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Dermatology (VEM 5387) > Immunosuppressive Therapy (Marsella) > Flashcards

Immunosuppressive Therapy (Marsella) Flashcards

1
Q

Medications & biopsy of autoimmune diseases

A
  • Address 2º infections 1st
  • Do not admin steroids prior to biopsy
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2
Q

Are abx during immunosuppressive therapy ok?

A

Yes, abx therapy is necessary in the 1st few months of therapy w/ autoimmune dz

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3
Q

Differentials to consider if skin lesions worsen w/ immunosuppression therapy

A
  • Demodicosis
  • Dermatophytosis
  • Bacterial infection
  • Calcinosis cutis (dog)
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4
Q

Immunotherapy and relapse of autoimmune dz

A
  • After relapse, resistance to previously used glucocorticoids may be observed
  • Most animals require therapy for life
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5
Q

Immunosuppressive drugs

A
  • Glucocorticoids
  • Azathioprine
  • Chlorambucil
  • Gold
  • Tetracycline-niacinamide
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6
Q

How to use steroids for immunosuppression

A
  • Oral steroids
  • Induction 10-14 days
  • Once no new lesions, taper to alternated day dose
  • Maintenance dose acheived ~8-10 wks
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7
Q

Side effects of steroid therapy

A
  • GI ulcers (help w/ famotidine, sucralfate)
  • PU/PD
  • Polyphagia
  • Panting
  • Behavioral changes
  • Diabetes
  • Hepatopathy
  • Muscle weakness
  • Osteoporosis
  • Redistribution of body fat
  • Decr. synthesis of thyroid hormones
  • Incr. risk of infection (skin, urinary tract)
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8
Q

Dermatologic specific side effects of steroid therapy

A
  • Thin skin
  • Comedones
  • Demodicosis
  • Calcinosis cutis (dogs)
  • Skin fragility (cats)
  • Incr. risk of skin infections
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9
Q

Azathioprine (Imuran)

A

Suppresses cell mediated & humoral immunity

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10
Q

Azathioprine (Imuran) side effects

A
  • Bone marrow suppression
  • Pancreatitis
  • Hepatitis
  • Vomiting
  • Hemorrhagic diarrhea
  • DO NOT USE IN CATS
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11
Q

Chlorambucil (Leukeran)

A
  • Immunosuppressive drug
  • Safe for cats
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12
Q

Chlorambucil (Leukeran) side effects

A
  • Bone marrow suppression
  • Vomiting
  • Diarrhea
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13
Q

Gold salts

A
  • Suppress antibody synthesis
  • Inhibits phagocytosis
  • Suppresses PG synthesis
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14
Q

Gold salts side effects

A
  • Bone marrow suppression
  • Nephrotoxcity
  • Hepatic necrosis
  • Drug eruption (EM, TEN)
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15
Q

Cyclophasphamide (Cytoxan) side effects

A
  • Bone marrow suppression
  • Hemorrhagic cystitis
  • Bladder fibrosis
  • Teratogenesis
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16
Q

Tetracycline & Niacinamide side effects

A
  • Vomiting
  • Diarrhea
  • Anorexia
  • Incr. liver enzymes
  • Seizures
17
Q

Cyclosporine

A
  • Adjunctive therapy - used to decr. glucocorticoid needs
  • Suppresses T cells
  • Metabolized by cytochrome P450 (decr. w/ liver dz)
18
Q

Cyclosporin side effects

A
  • GI upset
  • Nephrotoxicity
  • Papillomatous dermatitis
  • Gigival hyperplasia
19
Q

Dapsone

A
  • Use in conjunction w/ glucocorticoids
  • Decr. complement, antibody produciton, PMN chemotaxis
20
Q

Dapsone side effects

A
  • Bone marrow suppression
  • Hepatotoxcity
  • GI upset
  • Drug eruptions (EM, TEN)

Dermatology (VEM 5387) (17 decks)

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