Immunosuppresion and Chemo Flashcards

1
Q

Name four NSAIDs

A

Carprofen
Flunixin
Meglumine
Phenylbutazone

Acronym: Nate-SAID Phenomenal Carl & Megan Flunked

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2
Q

COX-2 inhibitors, analgesics, less potent than glucocorticoids for anti-inflammatory

A

NSAIDs

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3
Q

Potent anti-inflammatory, generally avoided unless needed & used at lowest effective dose

A

Glucocorticoids

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4
Q

Four types of cytokine inhibitors used for immunomodulatory therapy

A

1) Leukotriene inhibitors (zafirlukast/zileuton)
2) Janus kinase inhibitors (oclacitinib)
3) Histamine inhibitors (diphenhydramine)
4) MMP inhibitors (doxycycline)

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5
Q

General immunomodulators (2 types) and uses

A

1) Tetracycline/Niacinamine –> immune dermatopathies

2) Metronidazole –> chronic inflammatory bowel disease

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6
Q

2 other strategies of immunomodulatory therapy

A

1) desensitization therapy

2) block specific cytokines

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7
Q

Prednisone:
(low/high) dose anti-inflammatories
(low/high) dose immunosuppression

A

LOW dose anti-infl

HIGH dose immunosuppression

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8
Q

Targets (2) for immunosuppressive drug action

A

Antimetabolites

T-Cell Inhibitors

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9
Q

__________ impair DNA synthesis particularly in rapidly dividing immune cells (lymphocyte) and can block signaling on T-cells

A

Antimetabolites

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10
Q

Azathioprine (Imuran) info

Antimetabolite

A
  • Oral medication (takes weeks for immunosuppression)

- Often started with pred for difficult immune disease

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11
Q

Azathioprine is contraindicated in __(species)__ due to

A

cats; toxicity in liver/bone marrow

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12
Q

Mycopenolate mofetil (cell cept) info

Antimetabolite

A
  • Less commonly used
  • Very expensive ($$$$)
  • Given orally (or slow IV infusion)
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13
Q

Leflunomide (Arava) info

Antimetabolite

A
  • Administered orally
  • Relatively few side effects
  • Less expensive ($$)
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14
Q

Two T-Cell inhibitors

A

Cyclosporine

Tracolimus topical

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15
Q

Cyclosporine MoA

A
  • Blocks cyclophilin/calcineurin which reduces T-cell activation and response
  • Inhibits production of various cytokines to alter function of other WBCs (eosinophils, mast cells, etc)
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16
Q

Clinical uses for Cyclosporine

A
  • Topically on eye to tx KCS in dogs
  • Systemically PO to tx perianal fistulas or as adjunct w/ glucocorticoids for other immune Dz
  • FDA approved for dogs/cats for allergic/autoimmune dermatitis (atopica)
17
Q

Tracolimus topical info:

A

Topical used in management of dermatologic dz, perianal fistulas
Slightly different target than cyclosporine but essentially the same MoA

18
Q

Chemotherapy Drugs info

A
  • More aggressive cellular inhibition

- Cancer chemotherapy drugs have more narrow therapeutic index than other drugs, may require special handling

19
Q

T/F: GI signs are most common adverse effect in chemotherapy

A

True, tx with antiemetics

20
Q

Chemo Bone Marrow Suppression/Immunosuppression

A
  • CBC typically monitored for drugs that cause myelosuppression
  • Neutropenia > thrombocytopenia > anemia
  • “Nadir”- Lowest neutrophil count (Generally predictable based on drug used)
21
Q

Toxicity with Chemotherapy

A
  • hemorrhagic cystitis with cyclophosphamide
  • Cardiotoxicity with adriamycin
  • Nephrotoxicity with platinum agents
22
Q

T/F: Cancer cells can develop resistance to chemo drugs

A

TRUE

23
Q

_____: Massive killing of cancer cells leading to severe systemic dz (DIC, Shock, etc)

A

Acute Tumor Lysis Syndrome

24
Q

How can you reduce resistance developing in cancer cell population and minimize toxicity?

A

Multi-Drug Chemotherapy

25
Q

Metronomic Chemotherapy PO

A
  • More common, differ the traditional

- Lower doses over longer periods of time