week 12+13 Flashcards
What is the first line drug to tx immune mediated dz
Corticosteroids
Corticosteroid dose for cats vs dog
Cats require 2x dose than dogs do because have a lower number of glucocorticoid receptors in liver and skin, and have a decreased binding affinity of glucocorticoid receptors
What glucocorticoid is used for cats
Prednisolone
Three “anti-metabolites”
1) Azathioprine
2) Mycophenolate Mofetil
3) Leflunomide
Azathioprine MOA
(anti metabolite): 6TGN (active metabolite) incorporated into DNA -> cytotoxic and immunosupressive
Onset of action for Azathioprine
2-5 weeks – so it is NOT a first line treatment
Azathioprine adverse effects
Myelosupression, GI upset
Never give to cats because they lack ThioPurineMethylTransferase
Azathioprine is used for…
Dermatological disease, IMHA, IBD
Mycophenolate Mofetil MOA
(anti metabolite) Inhibit imosine monophosphate dehydrogenase which suppresses lymphocyte proliferation and suppresses antibody synthesis by B cells
Mycopheonlate Mofetil adverse effect
GI (DIARRHEA)
Leflunomide MOA
(anti metabolite) inhibit synthesis of pyrimidine by inhibiting enzyme dihydroorotate dehydrogenase which messes with the function of B and T cells
Leflunomide is used for…
Use when other drugs don’t work (not first line)
Two T cell inhibitors
1) Cyclosporine/Atopica
2) Tacrolimus
Cyclosporine/atopica MOA
Binds to calcineuria -> suppress nuclear factor of activated T cells -> inhibits T cell receptor activated signal transduction pathway -> SUPPRESSES IL-2 AND TNFa AND BLOCKS T CELL PROLIFERATION
Use of cyclopsorine for dogs vs cats
Dogs: atopic dermatitis, perianal fistula, (ophthalmic use=KCS)
Cat: allergic dermatitis
What drug should you administer Cyclosporine with and why
Cyclosporine is metabolized by CYTP450, so administer with Ketoconazole because it inhibits CYTP450
Cyclosporine adverse effects
GINIGIVAL HYPERPLASIA, papillomatosis, hyperkeratosis of footpads, coat shedding, hirtuism
Tacrolimus is used for…
Topical administration for perianal fistulas
MOA of alkylating agents
Prevent DNA replication, has cytotoxic effect on lymphocytes, can directly suppress B cell activity and no AB formation
Active metabolite in Cyclophosphamide
Acrolein
Cyclophosphamide adverse effect
Sterile hemorrhagic cystitis due to metabolite acrolein
What drug do you administer Cyclophosphamide with in order to mitigate adverse effects?
Furosemide – administer in morning, make sure animal has high water intake, give animal many opportunities to urinate throughout the day
Cyclophosphamide is used for…
Lymphoma in dogs and cats
