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2. Immunology > Immunomodulators > Flashcards

Immunomodulators Flashcards

1
Q

Immunomodulators

A

Medications used to modify (weaken or stimulate) the activity of the immune system

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2
Q

What conditions require immunosuppression?

A

Autoimmune (lupus, IMHA, immune mediate thrombocytopenia)
Allergy (cell-mediated- atopic derm and graft rejection)
Chronic inflammation(IBD)

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3
Q

What are the classes of immunosuppressive drugs?

A

Non-specific agents
Specific agents

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4
Q

Non-specific agents

A

Reduce response of T and B cells to Ags
Dangerous- intestinal epithelium and hematopoietic stem cells affected
Ex: Radiation, cytotoxic drugs

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5
Q

Specific agents

A

Selectively eliminate specific immune cell population
Ex: therapy, leflunomide

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6
Q

Glucocorticoids

A

Stimulate synthesis of IKBa (inhibitor of NF-KB)
Blocked cytokine synthesis and T cell responses
Inhibit enzyme phospholipase
ANTI-INFLAMMATORY

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7
Q

Cyclophosphamide (cytotoxic drugs) method of action

A

Cytotoxic effect, DNA damage, block cell division
Directly suppresses B cell activity and Ab formation

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8
Q

How is cyclophosphamide used?

A

Lymphoid tumors, immune mediated skin diseases
Administered orally or parenterally
Need to be activated in liver

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9
Q

Adverse effects of cyclophosphamide?

A

Bone marrow suppression
Secondary infections, thrombocytopenia, anemia
Sterile hemorrhagic cystitis
Minimized by concurrent use of glucocorticoids or furosemide

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10
Q

How is azathioprine used?

A

As an alternative to cyclophosphamide
For dermatological and immune mediated diseases and to control allograft rejection

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11
Q

Azathioprine method of action

A

Prodrug: intracellular enzyme
Metabolites inhibit DNA synthesis

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12
Q

What are the adverse effects of azathioprine

A

Leukopenia and thrombocytopenia (monitor closely with CBC)
Canine patients develop hepatic toxicity
Long terms effects of demodex infection, recurrent pyoderma and dermatophyte infections

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13
Q

Methotrexate (folic acid antagonist)

A

Suppresses Ab formation
Used for the testament if rheumatoid arthritis in humans

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14
Q

Cyclosporine

A

Selective immunosuppressant and calcineurin inhibitor
More specific for T cells
Birds and inhibits calcineurin

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15
Q

What are the results of cyclosporine

A

Cytokines can’t be produced
Block proliferation of activated T cells and block Th1 responses

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16
Q

Clinical use of cyclosporine

A

Dermatological conditions
Immune mediated diseases
Cats (organ transplant, eosinophilia granuloma complex)
Ophthalmic products

17
Q

Adverse effects of cyclosporine

A

Vomiting and diarrhea
Gingival hyperplasia (33%)
Increased risk of infection
Lymphoma

18
Q

Tacrolimus (calcineurin inhibitor)

A

Causes severe intestinal toxicity in dogs
Used for atopic derm, discoid lupus erythrmatosus
More potent than cyclosporine

19
Q

Target of Rapamycin inhibitors (selective immunosuppressant)

A

Inhibits serine kinase: mechanistic target if rapamycin
R inhibits B and T cell proliferation and sever intestinal toxicity in dogs

20
Q

Target of Rapamycin inhibitors is a synergistic to ____________

A

Calcineurin inhibitors

21
Q

Monophosphate dehydrogenase inhibitors

A

Prevents synthesis of DNA
Blocks B and T cell proliferation and Ab formation
Prevents renal allograft rejection between unrelated dogs

22
Q

What are Monophosphate dehydrogenase inhibitors effective in?

A

Immune mediated conditions
Well tolerated by dogs

23
Q

Leflunomide therapy

A

Anti-inflammatory agent that inhibits pyrimidine synthesis
Used in prevention of allograft rejection in dogs

24
Q

Intravenous immunoglobulin therapy

A

Immunosuppressive and anti-inflammatory
Used to inhibit activities of autoantibodies
Used in autoimmune diseases

25
Q

What activates B and T cells

A

Mediated responses, phagocytosis, allograft rejection and resistance to infection

26
Q

How do bacteria and bacterial products act?

A

ACH through toll like receptors

27
Q

What is canine CD4 and CD8 used for?

A

Monoclonal Abs
Used to control rejection of canine renal allografts

28
Q

What treats rheumatoid arthritis?

A

Anti-TNFR and anti- TNFRa

29
Q

Anti-IgE (xolair) and Anti-IL-31 (Lokivetmab)

A

Canine atopic derm
Relief itch in canine atopic derm

2. Immunology (24 decks)

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