immunosuppressive drugs Flashcards
How are glucocorticoids used in immunosuppressive cases?
decrease IgG and complement. Decreased lymphocyte and monocyte function. There is decreased ability of dendritic cells to present antigen and activate T cells.
What is the immunosuppressive dose for glucocorticoids?
Dogs 2-4mg/kg/day Cats: 4-8mg/kg/day
what is steroid tacyphylaxis?
Deminished response due to the drug dose used
What is an indication for using cyclosporine in an immunosuppressive situation?
whole organ transplant
what effect does cyclosporine have when used at an immunosuppressive dose?
T and B cell inhibition. reduced cytokine production.
what is the immune suppressive dose for cyclosporine?
7-20mg/kg q12-24h
What medication is a calcineurin inhibitor?
tacrolimus
What enzyme is critical for the metabolism of Azathioprine in order to have maximal clinical benefit?
thiopurine-s-methyltransferase. If this enzyme is not present then there will be an acumulation of toxic metabolites.
what is the mechanism of action for Oclicitinib
This is a JAK1 and JAK 3 inihbitor. It acts by inhibiting the production of inflammatory cytokines.
What is the immunosuppressive does of azathioprine in dogs?
2mg/kg//day PO initially and then decreased to 0.5-1.0 mg/kg/day PQ q48hr
what is the immunosuppressive dose of azathioprine in cats? Why is this smaller than the canine dose?
0.3mg/kg/day this is smaller due to the increased risk of neutropenia (@ dose of 1.1-2.2mg/kg/day)
What is mycophenolate mofetil’s MOA?
this is a purine synthesis inhibitor. It is cleaved to the active metabolite: mycophenolic acid. This suppresses proliferation and decreases Ab synthesis by B-cells
what condition is mycophenolate mofetil used for ?
commonly pemphigus foliaceus
what is the dose of Mycophenolate mofetil for immunosuppression?
20-40mg/kg/day divided among 3 doses on an empty stomach
What is the mode of action for Doxycycline?
This is a bacteriostatic antibiotic that inhibits 30S ribosomal unit. It suppresses leukocyte chemotaxis secondary to complement activation by antibody-antigen complexes and protease release from leukocytes. This is often combined with Niacinamide
What is the immunosuppressive dose of doxycycline?
5mg/kg PO q12h
What is Niacinamide?
Vitamin B3
What is the MOA of Niacinamide?
immunomodulatory- blocks antigen IgE induced histamine release. This inhibits mast cell degranulation. this is synergistic with Doxycycline
How does Chlorambucil work?
This inhibits DNA cross-linking, and induces apoptosis. This is an expensive medication and is not used as frequently anymore
How are intravenous immunoglobulins used?
These may be used while your other immunosuppressive drugs kick in. This is basically a bandaid and buys you time.
This interferes with complement activation and cytokine network.
what is a side effect we are most concerned about when administering intravenous immunoglobulins?
anaphylaxis with repeated injections
What is the effect of Pentoxifylline?
Both rheologic and antiinflammatory (this increases the pliability of RBC and WBC and is used for vasculitis cases.
Phosphodiesterase 4 inhibitor
