Unit 4- Immunosuppressants

Question 1

Antimetabolites

Answer 1

Inhibit purine synthesis or pyrimidine synthesis, prevents cellular proliferation and arrests function

Question 2

Azathioprine

Answer 2

Purine inhibitor, inhibits lymphocyte DNA synthesis, blocks CD28 signaling on T cells and RNA synthesis

Question 3

Azathioprine Uses

Answer 3

Combine with steroids for immune mediated diseases, IMHA, immune mediated thrombocytopenia, colitis, skin disease, myasthenia gravis, IBD, inflammation, perianal fistula, skin disease in horse

Question 4

Azathioprine PK

Answer 4

Prodrug needs to be metabolized, cats cannot detoxify

Question 5

Azathioprine Adverse Effects

Answer 5

Bone marrow suppression, leukopenia, thrombocytopenia, risk of infection, hepatotoxicity, pancreatitis, mutagenic, carcinogenic

Question 6

Leflunomide

Answer 6

Pyrimidine inhibitors, prevents lymphocyte DNA synthesis

Question 7

Leflunomide Uses

Answer 7

IMHA, immune mediated thrombocytopenia, immune mediated polymyositis, multifocal encephalitis, Evan’s syndrome

Question 8

Leflunomide Adverse Effects

Answer 8

Uncommon in dogs, GI disturbance, anemia

Question 9

Polymyositis

Answer 9

Inflammatory muscle weakness and fatigue in dogs, treated with Azathioprine, Leflunomide, Cyclosporine, and Prednisone

Question 10

Cyclosporine

Answer 10

Inhibits IL-2, decreases t lymphocyte action, increases TGFB that inhibits IL-2, decreases histamine release from canine mast cells

Question 11

Cyclosporine Uses

Answer 11

Keratoconjunctivitis sicca, perianal fistulas, IMHA

Question 12

Cyclosporine Adverse Effects

Answer 12

GI disturbance, gingival hyperplasia, papillomatosis in dog, viral infection in cats

Question 13

Tacrolimus

Answer 13

Inhibits IL-2 to teat keratoconjunctivitis sicca and local topical immune mediated diseases

Question 14

Pentocyfylline

Answer 14

TNFa inhibitor, suppresses platelet activating factor, inhibits platelet activating factor on neutrophils

Question 15

Pentoxyfylline Uses

Answer 15

Canine skin diseases, equine systemic inflammatory response syndrome and caudal heat syndrome

Question 16

Tetracyclines

Answer 16

Antibiotics, inhibit matrix metalloproteases

Question 17

Short Acting Tetracyclines

Answer 17

Tetracycline, ocytetracycline

Question 18

Long Acting Tetracyclines

Answer 18

Doxycycline, minocycline

Question 19

Tetracycline Adverse Effects

Answer 19

Vomiting, diarrhea, kidney damage, liver damage, loss of appetite

Question 20

Gold Therapy

Answer 20

Auranofin and gold sodium thiomalate, inhibits macrophages and T cells

Question 21

Gold Therapy Uses

Answer 21

Idiopathic polyarthritis, rheumatoid arthritis in dog, gingivitis in cat, and pemphigus foliaceus in dog, cat, and horse

Question 22

Gold Therapy Adverse Effects

Answer 22

Stomatitis, skin lesions, hepatic necrosis, renal toxicity, GI disturbance

Question 23

Niacinamide

Answer 23

Vitamin B3, blocks mast cell degranulation and inhibits protease release

Question 24

Niacinamide Uses

Answer 24

Discoid lupus erythematosus, pemphigus erythematosis, pemphigus foliaceus, autoimmune

Question 25

Niacinamide Adverse Effects

Answer 25

GI disturbance, lethargy, hepatic enzyme elevation

Question 26

Immune Mediated Hemolytic Anemia

Answer 26

Body attacks its own RBC, anemia in dogs