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Pharmacology > Immunology and Neurology > Flashcards

Immunology and Neurology Flashcards

1
Q

Corticosteroids (immunology)
MOA and Adverse effects

A

Binds with intracytoplasmic GC recepotr -> receptor complex is translocated to cell nucleus -> binds DNA GC response elements that affect gene transcription

GI ulceration, iatrogenic hyperadrenocorticism/adrenal gland suppression
Insulin resistance + secondary diabetes mellitus
Hypercoagulability
Muscle catabolism
Delayed wound healing
Opportunistic infections
Behavior changes
PU/PD, polyphagia, weight gain
Increased panting
Elevations of ALP activity (induction of steroid-induced isoenzyme)

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2
Q

Corticosteroids - effects on immune system

A
  1. Inhibits macrophage function (downregulates Fc receptor expression)
  2. Decreased antigen processing
  3. Decreased cell adhesion
  4. Suppression of T cell function
  5. T cell apoptosis
  6. Suppression of antibody production
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3
Q

Azathioprine

A

MOA: Thiopurine analog - disrupts DNA/RNA synthesis

Effects: decreased lymphocyte number + T-cell dependent Ab production

AE: GI disturbances, myelosuppression, hepatotoxicity, pancreatitis, secondary infection

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4
Q

Cyclosporin

A

MOA: Calcineurin inhibitor -> suppresses cytokine transcription

Effects: decreases T-cell proliferation + maturation (primarily T-helper cells)

AE: GI disturbances (freezing may help), gingival hyperplasia, secondary infection, alopecia, nephrotoxicity, hepatotoxicity, lymphoid neoplasia

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5
Q

Mycophenolate mofetil

A

MOA: purine syntehsis inhibitor - inhibits de novo guanine synthesis + disrupts DNA formation (inhibition of inosine-5’-monophosphate dehydrogenase [IMPDH])

Effects: Inhibits B-cells and T-cells, T-cell apoptosis, suppression of dendritic cell + monocyte activities

AE: Diarrhea/anorexia, myelosuppression, secondary infection, pancreatitis, allergic reaction (IV)

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6
Q

Mycophenolate metabolism in cats?

A

May be a problem because of their lack of glucuronidation

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7
Q

Chlorambucil

A

MOA: Alkylating agent - cell-cycle nonspecific; Prevents DNA synthesis through cross-linking DNA strands

Indications: Feline small cell GI lymphoma, chronic enteropathy, PRCA, pemphigus, ITP (cats), ICGN (dogs)

AE: GI upset, myelosuppression, neurotoxicity (cats), Fanconi syndrome (cats)

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8
Q

Leflunomide

A

MOA: Pyrimidine synthesis inhibitor - disrupts DNA synthesis

Effects: inhibits B-cells and T-cells

AE: Lethargy, GI upset, myelosuppression

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9
Q

Vincristine

A

MOA: Prevents assembly of microtubules - stimulates megakaryocyte fragmentation + may inhibit macrophage function

AE: GI upset, peripheral neuropathy, perivascular sloughing due to extravasation

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10
Q

Human IVIG

A

MOA: Consists of 90% purified human IgG (+trace IgM, IgA, CD4, CD8, HLA)

Effects: regulation of the immune system, inhibition of phagocytosis and reduction in tissue damage
1. Fc receptor blockade
2. Autoantibody elimination
3. Cytokine modulation
4. Complement inhibition
5. Fas-Fas ligand blockade

AE: Hypotension, hypersensitivity/anaphylaxis, thrombosis, AKI

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11
Q

Phenobarbital

A

MOA: y-aminobutyric acid (GAbA)-ergic activity by prolonging the opening of the chloride channel associated with the GABAa receptor. Inhibit glutamate receptors and voltage =-gated calcium channels

AE: Loading: extreme sedation, hypoventilation and/or hypotension
Hepatotoxicity (above 40mcg/mL), sedation, ataxia/CP deficits, PU/PD, polyphagia, excitation, bone marrow suppression, superficial necrolytic dermatitis, lowers thyroid levels, positive cPLI

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12
Q

Bromide (K/Na)

A

MOA: Halide anticonvulsant. Hyperpolarization of the neuron via movement of Br ions intracellularly through Cl channels

AE: Do not use in cats- fatal pneumonitis 35-42%
Transient GI disturbances with rectal administration
Neurologic deficits (sedation, agitation/excitability, caudal paresis, ataxia, decreased pelvic limb flexor withdrawals), polyphagia, PU/PD, vomiting, pancreatitis, gastric irritation, hyperchloremia (artifact)

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13
Q

Zonisamide

A

MOA: Sulfonamide drug. Inhibition of voltage-gated Na channels, inhibition of T-type Ca channels, modulation of dopaminergic activity, enhancement of GABA activity in the CNS, inhibition of carbonic anhydrase activity

AE: Ataxia, sedation, GI signs (vomiting, anorexia), KCS, decreased TT4, reported idiosyncratic hepatopathy in dogs

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14
Q

Levetiracetam

A

MOA: binding to synaptic vesicle protein SV2A -> decrease release of NT into the synapse

AE: Uncommon / usually mild
Sedation, salivation, vomiting (1200mg/kg/day)
Ataxia, stiff gait (300mg/kg/day)

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15
Q

Benzodiazepines

A

MOA: Facilitation of GABA-mediated inhibition and increased intracellular Cl flux

AE: Sedation, ataxia, weakness, hyperactivity, idiosyncratic hepatopthy in cats with PO diazepam

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16
Q

Gabapentin / Pregabalin

A

MOA: Binding to the a2d subunit of neuronal voltage-gated Ca channels -> inhibition of release of excitatory NTs into the synapse

AE: sedation and/or ataxia, chemistry abnormalities if hepatic insufficiency

17
Q

Felbamate

A

MOA: Inhibition of N-methyl-d-aspartate receptor mediated excitation along with potentiation of GABAergic activity

AE: Usually in dogs >300mg/kg/day
Ataxia, limb rigidity, tremors, salivation, emesis, weight loss, elvated liver enzymes, hepatopathy, blood dyscrasias

18
Q

Bethanecol chloride

A

Desired effect: Stimulate detrusor contraction

MOA: cholinergic stimulation

AE: increased GI motility, vomiting, diarrhea, hypersalivation, hypotension, bradycardia, dyspnea

19
Q

Cisapride

A

Desired effect: stimulate detrusor contraction

MOA: Increased acetylcholine release

AE: Diarrhea, abdominal pain

20
Q

Propantheline bromide

A

Desired effect: decrease detrusor hyperreflexia

MOA: Anticholinergic antispasmodic

AE: pupillary dilation, decreased GI motility, constipation, dry mucous membranes

21
Q

Oxybutynin chloride

A

Desired effect: decrease detrusor hyperreflexia

MOA: Direct antispasmodic

AE: Urine retention, vomiting, constipation, tachycardia

22
Q

Phenylpropalamine

A

Desired effect: increased urethral sphincter tone

MOA: a-adrenergic agonist

AE: CNS stimulation, tachycardia, urine retention

23
Q

Impramine

A

Desired effect: increased urethral sphincter tone

MOA: a- and B-adrenergic stimulation

AE: Seizures, tremors, hyperexcitability

24
Q

Diethylstilbestrol

A

Desired effect: increase urethral sphincter tone

MOA: Increase sphincter sensitivity to norepinephrine

AE: Bone marrow suppression, oestrus

25
Q

Testosterone

A

Desired effect: increase urethral sphincter tone

MOA: ??

AE: Prostatic hypertrophy, behavior changes

26
Q

Phenoxybenzamine

A

Desired effect: decrease urethral tone

MOA: a-adrenergic antagonist

AE: hypotension, tachycardia

27
Q

Prazosin

A

Desired effect: decreased urethral tone

MOA: a-adrenergic antagonist (a1-specific)

AE: hypotension, tachycardiaDia

28
Q

Diazepam (micturition)

A

Desired effect: decreased urethral tone

MOA: skeletal muscle relaxant

AE: hepatoxicity in cats, sedation, excitement

29
Q

Dantrolene

A

Desired effect: decrease urethral tone

MOA: skeletal muscle relaxant

AE: Weakness, GI upset, sedation, hepatotoxicity

30
Q

Tamsulosin

A

Desired effect: decrease urethral tone

MOA: a-adrenergic antagonist with selectively for the a1A adrenoreceptor (urinary tract)

AE: hypotension with high doses

Pharmacology (6 decks)

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