Immunopharmacology

dr Fia Fia
Obat:
Menekan sistem imun (penyakit autoimun)
Meningkatkan sistem imun (terapi AIDS,
kanker, imunodefisiensi, infeksi)
Menekan reaksi alergi
Menyebabkan alergi (hipersensitivitas
obat)
Immunosuppresive agents
Digunakan untuk:
Transplantasi organ dan sumsum tulang
Penyakit autoimun/isoimun
Mencegah proliferasi sel (stent koroner,
neovascular macular degeneration)
Immunomodulation therapy: cytokines &
inhibitors
Immunosuppresive agents
Glukokortikoid
Calcineurin inhibitors (cyclosporin, tacrolismus)
Proliferation signal inhibitors (sirolimus,
everolismus)
Mycophenolate mofetil
Thalidomide
Cytotoxic agents
Immunosupressive antibodies
Monoclonal antibodies
Glukokortikoid
Bersifat imunosupresif dan anti-inflamasi
Indikasi: transplantasi organ, penyakit
autoimun, penyakit alergi (asma),
premedikasi sblm pemberian obat lain
(darah/kemoth)
ES: cushing syndrome, endokrin-metabolik
(DM, HT), osteoporosis, katarak, infeksi,
ggn mental, retardasi pertumbuhan, dsb.
Calcineurin inhibitor
Cyclosporin (IV/PO/ophthalmic, inhaled)
Tacrolimus (sistemik & topikal)
Indikasi: transplantasi organ, peny autoimun
M.k: menghambat aktivasi sel T
ES: nefrotoksik, HT, hiperglikemia, disfungsi hati,
hiperkalemia, perubahan status mental, kejang,
hirsutism, peningkatan insidens keganasan
Proliferation signal inhibitor
Sirolimus, Everolimus
M.k: menghambat proliferasi sel T & sel B (prod
Ig)
Indikasi: profilaksis dan th/ GVHD akut & kronik
yg refrakter thd steroid pd transplantasi
hematopoietic stem cell
ES: mielosupresi (t.u trombositopenia),
hepatotoksik, diare, hipertrigliseridemia,
pneumonitis, sakit kepala, nefrotoksik
Mycophenolate mofetil (MMF)
M.k: hambat respon sel T & B limfosit
Indikasi: GVHD yg refrakter, cegah/mkan
chronic allograft vasculopathy pd resipien
transplantasi jantung, lupus nephritis, RA,
inflammatory bowel disease, peny kulit
ES: ggn GI, sakit kepala, HT, mielosupresi
reversibel (t.u netropenia)
Thalidomide
M.k: menghambat angiogenesis, anti-inflamasi,
imunomodulasi: hambat TNF-, m fagositosis
netrofil, m prod IL-10, m cell-mediated
immunity oleh T cell.
Indikasi: multiple myeloma, leprosy, SLE (kulit),
dll
ES: teratogenik, neuropati perifer, konstipasi,
rash, fatigue, hipotiroidisme, p risiko DVT
Cytotoxic agents
Azathioprine
Cyclophosphamide
Leflunomide
Hydroxychloroquine
Lain2: vincristine, methotrexate, cytarabine,
vinblastine, pentostatin
Immunosuppresive antibodies
Antilymphocyte (ALG) & antithymocyte
antibodies (ATG): utk transplantasi sumsum tlg
dan organ (cegah penolakan)
Muromonab-CD3: utk autoimun dan
transplantasi
Immune globulin intravenous (IGIV): utk SLE,
ITP, kawasakis disease, HIV, dll
Rh0(D) immune globulin: utk HDN
Hyperimmune globulins: utk virus (RSV, CMV,
VZV, HHV3, HBV, rabies, tetanus), overdosis
digoksin atau toksin (ular)
Monoclonal antibodies (MABs)
Antitumor MABs
Alemtuzumab
Bevacizumab
Ranibizumab
Cetuximab
Gemtuzumab
Panitumumab
Rituximab
trastuzumab
Monoclonal antibodies (MABs)
MABs utk menandai tumor:
Arcitumomab
Capromab pendetide
Ibritumomab tiuxetan
Nofetumomab
Satumomab
Tositumomab
Monoclonal antibodies (MABs)
MABs utk imunosupresan & anti-inflamasi
Anti TNF-: adalimumab, etarnecept, infliximab
Abartacept
Alefacept
Basiliximab
Daclizumab
Efalizumab
Omalizumab
Monoclonal antibodies (MABs)
Lain-lain:
Abciximab: utk anti agregasi platelet
Eculizumab: utk paroxysmal nocturnal
hemoglobinuria (PNH)
Palivizumab: cegah infeksi RSV pada neonatus
Immunomodulation therapy
Meningkatkan respon imun pada pasien
imunodefisiensi:
Digunakan utk:
Penyakit imunodefisiensi (termasuk AIDS)
Infeksi kronis
Cancer
Tdd: sitokin (IFN, IL, TNF, dsb) dan inhibitor
sitokin (anankira: antagonis reseptor IL-1 utk
RA)