14 Antihistamines Flashcards
which inflammatory cytokines do tissue cells release in times of stress or injury, or in response to T-cell cytokines?
IL-1, IL-6
What do phagocytes release in response to inflammatory stimuli?
inflammatory cytokines TNFalpha, IL-1, and IL-6; cytotoxic agents; proteases for degrading tissue; and lipid mediators to enhance local inflammation
What is the effect of inflammatory cytokines in the hypothalamus? in the liver?
in the hypothalamus, cytokines produce fever, and in the liver they induce the acute phase response
which class of drugs commonly target the cytokines that promote inflammatory activity (TNFalpha, IL-1)?
Disease-modifying antirheumatic drugs (DMARDS)
Infliximab, adalimumab, and etantercept are all examples of what type of drug?
Anti-TNFalpha agents
What are anti-TNFalpha agents and what is their mechanism of action?
anti-TNFalpha agents are either antiTNFalpha antibodies (infliximab and adalimumab) or other proteins (etanercept) that bind to TNFalpha to prevent its interaction with its receptor
what are the therapeutic applications of anti-TNFalpha agents, and what is the typical route of administration?
often used to treat rheumatoid arthritis and Crohn’s; parenteral administration is required
what is the main complication associated with anti-TNFalpha agents?
increased susceptibility to infection, especially upper respiratory and urinary infections
what type of drug is anakinra and what is its mechanism of action?
anakinra is an anti-IL1 agent that is a competitive IL-1 receptor antagonist
what type of drug is tofacitinib and what is its mechanism of action?
tofacitinib is a Jak kinase inhibitor that inhibits all activity of cytokines required for adaptive immunity
what are the therapeutic applications of anti-TNFalpha agents, and what is the typical route of administration?
often used to treat rheumatoid arthritis and Crohn’s; parenteral administration is required
What causes mediator release from activated leukocytes?
Lipid mediators are released in response to signals that activate phospholipase A2
How does phospholipase A2 cause the release of lipid mediators from leukocytes?
PLA2 hydrolyzes membrane phosphatidylcholine to release arachidonic acidAA is the substrate for production of lipid mediators of inflammation – cyclooxegenases produce prostaglandins, and lipoxygenases produce leukotrienes.
T or F: Stored mediators such as histamine are released from leukocytes in response to signals that activate phospholipase C
T
T or F: annexins/lipocortins inhibit PLC activity
F; they inhibit PLA2
What class of drugs inhibit cyclooxygenase, and what effect does this produce?
NSAIDS; decreased production of prostaglandin
What drug inhibits lipoxygenase, and what effect does it produce?
Zileuton; decreased production of prostaglandins
Cromolyn and nedocromil both inhibit which process?
They inhibit PLC mediated degranulation of stored mediators from leukocytes
What do glucocorticosteroids inhibit, and what effects do they produce?
Glucocorticosteroids inhibit PLA2 to reduce production of prostaglandins and leukotrienes, and they also inhibit production of chemotactic factors, which results in decreased recruitment of leukocytes