Haematopoeitic Therapeutics Flashcards
1
Q
Cyclophosphamide (cytoxan), doxorubicin (adriamycin), vincristine (oncovin), prednisolone, L-asparaginase (CHOP)
A
- Chemotherapy
- Canine + feline lymphoma
2
Q
Chlorambucil
A
- Chemo
- Chronic lymphocytic leukaemia (CLL)
3
Q
Vitamin K (e.g. Konakion MM, phytomenadione)
A
- Co-factor in gamma-carboxylation of F II, VII, IX and X
- SC/PO
- Vitamin K-dependent coagulopathies (bleeding disorders): vit K deficiency 2y to pancreatic deficiency, rodenticide poisoning
4
Q
Heparin & low molecular weight heparins (LMWHs)
A
- Glycosaminoglycans present in mast cells
- Extracted from beef/pig
- Inhibit coagulation by increasing affinity of antithrombin III to thrombin + other protease enzymes in coagulation cascade
- Heparin IV/SC (not IM - causes hematomas)
- LMWHs SC
- Promotion of anticoagulation: maintenance of IV catheter placement (heparin), prevention of 2y thromboembolic disease, disseminated intravascular coagulation (DIC) (controversial)
- AE: haemorrhage (stop, give antagonist for heparin = protamin sulfate); heparin-induced thrombocytopenia; interacts w/ other drugs affecting coagulation e.g. aspirin/NSAIDs; may antagonise corticosteroids/insulin -> may inc diazepam levels
5
Q
Aspirin
A
- NSAID, antiplatelet
- Inhibits platelet thromboxane A2 synthesis - reduced platelet activation
- AE: GI ulceration + irritation; caution in renal disease
6
Q
Clopidogrel
A
- Antiplatelet
- Prodrug - inhibits P2Y12 (an ADP-activated GPCR on platelets)
- Can be given w/ aspirin
- AE: Caution in hepatic + renal disease, has bad taste
- Dec risk of thromboembolism
7
Q
Prednisolone
A
- Oral glucocorticoid
- Immunosuppressant
- Companion animals
- Can be given w/ azathioprine (not cats), cyclophosphamide, cyclosporin, chlorambucil adjuvant agents
- Immune-mediated haemolytic anaemia (IMHA); Immune-Mediated Thrombocytopenia (IMTP); eosinophilia; leukaemia
- (Give gastroprotective therapy - e.g. H2 antagonist or omeprazole)
- AE: Care w/ giving for hypothalamic-pituitary-adrenal (HPA) axis, high dose may shut adrenal glands down -> dec steroid production; may antagonise effect of insulin
- Contraindicated: pregnant animals, diabetes mellitus, renal insufficiency, corneal ulceration, alongside live vaccines
8
Q
Dexamethasone
A
- Immunosuppressant
- Glucocorticoid
- IV/IM
- Horses
- Can be given w/ azathioprine, cyclophosphamide, cyclosporin, chlorambucil adjuvant agents
- Immune-mediated disease; inflam skin conditions; blood transfusion (hypersensitivity/anaphylactic) reaction
- AE: Care w/ giving for hypothalamic-pituitary-adrenal (HPA) axis, high dose may shut adrenal glands down -> dec steroid production; may antagonise effect of insulin; contradicted use alongside NSAIDs
- Contraindicated: pregnant animals, diabetes mellitus, renal insufficiency, corneal ulceration, alongside live vaccines
9
Q
Azathioprine, cyclophosphamide, cyclosporin, chlorambucil
A
- Immunosuppressants
- Co-admin w/ glucocorticoids - steroid sparing to dec steroid dose + effects
- Azathioprine - don’t give to cats
- Immune-mediated diseases e.g. IMHA
10
Q
Ciclosporin
A
- Immunosuppressive but not cytotoxic (like azathioprine and chlorambucil)
- Inhibits calcineurin -> dec signalling of inflam cytokine IL-2 and dec T-cell proliferation/activity, inhibits APC in skin, inhibits degranulation of mast cells and release histamine
- Chronic allergic dermatitis (cats); atopic dermatitis (dogs)
- Give 2 h prior / after food to prevent fast absorption w/ food
- AE: Well-tolerated + uncommon in dogs; cats = common: GI signs (V+/D+/anorexia/hypersalivation), lethargy, weight loss, lymphopoenia
- Plasma conc lowered by anticonvulsants + some ABs; drugs that inhibit/induce cytochrome p450 interfere w/ conc; use w/ aminoglycoside AB/trimethoprim -> inc nephrotoxicity
- Contraindicated: Hx of malignant disorders, live vaccination (2 w before/after); diabetic dogs, w/ other immunosuppressive agents; dogs <6 m, cats w/ FeLV or FIV
11
Q
Apoquel (oclacitinib)
A
- Immunosuppressant
- Janus kinase (JAK) inhibitor
- Inhbits func of cytokines dependent on JAK enzyme activity - esp. IL-31
- Dogs: pruritus, atopic dermatitis
12
Q
Cytopoint (Lokivetmab)
A
- Immunosuppressant
- Caninised monoclonal antibody (mAb), targets canine interleukin-31
- Dogs: pruritus, atopic dermatitis
- Alternative to Apoquel
13
Q
Azathioprine
A
- Immunosuppressant
- Cytotoxic - inhibits purine synthesis -> impacts DNA & RNA synthesis; inhibits clonal proliferation during induction phase of immune response (cell- and antibody-mediated)
- AE: BM suppression; GI upset/anorexia, poor hair growth, acute pancreatitis, hepatotoxicity; caution use in renal impairment/hepatic disease
- Not recommended for cats - low in enzyme which metabolises azathioprine so prone to toxicity (fatal leukopenia/thrombocytopenia)
14
Q
Chlorambucil
A
- Immunosuppressant (not v well characterised in companion animals)
- Small cell alimentary lymphoma; IMHA
- Cytotoxic - alkylating agent which cross-links DNA during all phases of the cell cycle, impeding replication
- AE: BM suppression, anorexia, nausea, vomiting, diarrhoea, poor hair growth, neurotoxicity and seizures reported (rare)
15
Q
Cyclophosphamide
A
- Immunosuppressant
- Cytotoxic - alkylating agent which cross-links DNA during all phases of the cell cycle, impeding replication
- AE: BM suppression, V+, D+, poor hair growth, myelosuppression, inc water intake in cats to reduce risk of haemorrhagic cystitis
- Immune-mediated disease, lymphoma, various cancers
