Immunosuppression/Chemo (Final)

Question 1

What is the first drug used for general immunosuppression?

Answer 1

high dose glucocorticoids

Question 2

Azathloprine

• type of drug
• administration
• contraindications
• use

Answer 2

• antimetabolite (immunosuppressive therapy)
• oral medication
• do not use in cats, toxicity in liver/bone marrow
• started with prednisone for difficult immune diseases

Question 3

Mycophenolate

• type of drug
• use
• administration

Answer 3

• antimetabolite (immunosuppressive therapy)
• less common, often reserved for immune disease unresponsive to other therapies
• given orally or slow IV infusion

Question 4

Leflunomide

• type of drug
• administration

Answer 4

• antimetabolite (immunosuppressive therapy)

- given orally

Question 5

Cyclosporine

• type of drug
• MOA
• use
• administration
• side effects

Answer 5

• t-cell inhibitor (immunosuppressive therapy)
• blocks cyclophilin/calcineurin which reduces T cell activation and response, inhibits production of cytokines to alter function of other WBCs
• in canines/felines for allergic/autoimmune dermatitis
• topical on eye for KCS
• PO for perianal fistulas or as adjunct with glucocorticoids
• side effects: GI upset, gingival proliferation, nephrotoxicity, hepatotoxicity

Question 6

Tacrolimus topical

- use

Answer 6

• management of dermatologic disease, and perianal fistulas

Question 7

Cyclophosphamide

• type of drug
• what does it treat

Answer 7

• chemotherapeutic drug

- treats immune-mediated hemolytic anemia

Question 8

Chlorambucil

• type of drug
• what does it treat

Answer 8

• chemotherapeutic drug

- treats inflammatory bowl disease

Question 9

Cytosine arabinoside

• type of drug
• what does it treat

Answer 9

• chemotherapeutic drug

- treats granulomatous meningoencephalitis

Question 10

What are possible adverse effects of chemotherapeutic drugs?

Answer 10

• GI signs, including nausea (most common)
• bone marrow suppression/immunosuppression (neutropenia)
• hair loss
• hemorrhagic cystitis, cardiotoxicity, nephrotoxicity
• drug resistance/loss of efficacy
• acute tumor lysis syndrome

Question 11

What is “nadir”?

Answer 11

lowest neutrophil count

Question 12

Describe metronomic chemotherapy

Answer 12

• lower doses of drugs are given over longer periods of time

Question 13

Duration of and what happens in each phase of the cell cycle

Answer 13

M phase: 1 hour
- mitosis
G1 phase: hours to days
- synthesis of proteins, RNA, and DNA
G0 phase: hours to weeks to years
- resting phase
S phase: 2-4 hours
- DNA synthesis
G2 phase: 3-8 hours
- protein and RNA synthesis