Medical Pharmacology: Immunopharmacology (Immunosuppressants/Immunomodulators) Practice Questions
Infleximab (Remicade)
TNF-α Antagonist:
Infleximab (Remicade)
Click on the correct answer.
Proinflammatory cytokines/cytokines:
TNF-α
Interleukin-1 (IL-1)
Both
Either
TNF-α and cytokines:
Increases prostaglandin synthesis
Associated with upregulation of COX-II
Both
Neither
Infleximab (Remicade):
Chimeric IgG1 monoclonal antibody comprised of an FC region and mouse variable region. (FC refers to the "fragment crystallizable (FC) region which is the tale of the antibody that interacts with other molecules and causes immune system activation).
Binds to TNF-α exhibiting high affinity, preventing cytokine binding to cytokine receptors.
Both
Neither
Infleximab (Remicade) pharmacokinetics:
Terminal half-life: 9-12 days
Volume of distribution: independent of dose; primarily localized within the vascular compartment.
Both
Neither
Infleximab (Remicade) pharmacokinetics:
Infleximab elimination is likely accomplished by protease catalyzed degradation.
Given its localization in the vascular compartment (volume of distribution is about 3-6 L), imatinib's long half-life reflects very low systemic clearance rates (11-15 ml/hr).
Both
Neither
Infleximab used for symptom management in rheumatoid arthritis is usually administered along with methotrexate, in those patients not responding to methotrexate monotherapy.
True
False
Combining infleximab with methotrexate decreases likelihood of human anitchimeric development by about 30% (10 mg).
True
False
Off-label use less uses of infleximab (Remicade):
Granulomatosis with polyangiitis (a.k.a. Wegener's granulomatosis)
Giant cell arthritis
Uveitis sarcoidosis
A & B
B & C
A & C
A, B & C
Patients should be treated for latent/active tuberculosis before initiating TNF-α antagonists.
True
False
Use of TNF-α antagonists appears to increase risk of hepatitis B virus reactivation.
If you wish to return to the Table of Contents
in ENGLISH, press the RETURN button above.
Otherwise, if the text is NOT displayed in
English and you are ready to leave this page,
Press here
to return to the Table of Contents
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.
Waller DG Sampson A Hitchings Ch 38 A
Medical Pharmacology & Therapeutics 6e Elsevier 2022
