14. Immunopharmacology

Question 1

Most important effect of NSAIDs

Answer 1

Inhibition of the arachidonic acid metabolism (inhibition of prostanoid synthesis by interfering with COX activity)

Question 2

Side effects of NSAIDs

Answer 2

Peptic ulcer, erosive gastritis-duodenitis

Question 3

Lipoxygenases

Answer 3

Leukotrienes (LTB4, LTC4, LTD4, LTE4)

Question 4

Cycloxygenases

Answer 4

Prostaglandins and thromboxane

Question 5

Effect of leukotrienes

Answer 5

Bronchoconstriction

Question 6

Inhibitors of COX-1

Answer 6

NSAIDs, aspirin

Question 7

Inhibitors of COX-2

Answer 7

COX-2 inhibitors, NSAIDs, aspirin

Question 8

COX-2 inducers

Answer 8

Cytokines, growth factors

Question 9

Effect of COX-1

Answer 9

Cytoprotective prostaglandins: Protect gastric mucosa, aid platelet aggregation

Question 10

Effects of COX-2

Answer 10

Inflammatory prostaglandins: Recruit inflammatory cells, sensitize skin pain receptors, regulate hypothalamic temp. control

Question 11

Antihistamines targets what receptors

Answer 11

• H1 receptor antagonists -> allergic rhinitis

- H2 receptor antagonists -> inhibit gastric HCL secretion

Question 12

Leukotriene inhibitors used for?

Answer 12

In the therapy of bronchial asthma

Question 13

5 types of cytostatic drugs

Answer 13

1. Alkylating agents
2. Folic acid antagonists (methotrexate)
3. Purine antagonists (azathioprine)
4. Pyrimidine antagonists (leflunomide)
5. Vinca alkaloids (vinblastin, vincristin)

Question 14

Target of alkylating agents

Answer 14

Prevents DNA synthesis by binding to DNA (cyclophosphamide, chlorambucil)

Question 15

When are non-cytostatic immunosuppressive drugs used?

Answer 15

In the case of transplanted patients

Question 16

Non-cytostatic immunosuppressive drug effects

Answer 16

Cyclosporin A and tacrolimus:

• T-cells: Reduced expression of IL-2-4, GM-CSF, TNFalpha, reduced proliferation, reduced serine esterase exocytosis
• B-cells: Reduced proliferation, induction of apoptosis following activation
• Granulocytes: Reduced Ca-dependent exocytosis of granule-associated serine esterases

Question 17

Drugs used in the base therapy of rheumatoid arthritis

Answer 17

DMARDs (disease modifying antirheumatic drug)

Question 18

A complete human monoclonal antibody

Answer 18

Denosumab

Question 19

Effect of denosumab

Answer 19

Binds RANKL and inhibits osteoclast formation, function and survival

Question 20

Anakinra

Answer 20

An IL-1R antagonist (used for rheumatoid arthritis)