Tacrolimus for the USMLE Step 1, clear as crystal.
Welcome to section two of immunology pharmacology in this section we’ll be discussing tacrolimus let’s get started before we jump into the magenta monic i think it would be helpful to take a step back and conceptually understand the mechanism of tacrolimus as you can see this is an overview figure of the various immunosuppressive drug targets within a t helper
Cell notice that tech role ms binds to the protein fk bp which is also known as fk506 binding protein from here tacrolimus and fk bp inhibit calcineurin as you can see from here the mechanism and pathway is very similar to cyclosporine ultimately il-2 transcription is inhibited which decreases t-cell growth and therefore decreases the ability of the immune system
To fight off infection this also prevents organ transplant rejection and can help mitigate the effects of autoimmune diseases all right with this background let’s dive into the specifics and help you memorize tec role illness this scene will take place inside of a classroom notice that some mischievious student has placed a pointy thumbtack on the teacher’s chair
The sound tack in the word thumbtack sounds like tech roll amiss and should help you remember that this image is all about tech roll emmis now you can see that we’ve shown the thumbtack on top of a nice fluffy pad this pad has the letters fk bp on it which stands for fluffy comfy butt pad after all it’s fluffy comfy and a pad for the teachers butt against the hard
Wooden chair in any case this fluffy comfy butt pad should make you think of fk bp also the fact that the thumbtack is on top of this pad should help you remember that tacrolimus binds to fk bp for ch initely the teacher didn’t realize that this thumb tack was on her chair so as she sat down eat her lunch she had a nice surprise waiting for her now we can see her
Jumping up in pain as a result she has accidentally knocked over her milk and sausage links she was planning on having for lunch we introduced this symbol in the cyclosporine video but the milk should make you think of calcium and the sausage links should make you think of a neuron so calcium plus neuron for calcineurin the fact that the food is being destroyed
Should make you think of calcineurin inhibition so putting this all together should help you remember that tacrolimus along with fk bp inhibit calcineurin one of her students was drawing on the desk minding her own business when she got splattered then knocked over milk i guess it was probably for the best because the student was actually vandalizing the desk
And drawing a warrior with a t-shaped flail directly into the desk recall that the t-shaped flail is our symbol for t-cells the fact that it’s getting splattered in milk and destroyed should make you think of t-cell inhibition so putting these ideas together should help you remember that tech rolla –mess blocks t-cell activation in addition to spilling milk on
Her student notice that the teacher is squishing this worker guy with her chair he was hired by the school to install these nice new interlocking wooden floors in the classrooms interlocking wooden floors like this are our symbol for interleukins also notice that he’s holding two panels one in each hand and this should make you think of the number two finally
He’s being prevented from installing the floors which should make you think of inhibition or prevention so collectively these ideas should help you remember that tacrolimus prevents transcription of interleukin 2 you may have been wondering who put that thumbtack on the teacher’s chair well it’s probably pretty obvious now this bully kid front and center of course
Notice that he’s also being a bully to the student in the black shirt by kicking open his lunchbox his lunch box has a slab of raw meat in it and looks kind of like a transplant cooler which should make you think of transplant it’s also being kicked away or rejected by the bully which should make you think of rejection together these ideas should help you remember
That tech columnist can be used for acute transplant rejection all right now let’s discuss the side effects associated with tech rolling miss the poor student lost his lunch meat but the good news is that he still has his green kidney beans if you look at the one green bean on his desk we can see that someone has taken a bite out of it which alludes to the idea
That the kidneys are harmed by tech rodimus so these beans are here to help you remember that tech columnist is nephrotoxic now we’ve shown the bully eating some sausage links he must have pulled him from the lunch box before he kicked it across the room this is our symbol for neurons because the sausage links resemble neurons and it’s in this part of the image
To help you remember that tech columnist is neurotoxic as the lunch box flew across the room it clashed into the trashcan and caused a bunch of dust and infectious particles to fly up into the air these distinct infectious particles should help you remember that tech columnist increases the risk of infection this makes sense right it’s an immunosuppressive agent
So patients are more likely to get sick when using this drug towards the back of the classroom we can see the good side humanity noticed that there was a bald girl sitting on her desk with the cancer hope ribbon around her neck she must be going through chemo and is now going bald her friend is kind enough to cut off a piece of her own hair and offer it to her
Anyway the cancer reference should help you remember that tech columnist increases the risk of malignancy finally if you look closely at the girl giving her a lock of hair you can see that it has many dyke beads in it this should make you think of diabetes and is here to help you remember that tech columnist increases the risk of diabetes alright that should be
Everything you need to know about tech columnist
Transcribed from video
Tacrolimus for the USMLE Step 1 By Physeo – USMLE Library