Pharm Immunomodulating Drugs

20 Questions | Total Attempts: 643

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Pharm Immunomodulating Drugs

Hello and welcome to a wonderful quiz on pharmacology, where today we’ll be looking at the topic of immunomodulators – drugs used to help regulate the immune system, which are used for such ailments as asthma and angioedema. What can you tell us about these drugs? Let’s find out.


Questions and Answers
  • 1. 
    Which of the following statements regarding immunosuppressive drugs are correct (Check all that apply)
    • A. 

      They work better if immunosuppression is initiated before than after the exposure of the body to the antigen

    • B. 

      Primary immune responses are more easily suppressed than secondary immune responses

    • C. 

      They act mainly through the inhibition of antigen processing by antigen presenting cells

    • D. 

      Some anticancer drugs are also used for maintenance immunosuppression in doses generally lower than those employed in anticancer therapy

    • E. 

      Unlike anticancer drugs, the toxicity of the immunosuppressive agents is usually negligible

  • 2. 
    Which of the following drug-induced disorders represent the major limitations to the general use of most immunosuppressant drugs ? (Check all that apply)
    • A. 

      Kidney failure

    • B. 

      Lymphomas

    • C. 

      Infections

    • D. 

      Neurologic disorders

    • E. 

      Myelosuppression

    • F. 

      Hepatic failure

  • 3. 
    Which of the following statements correctly pair the immunomodulators with its appropriate mechanism of action? (Check all that apply)
    • A. 

      Tacrolimus - increases the catabolism of IgG antibodies

    • B. 

      Azathioprine - stimulates interleukin-2 synthesis in CD4 helper cells

    • C. 

      Sirolimus - inhibits mammalian kinase

    • D. 

      Cyclophosphamide - inhibits inosine monophosphate dehydrogenase

    • E. 

      Muromonab-CD3 - inhibits calcineurin

    • F. 

      Daclizumab - blocks interleukin-2 receptors

  • 4. 
    Which of the following drugs is a macrolide antibiotic that binds to a FK binding protein located in T cells, so blocking the gene expression for interleukin 2 production?
    • A. 

      Azithromycin

    • B. 

      Azathioprine

    • C. 

      Tacrolimus

    • D. 

      Cyclosporine

    • E. 

      Tobramycin

  • 5. 
    Which of the following drugs can bind to and neutralize TNF alpha, so inhibiting its actions? (Check all that apply)
    • A. 

      Etanercept

    • B. 

      Infliximab

    • C. 

      Muromonab CD3

    • D. 

      Tacrolimus

    • E. 

      Aldesleukin

  • 6. 
    A 28-year-old woman was admitted to the hospital with fever, a malar butterfly erythema, arthralgia, intermittent pleuritic pain and oral ulcers. Her lab tests revealed the following: serum creatinine 5.2 mg/dL, BUN 35 mg/dL, and high serum level of antinuclear antibodies. Which of the following drugs was most likely included in the therapeutic management of this patient?
    • A. 

      Infliximab

    • B. 

      Prednisone

    • C. 

      BCG vaccine

    • D. 

      Interferon-beta-1b

    • E. 

      Aldesleukin

  • 7. 
    A 32-year-old woman, who has been suffering from myasthenia gravis for four years, developed progressive dyspnea several days after an upper respiratory tract infection. Physical examination disclosed bilateral ptosis, bilateral facial weakness an diminished upper and lower motor strength. An IV edrophonium injection improved muscle strength. A serum assay for anti-acetylcholine receptor antibody was 4.8 (normal < 0.5). The appropriate treatment, promptly instituted, included a parenteral injection of prednisone. Which of the following statements best explains the most likely mechanism of action of the drug in this case?
    • A. 

      Inhibition of plasma cholinesterase

    • B. 

      Activation of Nm receptors

    • C. 

      Stimulation of synthesis of interleukin 2

    • D. 

      Inhibition of T cell activation and proliferation

    • E. 

      Stimulation of synthesis of interleukin 1

  • 8. 
    A 35-year-old man, who was scheduled for a heart transplant, received a triple immunosuppressive therapy just before surgery. Which of the following three drug combinations were most likely administered?
    • A. 

      Azathioprine, prednisone, aldesleukin

    • B. 

      Cyclosporine, azathioprine, prednisone

    • C. 

      Prednisone, triamcinolone, cyclosporine

    • D. 

      Aldesleukin, infliximab, etanercept

    • E. 

      Infliximab, etanercept, triamcinolone

  • 9. 
    A 42-year-old man came to the clinic complaining of an extensive rash, white plaque-like lesions in his mouth, dry eyes, hyperpigmentation of the tissues surrounding the eyes, and diarrhea. Three months before the man, who was suffering from chronic myelogenous leukemia, underwent an allogeneic bone marrow transplantation from his sister and was successfully treated for his acute graft versus host disease. The patient had had no major health problems after that disease. Which of the following pairs of drugs were most likely included in the therapeutic treatment of this patient?
    • A. 

      Prednisone and cyclosporine

    • B. 

      Cyclosporine and erythromycin

    • C. 

      Cyclophosphamide and doxorubicin

    • D. 

      Vinblastine and prednisone

    • E. 

      Doxorubicin and vinblastine

  • 10. 
    A 32-year-old man suffering from extensive psoriasis resistant to topical agents and photochemotherapy, started an immunosuppressive treatment with oral cyclosporine. Which of the following cells represent the main site of action of the drug?
    • A. 

      Macrophages

    • B. 

      Dendritic cells

    • C. 

      T-helper cells

    • D. 

      Plasma cells

    • E. 

      Natural killer cells

  • 11. 
    A 45-year-old man, who had received an heart transplant one month ago, was in the hospital and scheduled for endomyocardial biopsy. The patients complained of a tingling sensation in his hands and peripheral edema. Significant blood test results were: potassium 6.1 mEq/L, creatinine 3.8 mg/dL, BUN 42 mg/dL Current medications included cyclosporine, prednisone, azathioprine, theophylline, diltiazem and famotidine. Biopsy results indicated no acute rejection. If the lab results were drug related, which of the following was the most likely causative agent?
    • A. 

      Prednisone

    • B. 

      Cyclosporine

    • C. 

      Azathioprine

    • D. 

      Theophylline

    • E. 

      Diltiazem

  • 12. 
    A 34-year-old man, who underwent liver transplantation for advanced biliary cirrhosis, has been receiving immunosuppression treatment with prednisone and cyclosporine. In spite of the therapy a liver biopsy still showed rejection 14 days after surgery. Which of the following drugs could be substituted to cyclosporine to treat this case of cyclosporine resistant rejection?
    • A. 

      Aldesleukin

    • B. 

      Vinblastine

    • C. 

      Tacrolimus

    • D. 

      Fluorouracil

    • E. 

      Paclitaxel

  • 13. 
    A 33-year old man with an end stage renal disease underwent a kidney transplant. The therapeutic management of the patient included an IV injection of azathioprine just before surgery. Which of the following statements best explains the most likely mechanism of action of the drug in this case?
    • A. 

      Blockade of receptors of TNF-alpha

    • B. 

      Inhibition of clonal expansion of T and B lymphocytes

    • C. 

      Inhibition of antigen presentation by dendritic cells

    • D. 

      Stimulation of genetic expression of interleukin 2

    • E. 

      Stimulation of macrophage phagocytic activity

  • 14. 
    A 44-year-old woman, who received a heart transplant 15 days ago, is now in the coronary unit. A blood exam reveals the following: RBC 4.1 x 10 / mm , WBC 6 3 1.2 x 103/mm, platelets 40,000/mm3.  Which of the following drugs most likely caused these findings?
    • A. 

      Cyclosporine

    • B. 

      Dobutamine

    • C. 

      Dopamine

    • D. 

      Azathioprine

    • E. 

      Fluorouracil

  • 15. 
    A 32-year-old man, who underwent renal transplant, showed signs of acute allograft rejection which was resistant to corticosteroid treatment. He was treated with muromonab CD3 that was able to reverse the rejection. Which of the following statements best explains the molecular mechanism of action of the drug in this case?
    • A. 

      It inhibits antibody formation by plasma cells

    • B. 

      It inhibits several enzymes involved in purine metabolism

    • C. 

      It inhibits calcineurin enzyme in T cell cytoplasm

    • D. 

      It stimulates the synthesis of interleukin-1 in T cells

    • E. 

      It neutralize a surface protein receptor complex in T cells

  • 16. 
    A 27-year-old primipara delivered a baby boy at term. The woman was Rho(D) negative and her husband was Rho(D) positive. The woman received an IV injection of Rho(D) immune globulin just after the delivery. Which of the following statements best explains the mechanism of action of the Rho(D) immune globulin?  
    • A. 

      It prevents placental crossing of Rho(D) positive erythrocytes in subsequent pregnancies

    • B. 

      It blocks the production of maternal antibodies against Rho(D) positive erythrocytes

    • C. 

      It prevents the hemolytic disease of the mother in subsequent pregnancies

    • D. 

      It blocks the production of fetal Rho(D) positive erythrocytes in subsequent pregnancies

    • E. 

      It prevents the placental crossing of fetal Rho(D) antibodies in subsequent pregnancies

  • 17. 
    A 42-year-old woman undergoing heart transplant received mycophenolate mofetil, cyclosporine and prednisone before surgery. Which of the following statements best explains why mycophenolate mofetil is currently substituted for azathioprine to prevent rejection in solid organ transplantation ?
    • A. 

      Its immunosuppressant activity is definitely superior to that of azathioprine

    • B. 

      It has significantly less adverse effects than azathioprine

    • C. 

      It has drastically reduced the risk of graft versus host disease

    • D. 

      It selectively inhibits macrophage-mediated production of several interleukins

    • E. 

      It selectively inhibits antigen recognition by antigen presenting cells

  • 18. 
    A 53-year-old man presented with complains of enlarging, painful lymph node in his groin. One year before his admission he had undergone surgical resection of a stage II malignant melanoma. A lymph node biopsy confirmed recurrence of malignant melanoma. The patient started a course of chemotherapy which included the IV administration of aldesleukin, a recombinant formulation of interleukin-2. Which of the following statements best explains the mechanism of action of this drug?
    • A. 

      It induces proliferation and differentiation of B and T lymphocytes

    • B. 

      It inhibits macrophage phagocytic activity

    • C. 

      It inhibits antigen presentation by dendritic cells

    • D. 

      It decreases the synthesis of calcineurin

    • E. 

      It inhibits the activity of natural killer cells

  • 19. 
    A 42-year-old woman presented to her ophthalmologist because of loss of central vision and pain on movement of her left eye. She reported that in the past she had had recurrent episodes of weakness and abnormal sensations in her arms and legs. The patient was referred to the neurologic clinic where labs exams and brain MRI confirmed the diagnosis of multiple sclerosis. The patient was prescribed a supportive therapy which included a recombinant cytokine endowed with immunostimulant properties. Which of the following drugs was most likely administered?
    • A. 

      Trastuzumab

    • B. 

      Infliximab

    • C. 

      Interferon beta-1b

    • D. 

      Prednisone

    • E. 

      Tacrolimus

  • 20. 
    The immunosuppressive effect of glucocorticoids seems mainly related to which of the following mechanisms of action? (Check all that apply)
    • A. 

      Inhibition of catabolism of IgG antibodies

    • B. 

      Inhibition of macrophage-mediated production of interleukin 1

    • C. 

      Activation of several immunophilins

    • D. 

      Early activation of T lymphocytes

    • E. 

      Activation of phospholipase A2

    • F. 

      Inhibition of T cell-mediated production of interleukin 2

    • G. 

      Direct lympholythic effect on cytotoxic T cells