Inmunosupresores

Descripción General

Definición

Los LOS Neisseria inmunosupresores son una clase de medicamentos que disminuyen la actividad del sistema inmunológico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum condiciones como enfermedades autoinmunes, trasplante de órganos y tumores malignos.

Sistema inmune

• El sistema inmunitario proporciona defensa (inmunidad) contra patógenos invasores, discriminando lo propio de lo ajeno para proteger al AL Amyloidosis huésped.
• 2 líneas de defensa (que se superponen):
  • Inmunidad innata (que no es específica), que incluye:
    • Fagocitos
    • Citocinas (e.g., interleucinas)
  • Inmunidad adaptativa (basada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el reconocimiento de antígenos específicos), que incluye:
    • Células T (células colaboradoras, citolíticas y reguladoras (supresoras))
    • Células B (producen anticuerpos)
• Estos componentes son diana para los LOS Neisseria diferentes agentes de inmunosupresión.

Clasificación

Los LOS Neisseria inmunosupresores se pueden clasificar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum varias categorías de medicamentos con diferentes objetivos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el sistema inmunitario y diversos mecanismos de acción:

• Agentes biologicos
• Inhibidores de la calcineurina
• Corticoesteroides
• Inhibidores de mTOR mTOR Peutz-Jeghers Syndrome
• Agentes citotóxicos y otros agentes inmunomoduladores

Agentes Biológicos

Definición

Los LOS Neisseria agentes biológicos se derivan de organismos vivos (e.g., seres humanos, animales o microorganismos) y están diseñados para suprimir componentes o vías específicas del sistema inmunitario.

Nomenclatura

Los LOS Neisseria nombres de los LOS Neisseria medicamentos se basan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum su estructura:

• “-cept”: receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors fusionado y la parte Fc Fc Crystallizable fragments composed of the carboxy-terminal halves of both immunoglobulin heavy chains linked to each other by disulfide bonds. Fc fragments contain the carboxy-terminal parts of the heavy chain constant regions that are responsible for the effector functions of an immunoglobulin (complement fixation, binding to the cell membrane via fc receptors, and placental transport). This fragment can be obtained by digestion of immunoglobulins with the proteolytic enzyme papain. Immunoglobulins: Types and Functions de la IgG1 humana
• “-mab”: un anticuerpo monoclonal (mAb, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
• “-ximab”: mAb quimérico
• “-zumab”: mAb humanizado
• “-umab”: mAb completamente humano

Medicamentos

• Inhibidores de células B:
  • Belimumab Belimumab Immunosuppressants
  • Ocrelizumab Ocrelizumab Immunosuppressants
  • Rituximab Rituximab A murine-derived monoclonal antibody and antineoplastic agent that binds specifically to the cd20 antigen and is used in the treatment of leukemia; lymphoma and rheumatoid arthritis. Immunosuppressants
• Inhibidores de interleucina:
  • Inhibición de IL-1:
    • Anakinra Anakinra Immunosuppressants
    • Canakinumab Canakinumab Immunosuppressants
    • Rilonacept Rilonacept Immunosuppressants
  • Inhibición de IL-6:
    • Sarilumab Sarilumab Immunosuppressants
    • Tocilizumab Tocilizumab Immunosuppressants
  • Inhibición de IL-17:
    • Ixekizumab Ixekizumab Immunosuppressants
    • Secukinumab Secukinumab Immunosuppressants
  • Bloqueo de IL-12/23:
    • Guselkumab Guselkumab Immunosuppressants
    • Ustekinumab Ustekinumab A humanized monoclonal antibody that binds to il-12 and il-23 and is used as a dermatologic agent in the treatment of patients with plaque psoriasis who have not responded to other therapies. Immunosuppressants
• Inhibidores del factor de necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage tumoral ( TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF)):
  • Adalimumab Adalimumab A humanized monoclonal antibody that binds specifically to tnf-alpha and blocks its interaction with endogenous tnf receptors to modulate inflammation. It is used in the treatment of rheumatoid arthritis; psoriatic arthritis; Crohn’s disease and ulcerative colitis. Disease-Modifying Antirheumatic Drugs (DMARDs)
  • Certolizumab Certolizumab Disease-Modifying Antirheumatic Drugs (DMARDs)
  • Etanercept Etanercept A recombinant version of soluble human tnf receptor fused to an IgG Fc fragment that binds specifically to tumor necrosis factor and inhibits its binding with endogenous tnf receptors. It prevents the inflammatory effect of tnf and is used to treat rheumatoid arthritis; psoriatic arthritis and ankylosing spondylitis. Immunosuppressants
  • Golimumab Golimumab Disease-Modifying Antirheumatic Drugs (DMARDs)
  • Infliximab Infliximab A chimeric monoclonal antibody to tnf-alpha that is used in the treatment of rheumatoid arthritis; ankylosing spondylitis; psoriatic arthritis and Crohn’s disease. Disease-Modifying Antirheumatic Drugs (DMARDs)
• Inhibición de células T:
  • Abatacept Abatacept A fusion protein immunoconjugate of the extracellular domain of ctla4 and the fc domain of human igg1. It functions as a t-cell co-stimulation blocker that inhibits tnf-alpha and prevents the activation of T-lymphocytes. It is used in the treatment of rheumatoid arthritis. Immunosuppressants

Inhibidores de células B

• La inhibición de la actividad de las células B reduce la inflamación y disminuye la respuesta inmunitaria mediante la realización de:
  • ↓ Producción de anticuerpos
  • ↓ Presentación de antígenos por células B a células T
  • ↓ Activación de células T por células B
  • ↓ Producción de citocinas proinflamatorias
• Estos medicamentos están disponibles en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma intravenosa, y belimumab Belimumab Immunosuppressants también se administra por vía subcutanea.

Inhibidores de interleucina

• Los LOS Neisseria inhibidores de interleucina tienen como objetivo las citocinas que transmiten señales químicas entre los LOS Neisseria leucocitos para prepararlos para tratar infecciones.
• La supresión de la acción de las citocinas provoca la supresión del sistema inmunitario y reduce la inflamación.
• Administrado IV y SC.

Inhibidores del factor de necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage tumoral

• Los LOS Neisseria agentes se unen al AL Amyloidosis factor de necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage tumoral ( TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF)) y bloquean su interacción con los LOS Neisseria receptores de TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF).
• Todos los LOS Neisseria medicamentos están aprobados para el tratamiento de la AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation

Inhibidor de células T

• Tiene como objetivo la vía para la activación de células T
• Medicamento: abatacept Abatacept A fusion protein immunoconjugate of the extracellular domain of ctla4 and the fc domain of human igg1. It functions as a t-cell co-stimulation blocker that inhibits tnf-alpha and prevents the activation of T-lymphocytes. It is used in the treatment of rheumatoid arthritis. Immunosuppressants
  • Proteína de fusión compuesta por proteína 4 asociada a linfocitos T citotóxicos (CTLA4, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) y la porción Fc Fc Crystallizable fragments composed of the carboxy-terminal halves of both immunoglobulin heavy chains linked to each other by disulfide bonds. Fc fragments contain the carboxy-terminal parts of the heavy chain constant regions that are responsible for the effector functions of an immunoglobulin (complement fixation, binding to the cell membrane via fc receptors, and placental transport). This fragment can be obtained by digestion of immunoglobulins with the proteolytic enzyme papain. Immunoglobulins: Types and Functions de IgG1
  • Un modulador selectivo de la coestimulación
• Mecanismo de acción:
  • Normalmente, CD80 y CD86 (proteínas B7 presentes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células presentadoras de antígenos ( APC APC A polyposis syndrome due to an autosomal dominant mutation of the apc genes on chromosome 5. The syndrome is characterized by the development of hundreds of adenomatous polyps in the colon and rectum of affected individuals by early adulthood. Familial Adenomatous Polyposis, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)) interactúan con los LOS Neisseria receptores coestimuladores en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células T (coestimulación)
  • La activación de las células T se inhibe al AL Amyloidosis unirse a CD80 y CD86 en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las APC APC A polyposis syndrome due to an autosomal dominant mutation of the apc genes on chromosome 5. The syndrome is characterized by the development of hundreds of adenomatous polyps in the colon and rectum of affected individuals by early adulthood. Familial Adenomatous Polyposis → bloqueando la interacción de CD28 CD28 Costimulatory t-lymphocyte receptors that have specificity for CD80 antigen and CD86 antigen. Activation of this receptor results in increased t-cell proliferation, cytokine production and promotion of t-cell survival. T cells: Types and Functions entre las APC APC A polyposis syndrome due to an autosomal dominant mutation of the apc genes on chromosome 5. The syndrome is characterized by the development of hundreds of adenomatous polyps in the colon and rectum of affected individuals by early adulthood. Familial Adenomatous Polyposis y las células T
• Farmacocinética:
  • Intravenosa, subcutanea
  • Vida media: 13 días (intravenosa)
• Indicaciones:
  • AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation
  • Artritis reumatoide juvenil idiopática
  • Artritis psoriásica
• Efectos secundarios:
  • Exacerbación de la enfermedad pulmonar obstructiva crónica (EPOC)
  • Infecciones
  • Malignidad
  • Reacciones de hipersensibilidad
• Contraindicaciones:
  • Hipersensibilidad al AL Amyloidosis medicamento
  • Infección tuberculosa activa
• Interacciones con medicamentos:
  • Vacunas: ↓ efectos terapéuticos de vacunas inactivadas y ↑ efectos secundarios de vacunas vivas
  • Uso con otros inmunosupresores: ↑ inmunosupresión

Inhibidores de Calcineurina

Definición

Los LOS Neisseria inhibidores de la calcineurina son agentes inmunosupresores que tiene como objtetivo la calcineurina, una fosfatasa de señalización importante en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la activación de las células T.

Medicamentos

• Ciclosporina
• Pimecrolimus Pimecrolimus Immunosuppressants
• Tacrolimus Tacrolimus A macrolide isolated from the culture broth of a strain of streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. Immunosuppressants

Farmacodinámica

Mecanismo de acción:

• Se une a una proteína intracelular, FKBP-12, y forma un complejo con proteínas dependientes de calcineurina → ↓ actividad de calcineurina fosfatasa → ↓ inmunidad celular
• También bloquea la transcripción de citocinas (e.g., IL-2, interferón gamma (IFN-γ)), lo que da como resultado la inhibición de la activación de las células T
• Prevención in vitro de la liberación de citocinas y mediadores inflamatorios de mastocitos

Farmacocinética

• Ciclosporina:
  • Formas de dosificación:
    • Sistémico: oral, intravenosa
    • Oftálmico
  • Formas sistémicas:
    • > 90% de unión a proteínas
    • Metabolismo hepático (citocromo P450 o CYP)
    • Excreción: principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum heces
• Pimecrolimús:
  • Tópico
  • Absorción sistémica baja
  • Metabolismo hepático (CYP)
  • Excreción: heces
• Tacrolimus Tacrolimus A macrolide isolated from the culture broth of a strain of streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. Immunosuppressants:
  • Formas de dosificación:
    • Sistémico: oral, intravenosa
    • Tópico
  • Formas sistémicas:
    • Absorción variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables con forma oral
    • Aproximadamente 99% de unión a proteínas
    • Metabolismo hepático (CYP)
    • Excreción: heces

Indicaciones

• Profilaxis del rechazo del trasplante y tratamientos a largo plazo (e.g., enfermedad de injerto contra huésped)
• AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation
• Psoriasis Psoriasis Psoriasis is a common T-cell-mediated inflammatory skin condition. The etiology is unknown, but is thought to be due to genetic inheritance and environmental triggers. There are 4 major subtypes, with the most common form being chronic plaque psoriasis. Psoriasis
• Dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) atópica

Efectos secundarios

• Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus (de nueva aparición, después del trasplante)
• Trastorno electrolítico (hiperpotasemia, hiperuricemia, hipomagnesemia)
• Hepatotoxicidad
• Hipertensión
• Infecciones
• Hipertrofia miocárdica
• Nefrotoxicidad
• Neurotoxicidad
• QT prolongado
• Aplasia Aplasia Cranial Nerve Palsies de eritrocitos
• Neoplasia maligna secundaria (e.g., linfoma)

Contraindicaciones

• Sensibilidad al AL Amyloidosis medicamento o a sus componentes
• Hipersensibilidad al AL Amyloidosis aceite de ricino polioxietilado (preparados intravenosos)
• Individuos con artritis y psoriasis Psoriasis Psoriasis is a common T-cell-mediated inflammatory skin condition. The etiology is unknown, but is thought to be due to genetic inheritance and environmental triggers. There are 4 major subtypes, with the most common form being chronic plaque psoriasis. Psoriasis con inmunodeficiencia primaria o secundaria
• Hipertensión mal controlada
• Infección grave no controlada

Interacciones medicamentosas

• Inductores de CYP3A4 CYP3A4 Class 3 Antiarrhythmic Drugs (Potassium Channel Blockers): ↓ concentración sérica de inhibidores de la calcineurina
• Inhibidores de CYP3A4 CYP3A4 Class 3 Antiarrhythmic Drugs (Potassium Channel Blockers): ↑ concentración sérica de inhibidores de calcineurina
• Zumo de toronja: aumenta la concentración sérica de inhibidores de la calcineurina
• Vacunas vivas: Los LOS Neisseria inhibidores de la calcineurina potencian los LOS Neisseria efectos secundarios de las vacunas vivas.
• Estatinas: la ciclosporina aumenta la concentración sérica de estatinas.

Corticoesteroides

Definición

Los LOS Neisseria corticosteroides tienen un papel en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la respuesta inmune, la inflamación y el metabolismo. Estos agentes hormonales interfieren con el ciclo celular de las células inflamatorias y otros componentes inflamatorios (e.g., citoquinas, enzimas, proteínas).

Medicamentos

Incluye (pero no se limita a):

• Hidrocortisona
• Metilprednisolona
• Prednisolona
• Prednisona

Farmacodinámica y farmacocinética

• Mecanismo de acción:
  • El receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de glucocorticoides está dentro del citoplasma, y con la unión de glucocorticoides, se inhiben la transcripción y traducción de genes Genes A category of nucleic acid sequences that function as units of heredity and which code for the basic instructions for the development, reproduction, and maintenance of organisms. DNA Types and Structure para leucocitos inflamatorios y células estructurales
  • ↓ En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum citocinas proinflamatorias, quimiocinas, moléculas de adhesión celular y otros componentes implicados en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la respuesta inflamatoria
• La farmacocinética varía con el tipo de corticosteroides.

Indicaciones

Las condiciones incluyen:

• Alérgico/respiratorio:
  • Anafilaxia
  • Exacerbación de asma ASMA Autoimmune Hepatitis y EPOC
  • Urticaria Urticaria Urticaria is raised, well-circumscribed areas (wheals) of edema (swelling) and erythema (redness) involving the dermis and epidermis with associated pruritus (itch). Urticaria is not a single disease but rather is a reaction pattern representing cutaneous mast cell degranulation. Urticaria (Hives) y angioedema Angioedema Angioedema is a localized, self-limited (but potentially life-threatening), nonpitting, asymmetrical edema occurring in the deep layers of the skin and mucosal tissue. The common underlying pathophysiology involves inflammatory mediators triggering significant vasodilation and increased capillary permeability. Angioedema
  • Sarcoidosis Sarcoidosis Sarcoidosis is a multisystem inflammatory disease that causes noncaseating granulomas. The exact etiology is unknown. Sarcoidosis usually affects the lungs and thoracic lymph nodes, but it can also affect almost every system in the body, including the skin, heart, and eyes, most commonly. Sarcoidosis
  • Enfermedad pulmonar intersticial
• Dermatológicas:
  • Dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) de contacto
  • Pemphigus vulgaris Pemphigus vulgaris Bullous pemphigoid and pemphigus vulgaris are two different blistering autoimmune diseases. In pemphigus vulgaris, autoantibodies attack the desmosomal proteins, which connect the keratinocytes to one another. This attack results in a more severe, potentially fatal condition with fragile, flaccid blisters, usually with significant mucosal involvement. Bullous Pemphigoid and Pemphigus Vulgaris
• Endocrinológicas:
  • Insuficiencia suprarrenal
  • Hiperplasia suprarrenal congénita
• Gastrointestinales:
  • Hepatitis autoinmune
  • Enfermedad inflamatoria intestinal
• Hematológicas:
  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica
  • Púrpura trombocitopénica idiopática
  • Leucemia
  • Linfoma
• Oftalmológicas:
  • Uveitis Uveitis Uveitis is the inflammation of the uvea, the pigmented middle layer of the eye, which comprises the iris, ciliary body, and choroid. The condition is categorized based on the site of disease; anterior uveitis is the most common. Diseases of the Uvea
  • Queratoconjuntivitis
• Reumatológicas:
  • Dermatomiositis
  • AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation
  • Polimialgia reumática
  • polimiositis
  • SLE SLE Systemic lupus erythematosus (SLE) is a chronic autoimmune, inflammatory condition that causes immune-complex deposition in organs, resulting in systemic manifestations. Women, particularly those of African American descent, are more commonly affected. Systemic Lupus Erythematosus
• Otras:
  • Maduración pulmonar prenatal
  • Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema cerebral
  • Esclerosis múltiple
  • Síndrome nefrótico
  • Trasplante de órganos

Efectos secundarios

• Cardiovasculares:
  • Arritmias cardíacas
  • Insuficiencia cardíaca (predisposición a enfermedades cardíacas)
  • Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema
  • Hipertensión
• Dermatológicos:
  • Atrofia de la piel
  • Erupción cutánea
  • Hipopigmentación o hiperpigmentación
• Endocrinos y metabólicos:
  • Hiperglucemia
  • Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus
  • Supresión suprarrenal
  • Características cushingoides
  • Supresión del crecimiento en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños
• Gastrointestinales: úlcera péptica
• Genitourinarios: irregularidades menstruales
• Hallazgos musculoesqueléticos:
  • Necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage aséptica de la cabeza humeral/cabeza femoral
  • Susceptibilidad a las fracturas
  • Miopatía
  • Osteoporosis Osteoporosis Osteoporosis refers to a decrease in bone mass and density leading to an increased number of fractures. There are 2 forms of osteoporosis: primary, which is commonly postmenopausal or senile; and secondary, which is a manifestation of immobilization, underlying medical disorders, or long-term use of certain medications. Osteoporosis
• Neurológicos y psiquiátricos:
  • Cefalea
  • Hipertensión intracraneal idiopática
  • Parestesia
  • Convulsiones
  • Vértigo
  • Psicosis
  • Agitación
  • Insomnio
• Oftálmologicos:
  • Glaucoma Glaucoma Glaucoma is an optic neuropathy characterized by typical visual field defects and optic nerve atrophy seen as optic disc cupping on examination. The acute form of glaucoma is a medical emergency. Glaucoma is often, but not always, caused by increased intraocular pressure (IOP). Glaucoma
  • Cataratas
• Otros: deterioro en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la cicatrización de heridas

Contraindicaciones

• Hipersensibilidad al AL Amyloidosis medicamento o sus componentes
• Administración reciente de vacunas vivas o vivas atenuadas
• Infecciones activas no controladas (e.g., bacterianas, virales o fúngicas)
• Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus no controlada
• Estados psicóticos no controlados
• Hipertensión no controlada
• Úlcera péptica

Interacciones medicamentosas

• Vacunas vivas e inactivadas: Los LOS Neisseria corticoides potencian los LOS Neisseria efectos secundarios de las vacunas
• Uso con AINE: ↑ riesgo de úlceras gastrointestinales y sangrado
• Warfarina: corticoides ↑ efectos anticoagulantes
• Agentes antihiperglucemiantes: los LOS Neisseria corticosteroides pueden ↓ efectos

Inhibidores de mTOR

Definición

• Medicamentos que reducen la actividad de mTOR mTOR Peutz-Jeghers Syndrome serina/treonina quinasa involucrada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el crecimiento celular, el metabolismo y la proliferación de células inmunitarias
• La vía de señalización de mTOR mTOR Peutz-Jeghers Syndrome está anormalmente activada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum algunos tumores.
  • Al AL Amyloidosis inhibir la actividad de mTOR mTOR Peutz-Jeghers Syndrome serina/treonina quinasa, se detiene la progresión del ciclo celular, disminuyendo la proliferación.
  • Los LOS Neisseria agentes también tienen efectos antiangiogénicos.
• Clase de medicamentos también llamados inhibidores de la señal de proliferación

Medicamentos

• Everolimus Everolimus A derivative of sirolimus and an inhibitor of tor serine-threonine kinases. It is used to prevent graft rejection in heart and kidney transplant patients by blocking cell proliferation signals. It is also an antineoplastic agent. Immunosuppressants
• Temsirolimus Temsirolimus Immunosuppressants
• Sirolimus Sirolimus A macrolide compound obtained from streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to immunophilins. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties. Immunosuppressants

Farmacodinámia

Mecanismo de acción:

• Forma 2 complejos:
  • mTORC1: importante en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el metabolismo de lípidos, glucosa, proteínas y nucleótidos
  • mTORC2: implicado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vía de señalización de la insulina, regulando el metabolismo de los LOS Neisseria lípidos y la glucosa
• Cambiar la actividad de mTOR mTOR Peutz-Jeghers Syndrome, lo que lleva a:
  • Interrupción del desarrollo mieloide y linfoide normal
  • Detención del ciclo celular en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la fase G1-S, evitando la progresión del ciclo celular y la proliferación celular
  • Efectos antiproliferativos y antiangiogénicos

Farmacocinética

• Everolimus Everolimus A derivative of sirolimus and an inhibitor of tor serine-threonine kinases. It is used to prevent graft rejection in heart and kidney transplant patients by blocking cell proliferation signals. It is also an antineoplastic agent. Immunosuppressants:
  • Oral, de rápida absorción
  • 74% de unión a proteínas
  • Vida media: aproximadamente 30 horas
  • Metabolismo hepático
  • Excreción: principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum heces
• Temsirolimus Temsirolimus Immunosuppressants:
  • Intravenoso
  • Vida media: aproximadamente 17 horas
  • Metabolismo hepático
  • Excreción: principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum heces
• Sirolimus Sirolimus A macrolide compound obtained from streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to immunophilins. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties. Immunosuppressants:
  • Oral, de rápida absorción
  • Vida media: aproximadamente 55 horas
  • Metabolismo intestinal y hepático
  • Excreción: heces

Indicaciones

Agentes relacionados (análogos de rapamicina (rapalogs)) e indicaciones:

• Everolimus Everolimus A derivative of sirolimus and an inhibitor of tor serine-threonine kinases. It is used to prevent graft rejection in heart and kidney transplant patients by blocking cell proliferation signals. It is also an antineoplastic agent. Immunosuppressants:
  • Carcinoma de células renales
  • Prevención del rechazo de trasplantes
  • Convulsiones de inicio parcial asociadas al AL Amyloidosis complejo de esclerosis tuberosa, angiomiolipoma renal y astrocitoma subependimario de células gigantes
  • Tumores neuroendocrinos
  • Cáncer de seno
• Temsirolimus Temsirolimus Immunosuppressants: carcinoma de células renales
• Sirolimus Sirolimus A macrolide compound obtained from streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to immunophilins. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties. Immunosuppressants
  • Linfangioleiomiomatosis
  • Prevención del rechazo de trasplantes

Efectos secundarios

• Infecciones graves
• Toxicidad pulmonar
• Angioedema Angioedema Angioedema is a localized, self-limited (but potentially life-threatening), nonpitting, asymmetrical edema occurring in the deep layers of the skin and mucosal tissue. The common underlying pathophysiology involves inflammatory mediators triggering significant vasodilation and increased capillary permeability. Angioedema
• ↑ Lípidos
• Neoplasia maligna secundaria

Contraindicaciones

• Hipersensibilidad al AL Amyloidosis medicamento o a sus componentes.
• Convulsiones
• Bilirrubina > 1,5 veces el límite superior del valor normal

Interacciones medicamentosas

• Inductores de CYP3A4 CYP3A4 Class 3 Antiarrhythmic Drugs (Potassium Channel Blockers): ↓ concentración sérica de inhibidores de mTOR mTOR Peutz-Jeghers Syndrome
• Inhibidores de CYP3A4 CYP3A4 Class 3 Antiarrhythmic Drugs (Potassium Channel Blockers): ↑ concentración sérica de inhibidores de mTOR mTOR Peutz-Jeghers Syndrome
• Vacunas vivas: los LOS Neisseria inhibidores de mTOR mTOR Peutz-Jeghers Syndrome aumentan los LOS Neisseria efectos secundarios de las vacunas vivas.
• Tacrolimus Tacrolimus A macrolide isolated from the culture broth of a strain of streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. Immunosuppressants: los LOS Neisseria inhibidores de mTOR mTOR Peutz-Jeghers Syndrome potencian los LOS Neisseria efectos secundarios del tacrolimus Tacrolimus A macrolide isolated from the culture broth of a strain of streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. Immunosuppressants.
• La hierba de San Juan disminuye la concentración sérica de inhibidores de mTOR mTOR Peutz-Jeghers Syndrome.

Inhibidores de JAK

Definición

Los LOS Neisseria inhibidores de JAK (Jakinibs) son agentes inmunosupresores de moléculas pequeñas que actúan sobre las cinasas Janus (JAK1, JAK2, JAK3 JAK3 A janus kinase subtype that is predominantly expressed in hematopoietic cells. It is involved in signaling from a broad variety of cytokine receptors including ones that utilize the interleukin receptor common gamma subunit. Severe Combined Immunodeficiency (SCID), TYK2), que son tirosina cinasas citoplasmáticas esenciales para la señalización de citocinas a través de la vía JAK-STAT.

Medicamentos

• Baricitinib Baricitinib Targeted and Other Nontraditional Antineoplastic Therapy
• Tofacitinib
• Upadacitinib
• Ruxolitinib Ruxolitinib Targeted and Other Nontraditional Antineoplastic Therapy
• Abrocitinib
• Ritlecitinib (Litfulo)
• Deuruxolitinib (Leqselvi, aprobado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum julio de 2024)

Farmacodinámia

Mecanismo de acción:

• Inhiben selectivamente las proteínas JAK, bloqueando las vías de señalización de las citocinas que impulsan la inflamación y la activación inmunitaria.
• Diferentes inhibidores de JAK tienen Perfiles de selectividad variables (JAK1, JAK1/2, JAK1/3, etc ETC The electron transport chain (ETC) sends electrons through a series of proteins, which generate an electrochemical proton gradient that produces energy in the form of adenosine triphosphate (ATP). Electron Transport Chain (ETC).)
• Provoca una reducción de la transcripción de genes Genes A category of nucleic acid sequences that function as units of heredity and which code for the basic instructions for the development, reproduction, and maintenance of organisms. DNA Types and Structure inflamatorios y una disminución de la activación de las células inmunitarias.

Farmacocinética

• La mayoría de los LOS Neisseria inhibidores de JAK se administran por vía oral con buena biodisponibilidad.
• Se metabolizan por vía hepática principalmente a través de las vías del CYP3A4 CYP3A4 Class 3 Antiarrhythmic Drugs (Potassium Channel Blockers).
• Las vidas medias varían según el agente (p. ej., tofacitinib: 3 horas, baricitinib Baricitinib Targeted and Other Nontraditional Antineoplastic Therapy: 12 horas).

Indicaciones

• Artritis reumatoide ( baricitinib Baricitinib Targeted and Other Nontraditional Antineoplastic Therapy, tofacitinib, upadacitinib)
• Dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) atópica (abrocitinib, upadacitinib, crema de ruxolitinib Ruxolitinib Targeted and Other Nontraditional Antineoplastic Therapy)
• Alopecia areata Alopecia Areata Loss of scalp and body hair involving microscopically inflammatory patchy areas. Alopecia ( baricitinib Baricitinib Targeted and Other Nontraditional Antineoplastic Therapy, ritlecitinib, deuruxolitinib)
• Artritis psoriásica (tofacitinib, upadacitinib)
• Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa (tofacitinib)
• Vitíligo (crema de ruxolitinib Ruxolitinib Targeted and Other Nontraditional Antineoplastic Therapy)

Efectos secundarios

• Mayor riesgo de eventos cardiovasculares graves, neoplasias malignas, trombosis y muerte (Advertencia de recuadro, FDA 2021)
• Infecciones graves (incluido el herpes zóster)
• Anormalidades de laboratorio (aumento del colesterol, disminución de linfocitos)
• Perforación gastrointestinal
• Hepatotoxicidad

Contraindicaciones

• Infecciones graves activas
• Necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage maligna conocida
• Hipersensibilidad al AL Amyloidosis fármaco

Interacciones medicamentosas

• Los LOS Neisseria inhibidores/inductores del CYP3A4 CYP3A4 Class 3 Antiarrhythmic Drugs (Potassium Channel Blockers) afectan los LOS Neisseria niveles del fármaco
• Vacunas vivas contraindicadas
• Inmunosupresión reforzada con otros inmunosupresores

Otros Agentes Citotóxicos e Inmunomoduladores

Medicamentos

• Algunos medicamentos tienen actividades inmunosupresoras y antineoplásicas y, por lo tanto, también se usan para tumores malignos.
• Algunos de estos son agentes citotóxicos que interfieren con la síntesis de ácidos nucleicos y proteínas de las células, y otros interrumpen la respuesta inmunitaria normal.
• Como los LOS Neisseria medicamentos tienen mecanismos variados y pertenecen a diferentes clases, la farmacología de estos agentes se discutirá individualmente.
  • Azatioprina
  • Ciclofosfamida
  • Hidroxicloroquina
  • Leflunomida
  • Metotrexato
  • Micofenolato
  • Talidomida

Azatioprina

• Profármaco de mercaptopurina
• Mecanismo de acción:
  • Dividido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 6-mercaptopurina → metabolizado por hipoxantina-guanina fosforribosiltransferasa (HGPRT) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum un metabolito tioinosina monofosfato (TIMP)
  • TIMP supera a los LOS Neisseria derivados de purina e inhibe las enzimas de la síntesis de purina
  • Las formas trifosfato de TIMP se incorporan al AL Amyloidosis ADN → ↓ proliferación celular y función de los LOS Neisseria linfocitos
• Farmacocinética:
  • Oral, buena absorción
  • Metabolismo hepático
  • Vida media: aproximadamente 2 horas
  • Excreción: renal
• Indicaciones:
  • Prevención del rechazo de trasplantes (e.g., trasplante de riñón)
  • AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation
  • También se usa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum indicaciones fuera de etiqueta, como la enfermedad de Crohn, la psoriasis Psoriasis Psoriasis is a common T-cell-mediated inflammatory skin condition. The etiology is unknown, but is thought to be due to genetic inheritance and environmental triggers. There are 4 major subtypes, with the most common form being chronic plaque psoriasis. Psoriasis
• Efectos secundarios:
  • Alopecia Alopecia Alopecia is the loss of hair in areas anywhere on the body where hair normally grows. Alopecia may be defined as scarring or non-scarring, localized or diffuse, congenital or acquired, reversible or permanent, or confined to the scalp or universal; however, alopecia is usually classified using the 1st 3 factors. Alopecia
  • Mielosupresión
  • Toxicidad gastrointestinal
  • Hepatotoxicidad
  • ↑ Infecciones (especialmente virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de la varicela y del herpes simple)
  • ↑ Riesgo de malignidad (e.g., linfoma posterior al AL Amyloidosis trasplante)
• Contraindicaciones:
  • Hipersensibilidad al AL Amyloidosis medicamento
  • Embarazo
  • Aquellos con AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation y uso previo de agentes alquilantes (↑ malignidad)
• Interacciones con medicamentos:
  • Alopurinol: bloquea la xantina oxidasa (enzima importante en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el catabolismo de los LOS Neisseria metabolitos de azatioprina) → ↑ metabolitos activos de azatioprina
  • Inhibidores de la enzima convertidora de angiotensina y otros agentes mielosupresores: ↑ efectos mielosupresores de la azatioprina

Ciclofosfamida

• Pertenece al AL Amyloidosis grupo de las mostazas nitrogenadas, agentes alquilantes que funcionan principalmente uniendo grupos alquilo a varias partes del ADN
• Propiedades antineoplásicas e inmunosupresoras
• Indicaciones (no oncológicas): síndrome nefrótico

Hidroxicloroquina

• Agente antimalaria y un medicamento antirreumático modificador de la enfermedad
• Un agente inmunomodulador:
  • Inhibe los LOS Neisseria sensores de ácido nucleico, incluido el receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors tipo Toll 9 y la GMP-AMP sintasa cíclica
  • ↑ pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance lisosomal, alteración del procesamiento de antígenos (vía endolisosomal)
  • Inhibe la producción de citocinas proinflamatorias, como el factor de necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage tumoral α (TNF-α), IFN-γ e IL-6
• Indicaciones (no palúdicas):
  • LES
  • AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation

Leflunomida

• Inhibidor de la síntesis de pirimidina
• Antiinflamatorio e inmunomodulador
• Mecanismo de acción: inhibe la dihidroorotato deshidrogenasa (enzima mitocondrial), que es importante en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la síntesis de pirimidinas → ↓ activación de linfocitos
• Farmacocinética:
  • Oral
  • Metabolito activo con vida media larga
  • Metabolismo hepático
  • Excreción: heces y orina
• Indicaciones: AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation
• Efectos secundarios:
  • Reacciones dermatológicas (e.g., síndrome de Stevens-Johnson)
  • Toxicidades hematológicas: pancitopenia, agranulocitosis y trombocitopenia
  • Hepatotoxicidad
  • Hipertensión
  • Infecciones
  • Nefrotoxicidad
  • Neoplasia maligna secundaria
• Contraindicaciones:
  • Hipersensibilidad al AL Amyloidosis medicamento
  • Inmunodeficiencia
  • Embarazo
  • Insuficiencia hepática y renal grave
• Interacciones con medicamentos:
  • Carbón activado y colestiramina ↓ leflunomida
  • Los LOS Neisseria medicamentos inmunosupresores potencian los LOS Neisseria efectos inmunosupresores de la leflunomida.
  • Vacunas: ↓ efectos terapéuticos de vacunas inactivadas y ↑ efectos secundarios de vacunas vivas

Metotrexato

• Análogo del ácido fólico, perteneciente a los LOS Neisseria agentes antimetabolitos, que bloquean la actividad del ácido fólico para inhibir la división celular
• Mecanismo de acción:
  • Se une a la dihidrofolato reductasa → inhibe la formación de tetrahidrofolato (FH ₄) → ↓ síntesis de ADN
  • La folilpoliglutamato sintetasa agrega residuos de glutamil a la molécula, lo que hace HACE Altitude Sickness que la molécula no pueda atravesar las membranas celulares
  • Este mecanismo de atrapamiento de iones permite la retención prolongada de MTX MTX An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of tetrahydrofolate dehydrogenase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. Antimetabolite Chemotherapy en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la célula
• Indicaciones (no neoplásicas):
  • AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation
  • Psoriasis Psoriasis Psoriasis is a common T-cell-mediated inflammatory skin condition. The etiology is unknown, but is thought to be due to genetic inheritance and environmental triggers. There are 4 major subtypes, with the most common form being chronic plaque psoriasis. Psoriasis
  • Artritis reumatoide juvenil idiopática

Micofenolato

• Micofenolato de mofetilo → hidrolizado a ácido micofenólico, el agente inmunosupresor activo
• Mecanismo de acción:
  • Ácido micofenólico inhibe reversiblemente la inosina monofosfato deshidrogenasa, una enzima en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vía de novo de la síntesis de nucleótidos de guanina
  • Los LOS Neisseria linfocitos T y B dependen de esta vía para su proliferación
• Farmacocinética:
  • Oral, rápida absorción
  • Vida media: aproximadamente 16 horas
  • Metabolismo: hepático, tracto gastrointestinal
  • Excreción: orina
• Indicaciones: para prevenir el rechazo del trasplante de órganos
• Efectos secundarios:
  • Infecciones
  • Depresión del sistema nervioso central (SNC)
  • Linfoma y malignidad de la piel
  • Neutropenia Neutropenia Neutrophils are an important component of the immune system and play a significant role in the eradication of infections. Low numbers of circulating neutrophils, referred to as neutropenia, predispose the body to recurrent infections or sepsis, though patients can also be asymptomatic. Neutropenia
  • Aplasia Aplasia Cranial Nerve Palsies de eritrocitos
  • Diarrea, vómitos
  • Hipertensión
• Contraindicaciones:
  • Hipersensibilidad al AL Amyloidosis medicamento
  • Alergia al AL Amyloidosis polisorbato 80 (formulación IV)
  • Embarazo
• Interacciones con medicamentos:
  • Resina de colestiramina: ↓ concentración sérica de micofenolato
  • Tacrolimus Tacrolimus A macrolide isolated from the culture broth of a strain of streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. Immunosuppressants: ↑ activación de poliomavirus como el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology BK (puede causar nefritis intersticial)
  • Vacunas: ↓ efectos terapéuticos de vacunas inactivadas y ↑ efectos secundarios de vacunas vivas

Talidomida

• Inmunomodulador
• Mecanismo de acción:
  • ↓ TNF-α, ↑ células asesinas naturales e IL-2
  • Altera la expresión de moléculas de adhesión celular
  • Efectos antiangiogénicos
• Farmacocinética:
  • Oral
  • Vida media: 7 horas
  • Metabolismo mínimo
  • Excreción: orina
• Indicaciones:
  • Mieloma múltiple
  • Eritema nodoso leproso
• Efectos secundarios:
  • Bradicardia
  • Mareo, somnolencia
  • Reacciones dermatológicas
  • Hepatotoxicidad
  • Mielosupresión
  • Hipotensión ortostática
  • Neoplasia maligna secundaria
  • Convulsiones
  • Teratogenicidad
  • Eventos tromboembólicos
• Contraindicaciones:
  • Hipersensibilidad al AL Amyloidosis medicamento
  • Embarazo
• Interacciones con medicamentos:
  • Anticonceptivos hormonales: ↑ efectos trombogénicos de la talidomida
  • Depresores del SNC: ↑ efectos de la talidomida sobre el SNC

Comparación de Agentes Inmunosupresores