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Pharmacology · USMLE Step 1

USMLE Pharmacology: Immunosuppressants and Antineoplastics

Immunosuppressant and chemotherapy drug classes with mechanism of action and one signature toxicity per card.

41 cards · basic cards · AI-written, checked twice. Edit anything.

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Cyclosporine: mechanism of action
Binds cyclophilin, inhibiting calcineurin and blocking IL-2 gene transcription
Signature toxicity of cyclosporine
Nephrotoxicity
Tacrolimus: mechanism of action
Binds FKBP, inhibiting calcineurin and blocking IL-2 transcription
Sirolimus (rapamycin): mechanism of action
Binds FKBP and inhibits mTOR, blocking the cellular response to IL-2
Unlike cyclosporine and tacrolimus, sirolimus causes ____ rather than nephrotoxicity.
pancytopenia and hyperlipidemia
Azathioprine: mechanism of action
A purine analog (prodrug of 6-mercaptopurine) that inhibits de novo purine synthesis, suppressing lymphocyte proliferation
Signature toxicity of azathioprine
Bone marrow suppression
Mycophenolate mofetil: mechanism of action
Inhibits inosine monophosphate dehydrogenase, blocking purine synthesis selectively in B and T lymphocytes
Basiliximab: mechanism of action
Monoclonal antibody that blocks the IL-2 receptor (CD25) on activated T cells
Signature toxicity of basiliximab
Hypersensitivity reactions and edema
Cyclophosphamide: mechanism of action
Alkylates and cross-links DNA at guanine N7, requiring hepatic activation to its active form
Signature toxicity of cyclophosphamide
Hemorrhagic cystitis, caused by the metabolite acrolein
Cisplatin: mechanism of action
Cross-links DNA, triggering apoptosis in a cell cycle nonspecific manner
Cisplatin's dose-limiting toxicities are ____.
nephrotoxicity and ototoxicity
Methotrexate: mechanism of action
Inhibits dihydrofolate reductase, blocking regeneration of tetrahydrofolate and halting DNA synthesis

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