Anti-Pruritic Medications Flashcards
Briefly describe the pathway that apoquel (oclacitinib) and cytopoint(lokivetmab) primarily act upon:
IL-31 –> activates JAK receptor –> activates STAT (transcription of pro-inflammatory cytokines + itch)
Both drugs act on this pathway but cytopoint acts higher (apoquel - targets JAK1, cytopoint - targets IL-31)
How do corticosteroids such as prednislone work to decrease inflammation?
Depending on dose either anti-inflammatory or immunosupressive - inhibit inflammation associated molecules + upregulate anti-inflammatory mediators
How dose cyclosporin work?
Calcineurin inhibitor - suppresses IL-2 –> blocks proliferation of T cells
How does onset of activity vary between prednisolone, cytopoint, apoquel and cyclosporin?
Prednisolone, cytopoint + apoquel - quick onset (within 24 hours)
Cyclosporin - 4 weeks to reduce pruritis in a dog (2-3 wks in a cat)
What are the side effects of apoquel?
Mild GI side effects
Don’t give to patients <1y of age –> Demodex + severe pneumonia have been observed
What are the major side effects observed with cytopoint?
No side effects seen
What are the major side effects of cyclosporin?
GI upset
Other side effects: increased hair growth, papillomas, gingival hyperplasia
What is the main drug that is contraindicated with the use of cyclosporins and why?
Ivermectin - cyclosporin affects the integrity of the blood brain barrier
What drug can cyclosporin be used in conjunction with to prolong it’s period of action?
Ketoconazole - inhibits the P450 enzyme in the liver
What are the main side effects of prednisolone?
PU/PD, polyphagia, polydipsea, behavioural changes, GI ulceration, hepatopathy, diabeties, hyperlidemia, decreased thyroid hormone
*** don’t use in conjunction with NSAID’s. (increased risk of GI ulceration + liver failure)
What anti-pruritic medications can be used in cats?
Cyclosporin - only routinely used medication in casts
