Drugs that affect the immune function of the body
1 Immunosuppressant cyclophosphamide (C.T.X)
1.1 Dosage form, dosage: tablet, 50 mg; injection, 200 mg (2 ml).
1.2 Usage: Total amount for adults: 150 mg/kg body weight. 0.05~0.15/day, orally, discontinued after the total amount is used; 20 mg/kg body weight/time, applied in 1~2 days, applied every two weeks or four weeks, changed to once every three months after six months, changed to once every six months after one year, discontinued after the total amount is used.
1.3. Pharmacological effects: This product can inhibit the proliferation of cells, non-specifically in killing antigen-sensitive lymphocytes and limiting their transformation into immunoblasts. It has inhibitory effect on both humoral and cellular immunity.
1.4 Adverse reactions.
1.4.1 Bone marrow suppression, mainly leukopenia.
1.4.2 Chemical cystitis.
1.4.3 Nausea, vomiting and anorexia, occasionally causing gastrointestinal mucosal ulcer disease and bleeding.
1.4.4 Hair loss, occasionally skin pigmentation and allergic eczema.
1.4.5 Long-term application may cause testicular atrophy and sperm deficiency in men; amenorrhea, ovarian fibrosis or teratogenesis in women. May induce tumors.
1.4.6 Occasionally affect liver function, jaundice and prothrombin reduction.
1.5 Precautions.
1.5.1 Avoid long-term supraphysiological dosing.
1.5.2 Avoid oozing during intravenous injection.
1.5.3 Use with caution in patients with poor liver function.
1.5.4 Combination with prednisone, phenobarbital and chloramphenicol may enhance or diminish the efficacy of this product.
Cyclosporine (Cyclosporine A)
1.1 Dosage: oral liquid, 50ml: 5g; capsule, 50mg.
1.2 Usage: Initial dose: 8~15 mg/kg body weight/day, divided into 2~3 oral doses; maintenance dose 2~6 mg/kg body weight/day, adjusted at appropriate times.
1.3. Pharmacological effects: This product has immunosuppressive effects, mainly on T lymphocytes, inhibiting the secretion of interleukins and other lymphokines, reducing the immune function of the body, but the bone marrow inhibition is not strong.
1.4 Adverse reactions: common are nephrotoxicity, hepatotoxicity, hypertension, central nervous system dysfunction and gastrointestinal dysfunction.
1.5 Precautions.
1.5.1 This product should be combined with nephrotoxic drugs with caution; if necessary, the dose should be adjusted at any time.
1.5.2 Drugs with hepatic enzyme-inducing effects such as phenobarbital and rifampin may reduce the plasma concentration of this product.
1.5.3 Ketoconazole, amphotericin, erythromycin and calcium antagonists will increase the blood concentration of this product.
1.5.4 When used in combination with other immunosuppressive drugs, the dose must be reduced.
1.5.5 Contraindicated in patients with hypersensitivity to cyclosporine, pregnant women and nursing mothers. Contraindicated or used with caution in patients with severe hepatic or renal impairment.
1.5.6 Blood level monitoring and timely dose adjustment are effective measures to reduce adverse reactions.
Snapdragon (mescaline, mycophenolate, MMF)
1.1 Dosage: Capsules, 250 mg.
1.2 Usage: Organ transplantation: adults, 2.0-2.5g day; children, 30mg/kg body weight/day, divided into 2 oral doses on an empty stomach. Autoimmune disease: adults, 1.0~1.5 g day, course of treatment for six months.
1.3. Pharmacological effects: This product is an inhibitor of purine synthesis. After oral absorption, it is hydrolyzed in vivo into the active metabolite mycophenolic acid (MPA), which blocks guanine nucleotide synthesis in lymphocytes by non-competitively inhibiting the activity of hypoxanthine nucleotide dehydrogenase in the purine synthesis pathway and blocking DNA synthesis, thereby inhibiting the proliferative response of T and B lymphocytes, inhibiting B cell antibody formation and differentiation of cytotoxic T cells.
1.4 Adverse effects: anorexia, diarrhea, esophagitis, gastritis, gastrointestinal bleeding, respiratory distress are seen. Occasionally, thrombocytopenia, anemia, and neutropenia are seen. May cause cutaneous herpesvirus and cytomegalovirus infections.
1.5 Precautions.
1.5.1 Contraindicated in pregnant and lactating women.
1.5.2 For those with severe chronic renal impairment, the dosage should not exceed 1 gram per time, twice a day. This product is mainly excreted by urine, and should not be used together with drugs that inhibit renal function.
1.5.3 Eating can reduce the peak plasma value of this product by nearly 40%, so it should be taken on an empty stomach.
Enova (Leflunomide)
1.1 Dosage: Tablet, 10mg.
1.2 Dosage: 10mg/kg body weight/day, orally for three days, after three days change to 40 mg daily, after one week change to 20~30 mg daily. half year course.
1.3. Pharmacological action: This product is a synthetic iso-fazole derivative anti-inflammatory and immunosuppressive agent. It is rapidly converted to the active metabolite A771726 in vivo, which acts by inhibiting the phosphorylation of tyrosine in T cells after IL-2 stimulation. Blocking the biosynthesis of pyrimidine nucleotides, inhibit the proliferation of T and B lymphocytes and non-immune cells.
1.4 Adverse effects: Gastrointestinal reactions such as anorexia, diarrhea, nausea and vomiting are seen. Other adverse reactions include hypertension, dizziness, pruritus, rash, emaciation, anemia, teratogenic fetus and reversible alopecia.
1.5 Precautions.
Because of the long half-life of its active metabolites, careful observation should be made after administration.
Azathioprine
1.1 Dosage: oral liquid, 50 ml: 5 g; capsule, 50 mg.
1.2 Usage: Initial dose: 8~15 mg/kg body weight/day, divided into 2~3 oral doses; maintenance dose 2~6 mg/kg body weight/day, adjusted when appropriate.
1.3. Pharmacological action: This product has purine antagonistic effect, so it can inhibit the synthesis of DNA of immunologically active cells, thus inhibiting the proliferation of lymphocytes, i.e. preventing the transformation of antigen-sensitive lymphocytes into immunoblasts and producing immunosuppressive effect. The inhibitory effect of this product on T lymphocytes is strong, and a smaller dose can inhibit cellular immunity, and the dose of inhibiting B lymphocytes is much larger than the dose of inhibiting T cells.
1.4 Adverse reactions: common include nephrotoxicity, hepatotoxicity, hypertension, central nervous system dysfunction and gastrointestinal dysfunction.
1.4.1 Mainly leukopenia and thrombocytopenia with bleeding tendency, which can cause bone marrow suppression in overdose.
1.4.2 Gastrointestinal reactions such as nausea, vomiting, diarrhea and loss of appetite, large doses can occur intestinal mucosal ulcers and oral ulcers, occasionally jaundice and hepatotoxicity.
1.4.3 Hyperuricemia is common in the treatment of leukemia.
1.4.4 It is used with caution for those with poor liver and kidney function, and is contraindicated for pregnant women.
2 Biological response regulator thymidine (thymosin, thymic polypeptide)
1.1 Dosage and dosage: tablet, 5mg; injection, 20mg.
1.2 Usage: 20~100mg/day, intravenous drip for a week, after a week, change to every other day 20 mg intramuscular injection.
1.3. Pharmacological effects: This product can make the stem cells produced by the bone marrow into T cells, and thus has the effect of enhancing cellular immune function, with little effect on humoral immunity.
1.4 Adverse reactions: fever, urticaria, rash in a few patients, dizziness in individual patients, etc. are common.
1.5 Precautions: Skin test is required before injection or after discontinuation of the drug.
Levamisole
1.1 Dosage form and dosage: tablet, 25mg.
1.2 Usage: 2.5 mg/kg body weight/day, divided into 2~3 times orally, three days per week orally, four days off, six months of treatment.
1.3. Pharmacological effects: This product can restore the immune function of immunodeficient or immunosuppressed hosts, the effect on the normal organism is not significant.
1.4 Adverse reactions: occasional dizziness, nausea, vomiting, abdominal pain, loss of appetite, fever, drowsiness, fatigue, rash, itching, etc., which can be relieved by themselves after stopping the drug. Individual patients may have leukopenia, exfoliative dermatitis and liver function impairment.