Immunosuppression and Chemo Flashcards Preview

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Flashcards in Immunosuppression and Chemo Deck (24):
1

T/F: NSAIDs are COX-1 inhibitors

FALSE, COX-2 inhibitors

2

T/F: carprofen, flunixin meglumine, and phenylbutazone are all examples of NSAIDs

TRUE

3

is dexamethasone more or less potent than prednisone/prednisolone?

more, 7-8x more

4

would you use a high or low dose when treating an animal with glucocorticoids for anti-inflammatory therapy?

LOW, avoided unless needed

5

given the overlapping adverse effects (esp. on the GIT) would you consider it safe to use glucocorticoids and NSAIDs together?

NO

6

what is your first-line of therapy for general immunosuppression when it comes to immunosuppressive therapy?

HIGH dose glucocorticoids, 2 mg/kg/day or more

7

T/F: glucocorticoids may be used initially and combined with other drugs that take longer to achieve immunosuppression allowing you to taper off and discontinue glucocorticoid when the other drug is 'on board'

TRUE, i.e. start high-dose pred and azathioprine at same time, after two weeks taper off pred

8

which of the following is a calcineurin T-cell inhibitor?
a. azathioprine
b. mycophenolate
c. leflunomide
d. cyclosporine

d. cyclosporine, the other drugs inhibit nucleotide synthesis

9

which of the following adverse events is NOT typical of cyclosporine?
a. gastrointestinal upset
b. gingival hyperplasia
c. decreased efficacy with ketoconazole
d. increased risk of protozoal infection

c. decreased efficacy with ketoconazole (inhibits the breakdown of cyclosporin, increasing efficacy)

10

T/F: sandimune and atopica are bioequivalent

FALSE, sandiummune = human product, it's cheaper but it doesn't work! beware of brand-name vs generic

11

which of the following is generally contraindicated in cats?
a. azathioprine
b. mycophenolate
c. leflunomide
d. cyclosporine

a. azathioprine, causes more toxicity in cats> dogs

12

T/F: azathioprine, mycophenolate mofetil, and leflunomide are all examples of t-cell inhibitors

FALSE, they are antimetabolites used for immunosuppressive therapy

13

which metabolite do you not want to use with cats?

azathioprine, can cause toxicity of liver/bone marrow

14

does azathioprine have a fast or slow onset?

SLOW, often started w/ prednisone in difficult cases

15

which antimetabolite has relatively few side effects?

leflunomide

16

what is a common t-cell inhibitor used for immunosuppressive therapy?

cyclosporine

17

what is cyclosporine used to treat for?

-keratoconjunctivitis sicca (KCS) in dogs
-perianal fistulas or as adjunct for other immune diseases (IMHA)
-allergic/autoimmune dermatitis in dogs and cats

18

what drug would you use to treat dermatologic dz, perianal fistulas?

tacrolimus (cyclosporine also used for perianal fistulas)

19

what might you be mindful of with vesicant drugs used in chemotherapy?

-catheter placement (first try!) to avoid extravasation
-long infusions
-body surface area dosing (better reflects metabolic 'size' of patient) mg/m2

20

"BAG" =

bone marrow, alopecia, GI

generally only worry about bone marrow and GI in veterinary practice

21

"nadir" =

lowest neutrophil count

22

T/F: acute tumor lysis syndrome is when you have massive killing of cancer cells leading to severe systemic disease (shock, DIC, etc)

TRUE

23

what might you use a multi-drug chemotherapy protocol?

to reduce resistance developing in cancer cell population and minimize toxicity, hit cancer cells in different ways by giving multiple drugs at different times

24

with metronomic chemotherapy do you give higher doses of drugs over a shorter period of time or lower doses of drugs over longer period of time?

lower doses over longer periods of time (PO, risk of owner exposure)