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DEN 2026 - Pharmacology > Drugs and the Immune System I > Flashcards

Drugs and the Immune System I Flashcards

1
Q

What are 5 cardinal signs of inflammation?

A
  1. Heat
  2. Redness
  3. Swelling
  4. Pain
  5. Loss of function
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2
Q

What is inflammation?

A

Localised process by which cells and fluid accumulate in irritated tissues, and usually tend to protect them from further injury

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3
Q

Describe innate immunity

A
  • 1st line of defence
  • Checks most potential pathogens
  • Breach of system result in activation of adaptive immune system
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4
Q

Describe adaptive immunity

A
  • Specific reaction to infectious agent
  • Eradicate the agent
  • T cells recognise antigen displayed
  • Capacity to remember infectious agent
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5
Q

Describe the initial sensitisation of the innate immune system

A
  • Pathogens are recognised by epithelial cells and macrophages
  • Pro-inflammatory cytokines released
  • Cytokines active inflammatory cells
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6
Q

Name 2 pro-inflammatory cytokines released by epithelial cells during

A
  1. TNF-α

2. IL-1

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7
Q

Name 2 types of inflammatory cells activated by cytokines

A
  1. Neutrophils

2. Mast cells

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8
Q

Describe the initial sensitisation of the adaptive immune system

A
  • Antigen presenting cells present to lymphocytes and natural killer cells
  • IL-2 produced leading to clonal expansion of activated T lymphocytes
  • Further mediators activate anti-inflammatory macrophages, cytotoxic T cells and B lymphocytes
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9
Q

Name 3 cell types which provide communication between adaptive and innate immunity

A
  1. Natural killer cells
  2. Lymphoid cells
  3. Mast cells
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10
Q

Name 2 sources of chemical mediators of inflammation

A
  1. Cellular

2. Plasma derived from liver

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11
Q

What are 2 types of cellular chemical mediators of inflammation?

A
  1. Synthesised

2. Preformed

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12
Q

Name 5 types of synthesised cellular chemical mediators of inflammation

A
  1. Prostaglandins
  2. Leukotrienes
  3. Cytokines (IL-1, IL-2, TNF-α)
  4. Nitric Oxide
  5. Platelet Activation Factors (PAFs)
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13
Q

Name 3 preformed cellular chemical mediators of inflammation

A
  1. Histamine
  2. Serotonin
  3. Lysosomal Enzymes
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14
Q

What type of cellular chemical mediator of inflammation does not cause vascular leakage?

A

Cytokines

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15
Q

What 3 types of cellular chemical mediator of inflammation cause chemotaxis?

A
  1. Leukotrienes
  2. PAFs
  3. Cytokines
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16
Q

Name 2 types of activation which can occur from plasma derived chemical mediators of inflammation

A
  1. Hageman Factor activation

2. Complement activation

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17
Q

Name 2 systems which are part of Hageman Factor activation

A
  1. Kinin system e.g. bradykinin

2. Coagulation / Fibrinolysis system

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18
Q

Name 4 chemical mediators during complement activation

A
  1. C3a
  2. C3b
  3. C5a
  4. C5b-9
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19
Q

What is the function of C3b chemical mediator?

A

Opsonisation

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20
Q

Which mediator of the complement activation does not cause vascular leakage or chemotaxis?

A

C3b

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21
Q

Name 4 ways drugs can modify the immune response

A
  1. Modulation of antigen processing (suppression)
  2. Enhancement of suppression of T cell function
  3. Modification of B cell responses and antibody production
  4. Interference with production / release of mediators or their effects (suppression / enhancement)
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22
Q

Name 2 main aims of treating inflammation

A
  1. Relief of pain

2. Stop tissue damage

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23
Q

Name 6 classes of drugs used to combat inflammation

A
  1. Histamine / Antihistamine
  2. Cytokines / Biologicals
  3. Immunosuppressive
  4. NSAIDs
  5. Steroidal Anti-Inflammatory Drugs
  6. Diseases Modifying Drugs
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24
Q

What is the chemical name for histamine?

A

Aminoethylimidazole

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25
Q

Name 4 places histamine is naturally found

A
  1. Plants
  2. Venoms / Stings
  3. Bacteria and certain fungi
  4. Throughout the human body
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26
Q

What enzyme is responsible for the synthesis of histamine?

A

Histidine decarboxylase (HDC)

27
Q

How many types of histamine receptors are there?

A

4

28
Q

Describe the gene location for H₁ receptor

A

Chromosome 3

29
Q

Describe the gene location for H₂ receptor

A

Chromosome 5

30
Q

Describe the gene location for H₃ receptor

A

Chromosome 20

31
Q

Describe the gene location for H₄ receptor

A

Chromosome 18

32
Q

What is the general function of H₁ receptors?

A

Rapid, short-lived vascular response, increasing vasodilatation, vascular permeability and hypotension

33
Q

Describe the immune response to stimulated H₁ receptors

A

Pro-inflammatory, increasing the release of histamine and other mediators and chemotaxis of eosinophils and neutrophils

34
Q

Describe the CNS response to stimulated H₁ receptors

A

Affect sleep, food intake, memory and learning

35
Q

What is the general function of H₂ receptors?

A

Slower, sustained vascular response, increasing bronchodilatation and vascular permeability

36
Q

Describe the immune response to stimulated H₂ receptors

A

Anti-inflammatory, decreasing chemotaxis of eosinophils and neurtophils

37
Q

Describe the CNS response to stimulated H₂ receptors

A

Neuroendocrine

38
Q

What is the general function of H₃ receptors?

A

Prevents excessive bronchoconstriction

39
Q

Describe the immune response to stimulated H₃ receptors

A

Pro-inflammatory

40
Q

Describe the CNS response to stimulated H₃ receptors

A

Decrease in histamine, dopamine, serotonin, noradrenaline and acetylcholine release

41
Q

What is the the general function of H₄ receptors?

A

Differentiation of myeloblasts and promyelocytes

42
Q

Describe the immune response to stimulated H₄ receptors

A

Increases calcium influx in human eosinophil cells and increases eosinophil and mast cell chemotaxis

43
Q

Name the major effect of histamine on H₁ receptors

A

Allergic inflammation

44
Q

Name the major effect of histamine on H₂ receptors

A

Gastric acid secretion

45
Q

Name the major effect of histamine on H₃ receptors

A

Neurotransmission

46
Q

Name the major effect of histamine on H₄ receptors

A

Immunomodulation

47
Q

Name 2 types of cells where histamine is stored

A
  1. Mast cells

2. Basophils

48
Q

How is histamine released from mast cells?

A

Degranulation

49
Q

Describe 4 types of hypersensitivity reactions

A
  1. Type I - Immediate allergic reaction requiring sensitisation
  2. Type II - Cytotoxic involving antibodies with tissue damage
  3. Type III - Immune complex mediated with tissue damage
  4. Type IV - Delayed and cell mediated involving T lymphocytes
50
Q

What is the triple response to histamine injection?

A
  1. Reddening
  2. Flare
  3. Wheal
51
Q

How do antihistamines function?

A

Competitively antagonize histamine at the receptor, thereby decreasing the availability of the receptors for histamine

52
Q

Name 2 H₄ receptor antagonists currently under development

A
  1. Seliforant

2. Adriforant

53
Q

What is the potential use for seliforant?

A

Acute unilateral vestibulopathy

54
Q

What is the potential use for adriforant?

A

Severe atopic dermatitis

55
Q

Name a H₃ receptor antagonist

A

Pitolisant

56
Q

What is the clinical use of pitolisant?

A

Treatment of narcolepsy with or without cataplexy

57
Q

Name 4 H₂ receptor antagonist drugs

A
  1. Cimetidine
  2. Ranitidine
  3. Nizatidine
  4. Lafutidine
58
Q

Name 4 H₁ receptor antagonist drugs

A
  1. Chlorphenamine
  2. Promethazine
  3. Terfenadine
  4. Cetirizine
59
Q

Name 3 clinical benefits when H₁ receptor antagonist drugs antagonize the receptor

A
  1. Reduce vasodilatation
  2. Reduce capillary permeability
  3. Reduce flare and itch response
60
Q

Describe the ADME of H₁ receptor antagonist drugs

A
  • Well absorbed from GIT
  • Distributed through whole body
  • Metabolised by the liver
61
Q

Name 3 uses of H₁ receptor antagonists

A
  1. Topical application to relieve itching
  2. Prophylaxis and treatment of allergic conditions e.g. rhinitis
  3. Common cold remedies
62
Q

Name 4 adverse effects of H₁ receptor antagonists

A
  1. Sedation (enhanced by alcohol)
  2. Stimulation (phenindamine)
  3. Cardiac problems are possible
  4. Xerostomia
63
Q

Name 2 dental applications of H₁ receptor antagonists

A
  1. Sedative (promethazine)

2. Allergic lesions on face and mouth

DEN 2026 - Pharmacology (22 decks)

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