Medical Pharmacology: Immunopharmacology Practice Questions
Mycophenolate Mofetil (Myfortic,
CellCept)
Click on the correct answer.
Mycophenylate (Myfortic, CellCept):
Mycophenolate mofetil, the prodrug, is hydrolyzed to the active drug MPA.
MPA exhibits selective, noncompetitive reversible inhibition of inosine monophosphate dehydrogenase.
Both
Neither
Inosine monophosphate dehydrogenase:
This enzyme is part of the
de novo guanine nucleotide synthesis pathway.
Both B and T-lymphocytes utilize
this pathway in support of cellular proliferation.
Both
Neither
MPA, the active drug form of mycophenolate mofetil,:
Inhibits lymphocyte proliferation and limits functionality.
Cellular adhesion, antibody formation and cell migration are reduced.
Both
Neither
Mycophenylate mofetil (MMF):
Semisynthetic derivative of mycophenolic acid.
Isolated from the mold Penicillium glaucus.
Both
Neither
Probable mechanism associated with mycophenylate-mediated decrease in T- and B-lymphocyte responses such as mileage and and "mixed lymphocyte responses": de novo purine synthesis.
True
False
Mycophenolate mofetil:
Formulations available include: oral and IV
Oral formulation undergoes rapid metabolism to mycophenolic acid.
Both
Neither
Approved clinical use/uses of mycophenolic mofetil: prevention of organ rejection (allogenic heart, kidney, or liver).
True
False
Antiproliferative properties of mycophenolate mofetil provide the rationale for:
First-line agent
designation for reducing or preventing chronic allograft vasculopathy (in the cardiac transplant setting).
Prophylaxis/treatment of acute and chronic graft-versus-host disease in hematopoietic stem cell transplant recipients.
Both
Neither
Primary toxicity/toxicities:
Gastrointestinal
Hematological
Both
Neither
Example/example of drug-drug interactions involving mycophenolate mofetil:
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Source Material:
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.
