Anti-inflammatories

Question 1

What do NSAIDS stand for

Answer 1

Non-steroidal anti-inflammatory drugs

Question 2

What did Felix Hoffmann add to salicylic acid to improve its properties

Answer 2

An acetyl group

Question 3

What was one of the first synthetic drugs created

Answer 3

Aspirin

Question 4

Benefits of aspirin

Answer 4

Less gut effects

Question 5

Examples of NSAIDS

Answer 5

Aspirin, Paracetamol, Ibuprofen

Question 6

What do NSAIDS target

Answer 6

Prostaglandins and thromboxane’s

Question 7

What do Phospholipase a2 generate

Answer 7

The precursors required for the synthesis of everything else (arachidonate)

Question 8

What is arachidonate converted into

Answer 8

Other mediators by cyclo-oxygenase

Question 9

What is PGF important for

Answer 9

Initiation of labour

Question 10

What is PDG needed for

Answer 10

Platelet aggregation

Question 11

What is PGE needed for

Answer 11

Blood vessel relaxation (Hyperalgesia)

Question 12

What do prostaglandins attract

Answer 12

Immune cells known as chemo attractants

Question 13

What are NSAIDS

Answer 13

Anti-inflammatory, analgesic anti-pyretic

Question 14

What does analgesic mean

Answer 14

Decreases pain

Question 15

What does anti-pyretic mean

Answer 15

Lowers raised temperature

Question 16

What is the COX1 enzyme responsible for

Answer 16

Constant constitutive synthesis of prostaglandins, has many homeostatic functions for maintaining health

Question 17

What is COX2 responsible for

Answer 17

It’s an inducible enzyme in response to inflammation

Question 18

Where is COX3 found

Answer 18

In the brain and kidneys

Question 19

What is COX made of

Answer 19

Two identical subunits

Question 20

What’s the difference between COX1 and COX2

Answer 20

The structure of the little pore where the arachidonic acid has to go up is smaller in COX2

Question 21

Which amino acid does COX1 have

Answer 21

Isoleucine

Question 22

Which amino acid does COX2 have

Answer 22

Valine

Question 23

Why does aspirin cause GI issues

Answer 23

Because prostaglandins maintain the mucus layer surrounding the stomach

Question 24

What do prostaglandins maintain

Answer 24

Blood flow in the kidneys

Question 25

What is a suicide inhibitor

Answer 25

A drug that covalently binds to its target to cause a permanent inactivation of its target

Question 26

Side effects of NSAIDS

Answer 26

Gut issues, renal function issues, liver damage, bronchospasms and skin rashes

Question 27

advantages of drugs to target COX1

Answer 27

Beneficial for people at risks of strokes - antithrombotic

Question 28

What can inhibition of COX2 lead to

Answer 28

An increase in blood pressure and salt retention

Question 29

What does arthritis involve

Answer 29

Swelling around the synovium of the joints

Question 30

Symptoms of arthritis

Answer 30

pain, poor sleep, morning stiffness, swelling in affected joints

Question 31

How is the inflammatory response activated in arthritis

Answer 31

t cells activate macrophages which release mediators

Question 32

What are the two mediators involved in arthritis

Answer 32

Cytokines known as IL1 and TNF alpha

Question 33

Which drugs limit the inflammatory response in arthritis

Answer 33

Methotrexate folic acid and DIMARDS

Question 34

What does methotrexate do

Answer 34

Works as an antagonist for folic acid. It's effective at low concentrations

Question 35

What do DIMARDS stand for

Answer 35

Disease modifying anti- rheumatoid drugs

Question 36

Examples of last resort drugs for arthritis

Answer 36

Cyclosporin's and glucocorticoids

Question 37

How do cyclosporins work

Answer 37

Binds to calcanewin and inhibits the function of NF Kabba B, limiting the production of cytokines

Question 38

Example of glucocorticoid

Answer 38

Prednisolone

Question 39

How do glucocorticoids work

Answer 39

Work directly on the level of transcription by binding to the DNA. They act as repressors, inhbiting the genes that make cytockines

Question 40

Example of biopharmaceutical which treats arthritis

Answer 40

Adalmumab

Question 41

What does Adalmumab do

Answer 41

It recognises and binds to TNF alpha so it can no longer bind to its receptors

Question 42

Advantages and costs of Adalmumab

Answer 42

Its a single injection which lasts 3 months, has much lower side effects but is expensive

Question 43

Issues with biological drugs

Answer 43

They are expensive and have a limited pattern time

Question 44

Examples of inflammatory respiratory diseases

Answer 44

COPD and asthma

Question 45

What is COPD

Answer 45

A progressive disease driven by macrophages

Question 46

Symptoms of asthma

Answer 46

Shortness of breath, coughing and wheezing

Question 47

What does asthma involve

Answer 47

Inflammation of the airways and involves bronchial-hyper reactivity

Question 48

How to treat asthma

Answer 48

Avoid the allergen, give salbutamol, steroid drugs administered through an inhaler

Question 49

How does salbutamol work

Answer 49

Its an agonist for the beta adreno receptors found in smooth muscle airways. These receptors relax once activated

Question 50

Two phases of asthma

Answer 50

Early phase: mediated by mast cells secreting histamine Late phase reactions: cytokines forcing an inappropriate inflammatory response to take place in the lungs

Question 51

What is asthma driven by

Answer 51

T cells

Question 52

What do steroid drugs do for asthma

Answer 52

Dampen down the production of cytokines and therefore control the response

Question 53

What are the unwanted side effects of steroid use

Answer 53

Crushing's syndrome