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BMSC1212 Introduction to pharmacology > Drugs and the immune system > Flashcards

Drugs and the immune system Flashcards

1
Q

What is an inflammatory reaction?

A

Events in the tissue in response to a pathogen or noxious substance

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2
Q

What is the initial innate immune response

A

Macrophages and dendritic cells

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3
Q

What are PAMPs?

A

Pathogen-associated molecular patterns

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4
Q

What are cytokines?

A

Protein/peptide mediators released by cells of the immune system during inflammation. Act locally by kinase-linked receptors.

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5
Q

Give two pro-inflammatory interleukins

A
  1. IL-1 (released from macrophages)

2. TNF-a (tumour necrosis factor

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6
Q

What does the Fc portion of an antibody do?

A

Activates complementation cascade and forms links to attach to neutrophils an macrophages. Binds to mast cells and basophils.

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7
Q

What does the autocrine effect lead to?

A

Cell-mediated Th-1 or antibody mediated responses

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8
Q

What does type one intermediate or anaphylactic hypersensitivity involve?

A

Histamine which acts on GPCRs, primarily fixed to IgE mast cells

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9
Q

What is type II cell-mediated complex hypersensitivity?

A

Where antibodies are reacting with soluble agents. Produces lupus erythematosus

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10
Q

What does type IV cell-mediated hypersensitivity involve?

A

T lymphocytes involved in transplant regection issues

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11
Q

What is histamine?

A

A basic amine synthesised from histidine by histidine decarboxylase. At the cellular level, there is a high concentration in mast cells and basophils.

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12
Q

When is histamine released?

A
  1. Receptor-mediated interaction with C3a and C5a of the complement system
  2. Interaction of antigen and IgE antibody
  3. Triggered by a release of intracellular Ca2+
  4. inhibition of release by a rise in cAMP e.g. B-adrenoreceptor agonists.
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13
Q

What are the 3 types of histamine receptors?

A
  • H1, vascular permeability, contraction of smooth muscle and vasodilation.
  • H2, stimulation of gastric acid secretion. Increase cardiac rate and force.
  • H3, Presynaptic sites, inhibit neurotransmitter release.
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14
Q

Which histamine receptor do we want anti-histamines to react with?

A

H1

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15
Q

Name 3 histamine H1 antagonists

A
  1. Diphenhydramine
  2. Promethazine
  3. Cetrizine and terfenadine
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16
Q

What are eicosanoids?

A

Generated de novo fro phospholipids. Implicated in control of many physiological processes. Include prostanoids and leukotrienes.

17
Q

what are the effects of prostanoids and leukotrienes?

A
  • Vasodilation
  • Potentiate the actions of histamine to increase vascular permeability.
  • Potentiate the actions of bradykinin to produce pain.
  • Production of fever.
18
Q

What are cytokines?

A

peptides released from immune system cells. Act by autocrine and paracrine mechanisms on kinase-linked receptors.

19
Q

Name 4 groups in the cytokine family.

A
  1. Interleukins
  2. Tumour necrosis factors
  3. Growth factors.
  4. Interferons
20
Q

What are the main actions of NSAIDS?

A

Inhibition of cyclooxygenase and decrease in prostanoid synthesis.

  1. Analgesic (peripheral action)
  2. Anti-inflammatory
  3. Antipyretic
21
Q

What do PGE1 and PGE2 respond to?

A

5-HT and brandykinin

22
Q

What is the cause of an increase in body temperature during infection?

A

Hypothalamus being affected by PGE2 synthesis from IL-1

23
Q

What does the decrease of COX-2 result in?

A

Decrease in the synthesis of PGE1 and PGE2 so:

  1. Reduction in vasodilation
  2. Reduced erythema
  3. Reduced local oedema.
24
Q

What can ILB4 do?

A

Stimulate movement of other WBC to the site of infection - it is a chemotaxin

25
Q

Give 6 general side-effects of using NSAIDs

A
  1. Damage to the GIT due to COX-1 inhibition
  2. Direct irritant action
  3. Renal disease from chronic use due to disturbance of PG-mediated blood flow
  4. Decreased activity in the uterus - can prolong labour
  5. Hypersensitivity reactions and potentially bone-marrow disturbance.
26
Q

What are salicylates?

A

Aspirin, irreversible inhibitor of COX

27
Q

What may aspirin cause in children?

A

Reye’s syndrome

28
Q

What is paracetamol?

A

Irreversible inhibitor of COX inhibition. Less anti-inflammatory than aspirin. Can cause severe liver damage due to metabolite NAPQI

29
Q

What do propionic acids include?

A

Ibuprofen and Naproxen (reversible COX inhibition)

30
Q

Name 2 COX-2 drugs

A
  1. Celecoxib

2. Rofecoxib

31
Q

How are adrenal steroids activated?

A

HPA axis

32
Q

What do adrenal steroids include?

A
  1. Mineralocorticoids

2. Glucocorticoids

33
Q

What are the two main functions of adrenal steroids?

A
  1. Resting state to facilitate hormonal actions
  2. Fight or flight response
    Inhibiting both early and late stages of inflammation
34
Q

Give 2 unwanted effects of using NSAIDs

A
  1. Suppression of response to infection

2. Suppression of natural corticosteriod synthesis by mimicry of feedback. Must be withdrawn slowly after chronic use.

BMSC1212 Introduction to pharmacology (17 decks)

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