Anti Inflammatories Flashcards
How do mast cells allow fluid / complement cells/ platelets into tissue from blood
contain histamine granules which cause endothelial permeability to allow complements in causing immune response to bacteria
Which types of things repair tissue after inflammation
Clotting system
Fibrin
Lipocortin
How does fibrin allow scarring to heal tissue
Lays collagen down
Why is there no scarring in small cuts
Collagen isn’t affected
Which types of things are released when phagocytosis occurs to start inflammation
IL8 chemokine
TNF a , IL 6, IL B1 ,
Prostaglandins, histamine
= attract more cells and increase permeability
What is the process IL 8 recruitment which causes Edema swelling in tissues
Chemotaxis
What are signalling / inflammatory molecules called produced from arachidonic acid
Eicosanoids
What are the 2 types of eicosanoids
Prostanoids
Leukotrienes
How is arachidonic acid produced
Phospholipase A2 which cleaves phospholipids
Which enzyme is involved in producing prostanoids
Cox
Cyclooxygenase
Which intermediate is produced by cyclooxygenase from arachidonic acid
PGH2
Which 3 prostanoids are produced from PGH2
Thromboxane
Prostaglandin
Prostacyclin
What 2 effects does prostacyclin produce
Vasodilation (increase blood)
Prevent platelet plug formation/ clotting
Which 2 side effects do prostaglandin release produce eg in inflammation
Pain
Fever
What do prostaglandins allow which increase inflammation more
Permeability of endothelium
How is thromboxane opposite to prostacyclin
Vasoconstriction and platelet plug formation induced
Which enzyme is involved in producing leukotrienes
Lipo oxygenase
Which intermediate is produced from arachidonic acid via lipo oxygenase (LOX)
5 HPETE
What do leukotrienes do in inflammation
Chemotaxis
Attract more neutrophils and eosinophils etc / complements
Can leukotrienes induce their own production
Yes
What are drugs called which block pain signals (dolor) due to things like Edema
Analgesic drugs
How can drugs be anti inflammatory
Prevent endothelial permeability
What are drugs called which stop fevers eg fevers from cytokines or prostaglandins
Antipyretic
What are the 4 types of drugs used for anti inflammation
Antihistamines (antagonists)
Immunosuppressants
NSAIDs eg ibuprofen
SAIDs (glucocorticoids)
Why isn’t paracetamol anti inflammatory but is still used for it
It is analgesic (pain relief) and anti pyretic (anti fever)
Which enzyme does ibuprofen block stopping inflammation
COX1 mostly
COX2 also
Is ibuprofen analgesic
Yes
What is the difference between cox 1 and cox 2
Cox 1 is always expressed
Cox 2 is only expressed during inflammation eg to increase inflammation via prostaglandin permeability or vaso dilation via prostacyclin
Which type of inhibitor is aspirin for cox 1 and 2
Irreversible (binds with covalent bonds)
Why can aspirin cause bleeding
Stops thromboxane production which would usually cause construction and platelet formation
Which nsaid drug is only a cox 2 inhibitor
Celecoxib
Why is celecoxib better than aspirin and ibuprofen
Only blocks cox 2 which is when inflammation occurs
Doesn’t stop production of others during normal times which would usually cause clotting etc = fewer side effects
What are SAIDs
Glucocorticoids eg cortisol
What do glucocorticoids target
Gene transcription
How are glucocorticoids immunosuppressive
Decrease levels of phospholipids
Induce lipocortin which blocks A2 Phospholipase
Also decrease COX transcription
These stop inflammation
How is the likes of blocking cox transcription, or Phospholipase A2 inflammation stopping
Because no prostacyclin for vasodilation
No prostaglandins for increased permeability
What are the 3 main effects of glucocorticoids
Cushing syndrome
Immunosupression
Hyperglycaemia (they increase glucose levels)
Which gene do glucocorticoids target which stops cox transcription
NF kb
Which gene do glucocorticoids stop expression of which then impairs wound healing and vitamin c and D
Ap1
Which 2 genes do glucocorticoids up regulate to cause immunosuppressant
Lipocortin
Tyrosine aminotransferase
What is an example of a natural glucocorticoid
ACTH - induced cortisol production
What types of artificial glucocorticoids are there
Allergy treatment
Inhalers for asthma
Which cytokine does cortisol inhibit to stop prostaglandin production and therefore stop inflammation
TNFa
Which cells do cortisol inhibit in inflammation
TH1 cells (macrophages)
Which response does cortisol increase which reverts inflammation
TH2 pathway
Which product is decreased with glucocorticoids and result of Cushing syndrome
Collagen
What causes Cushing syndrome features like moon face
Fat deposits
Which 2 types of Cushing syndrome are there
Iatrogenic - high dose of corticoids
Endogenous - acth over production
