Drugs used in treating Immune mediated disease

Question 1

What is the effect of Glucocorticoid on immune mediated disease?

Answer 1

1. Antiinflammatory
2. Immunosuppression
3. Anti-fibrotic

• upregulates antiinflammatory protein, down regulate pro inflammatory proteins
• affect B and T cell activity
• suppress chemotaxis, mononuclear phagocytic activity
• Reduce cytokines, leucotriennes, prostaglandin production
• T cell apoptosis
• Decrease neutrophil migration

Question 2

Azothioprine

• mode of action
• side effects

Answer 2

• affect DNA synthesis by compete with purines

- myelosuppression, hepatopathy

Question 3

Cyclophosphamide and chlorambucil mode of action

Answer 3

Alkylating agent- cross linkage with cellular DNA rendered its use for synthesis

Cell cycle non specific

Side effects cyclophosphamide - myelosuppression, sterile hemorrhagic cystitis

chlorambucil- myelosuppression

Question 4

Ciclosporin mode of action and side effects

Answer 4

T cell inhibition

GI signs, T. gondii recrudescence for cat , gingival hyperplasia

Question 5

Vincristine mode of action and side effects

Answer 5

Interfere with microtubule formation in metaphase causing apoptosis

may stimulate platelet proliferation and prevent platelet destruction

Phlebitis if extravasation

Question 6

Mycophenolate mode of action and side effects

Answer 6

Affect purine synthesis and therefore B and T cell proliferation

myelosuppression

Question 7

Leflunomide mode of action and side effects

Answer 7

Inhibits T and B lymphocyte proliferation, suppresses immunoglobulin production, and interferes with leucocyte adhesion and diapedesis, usually through inhibition of tyrosine kinases.

Also inhibits dihydro-orotate dehydrogenase, an enzyme involved in de novo pathway of pyrimidine synthesis.

Mylesuppression and GI problem