Non-steroidal immunomodulators

Question 1

Calcineurin inhibitor

• Used to decrease autoimmunity, or transplant rejection, or to treat dry eye
• Can cause vomiting, appetite loss

Answer 1

Cyclosporin

Question 2

Calcineurin inhibitor

• Topically to treat dicoid lupus
• More toxicities

Answer 2

Tacrolimus

Question 3

Cytotoxic to T cells, B cells and other rapidly dividing cells

• T cells seem to recover quickly–> greater effect on antibody production
• Used to treat cancer, lupus, hemolytic anemia
• Causes bone marrow supression, nausea, vomitting, diarrhea, alopecia, sterile hemorrhagic cystitis(damage and irritation to bladder epithelium, which can be treated with other drugs)

Answer 3

Cyclophosphamide

Question 4

Cytotoxic to T cells, B cells and other rapidly dividing cells

• T cells seem to recover quickly–> greater effect on antibody production
• Used to treat cancer, lupus, hemolytic anemia
• Causes(not as severe) bone marrow supression, nausea, vomitting, diarrhea, alopecia
• Takes longer to work

Answer 4

Chlorambucil

Question 5

Inhibits purine synthesis

• Active metabolites disrupt purine synthesis
• Interferes with B and T cell proliferation
• Takes weeks for effect
• Can be used in combination with steroids to use lower dose of steroids
• Causes bone marrow supression(more pronounced in cats), GI upset

Answer 5

Azathioprine

Question 6

Inhibits purine synthesis

• Pro-drug–> metabolite disrupts guanine synthesis
• Interferes with B and T cell proliferation
• Causes bone marrow supression(more pronounced in cats), GI upset

Answer 6

Mycophenolate mofetil