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Introduction to Pharmacology > Drugs and the Immune Response > Flashcards

Drugs and the Immune Response Flashcards

1
Q

What is the inflammatory response?

A

Events in the response to a pathogen or noxious substance

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2
Q

What is the innate response?

A

Macrophages and antigen presenting cells recognise pathogen associated molecular patterns and release cytokines to trigger the specific response

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3
Q

How does the innate response result in swelling?

A

Arterioles dilate and blood flow becomes static. The stasis of blood increases venule permeability and therefore the exudation of fluid into the tissues

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4
Q

What is induction in the specific response?

A

Antigen is presented to T cells which triggers clonal expansion in T and B cells

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5
Q

Describe the humoral specific response

A

The Fab portions of the immunoglobulin bind to antigens and the Fc portion activates cascades by binding to neutrophils and macrophages

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6
Q

What does IgE do?

A

Binds to mast cells and basophils and triggers histamine release

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7
Q

What do immunoglobulins do?

A

Stimulate phagocytosis and direct natural killer cells and stimulate complement sequences

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8
Q

Describe the cell mediates response

A

Stimulation of cytotoxic T cells to kill virally infected cells and stimulate helper T cells to activate macrophages, lymphocytes and proliferation of other T cells

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9
Q

Describe anaphylactic hypersensitivity and its causes

A

The release of histamine triggered by non-pathogenic material. Can be caused by pollen, house dust, morphine, penicillin, etc

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10
Q

Describe antibody mediated cytotoxic hypersensitivity

A

Antibodies are directed against cells.
Haemolytic anaemia - reduction in erythrocytes caused by sulfonamides or antibacterial agents
Thrombocytopenia - reduction in platelets caused by cardiac controlling drugs and digoxin

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11
Q

Describe complex mediated hypersensitivity

A

Antibodies react with soluble agents and attach to mast cells. Caused by penicillins, lupus erythematosus
Results in rashes, swollen joints, fever

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12
Q

Describe cell mediated hypersensitivity

A

T lymphocytic response
Involved in transplant rejection, rheumatoid arthritis, type I diabetes, multiple sclerosis and skin reactions to drugs and chemicals

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13
Q

Where are histamines found in abundance?

A

Lungs, skin and GI tract

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14
Q

Which leukocytes are histamines found in and how are they stored?

A

Mast cells and basophils

Stored in granular complexes with heparin

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15
Q

Decribe the release of histamines

A

A receptor mediated interaction between and antigen and IgE results in a rise of intracellular calcium and therefore calcium dependent exocytosis of the histamines

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16
Q

What is the role of H1 histamine receptors?

A

Increases vascular permeability, smooth muscle contraction and vasodilation

17
Q

What is the role of H2 histamine receptors?

A

Increases gastric acid secretion and heart rate

18
Q

What is the role of H3 histamine receptors?

A

Inhibits neurotransmitter release

19
Q

Name the antagonistic drugs for H1 receptors

A

Diphenhydramine
Promethazine
Cetirizine
Fexofenadine

20
Q

Why does diphenhydramine and promethazine cause lethargy?

A

They have a high affinity for muscarinic receptors and so has a sedative effect

21
Q

What are the two types of eicosanoids?

A

Prostanoids and leukotrienes

22
Q

What are examples of prostanoids?

A

Prostaglandins
Thromboxane
Prostacyclin

23
Q

What effects do prostanoids have on the body?

A

Vasodilation
Potentiates histamines and bradykinin
Produces fever
Bronchoconstriction

24
Q

What effects does platelet aggregating factor have on the body?

A

Vasodilation
Hyperalgesia
Chemotaxis
Vascular permeability

25
Q

What are NSAIDs and their actions

A

Non-steroidal anti inflammatory drugs

Inhibition of cyclooxygenases and decrease release of prostanoids

26
Q

What three effects do NSAIDs have on the body?

A

Analgesic
Antipyretic
Anti-inflammatory

27
Q

How do NSAIDs have an analgesic effect?

A

They sensitise nociceptors which respond to pain mediators. They have a peripheral affect - they block the ability of receptors to relay signals rather than block the signals

28
Q

What types of pain do NSAIDs counteract?

A

Mild to moderate integumentary pain

29
Q

How do NSAIDs have an antipyretic effect?

A

Interleukin release from white blood cells stimulate prostaglandin release in the hypothalamus to increase the temperature of the body. NSAIDs stop the prostaglandin release

30
Q

How do NSAIDs have an anti-inflammatory effect?

A

The inhibition of COX2 decreases prostaglandins and prostacyclins and reduces vasodilation and oedema.

31
Q

What unwanted effects does COX1 inhibition have on the body?

A

Decreases the production of gastric mucosa and so can cause ulcers and gastrointestinal bleeding

32
Q

What is analgesic nephropathy?

A

The reduction of prostaglandins results in reduction of blood flow in the kidneys which impairs function

33
Q

What are the effects of using NSAIDs in labour?

A

The labour will be prolonged due to the anti-prostaglandin effect

34
Q

Describe the action of salicylates and their side effects

A

Irreversible inhibition of COX enzymes
Equal analgesic, antipyretic and anti-inflammatory effects
Inhibits thromboxane production and platelet aggregation
Can cause acidosis and Reye’s syndrome in children

35
Q

Describe the action and side effects of paracetamol

A

Reversible COX inhibition
Equal analgesic and antipyretic, little anti-inflammatory effect
Has a toxic metabolite that can cause liver damage

36
Q

Describe the effects of propionic acids

A

Equal major effects and little side effects

37
Q

How are COX2 inhibitors selective?

A

COX2 has an extra binding site that COX1 doesn’t have where the drug can bind to

38
Q

What are adrenal steroid drugs used for?

A

Powerful antiinflammatory effects

39
Q

What are the unwanted side effects of adrenal steroid drugs?

A

Suppression of response to infection

Suppression of natural corticosteroid release

Introduction to Pharmacology (12 decks)

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