Veterinary Medicine - May 2008 - (Page 274) Cyclosporine PEER-REVIEWED CE You can earn two hours of Continuing Education credit from Kansas State University by answering the following questions on cyclosporine. Circle only the best answer for each question, and transfer your answers to the form on page 276 or take the test online at http://outreach.ksu.edu/ce. The test expires June 1, 2009. Article #1 1. Cyclosporine’s mechanism of action is through: a. Serotonin uptake inhibition b. Calcineurin inhibition c. Calcineurin activation d. Direct inhibition of T cell binding e. Serotonin uptake activation c. Dogs < 4 lb d. Dogs with a history of malignant neoplasia e. All of the above 9. Which statement about administering cyclosporine for sebaceous adenitis is false? a. A recent study showed overall marked improvement in clinical signs when cyclosporine was administered at 5 mg/kg once daily. b. When cyclosporine was discontinued, the dogs in one study remained normal without additional treatment. c. One study noted decreased inflammation and an increase in the number of hair follicles with sebaceous glands in dogs treated with cyclosporine. d. Cats with sebaceous adenitis have been treated successfully with cyclosporine. e. Sebaceous adenitis is not curable. 6. Cyclosporine has been reportedly used to treat: a. Atopic dermatitis in dogs and cats b. Eosinophilic granuloma complex in cats c. Perianal fistulas in dogs d. All of the above e. None of the above 2. The anti-inflammatory properties of cyclosporine are due to: a. Decreased T cell activation b. Decreased inflammatory cytokine production c. Impaired mast cell and eosinophil production, survivability, and degranulation d. All of the above e. A & B only 7. Which statement about cyclosporine administration for the treatment of canine atopic dermatitis is false? a. Unlike glucocorticoids, there is a lag between the start of cyclosporine administration and when clinical benefits will be noted. b. Cyclosporine has been reported to benefit (good to excellent response) 65% to 76% of dogs with atopic dermatitis. c. If a dog has gastrointestinal upset at the beginning of cyclosporine administration, it will never adjust to the medication. d. Some clinical improvement should occur within four to six weeks of initiating cyclosporine for atopic dermatitis. e. Depending on response to therapy, patients may benefit from not having the drug dosage decreased after the initial four weeks. 3. Concurrently administering cyclosporine and ketoconazole may alter the serum concentration of cyclosporine by: a. Interfering with hepatic metabolism by competitively binding at the cytochrome P-450 enzyme system b. Decreasing renal clearance c. Increasing renal clearance d. Decreasing gastrointestinal absorption e. None of the above 10. Which is not part of the authors’ recommendation for treating perianal fistula? a. Administer cyclosporine at an initial dose of 5 mg/kg twice daily or 5 mg/kg once daily along with ketoconazole at 8 mg/kg once daily. b. Once clinical remission has been established, treat the patient for an additional four weeks and then discontinue the drug. c. If a patient relapses, repeat the initial protocol and then establish a maintenance dose of cyclosporine that keeps the lesions in remission. d. All of the above e. None of the above 4. What is the most common side effect of cyclosporine administration in dogs? a. Nephrotoxicosis b. Hepatotoxicosis c. Gastrointestinal upset d. Hypertension e. Increased appetite 5. The safety of cyclosporine administration has not been determined for or the drug should not be used in: a. Pregnant, breeding, or lactating animals b. Dogs < 6 months of age 8. What is the recommended starting dose of cyclosporine for dogs with atopic dermatitis? a. 5 mg/kg once daily b. 5 mg/kg twice daily c. 10 mg/kg once daily and concurrent ketoconazole administration d. 2.5 mg/kg once daily e. 0.5 mg/kg once daily 274 May 2008 VETERINARY MEDICINE http://outreach.ksu.edu/ce
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