hormones Guyton and Hall Textbook of Medical Physiology 14e
Elsevier 2021.
