E3 Autoimmune Flashcards
What is the protective function known as self-tolerance?
prevent the body from attacking itself
dampen the actions of both helper T cells and cytotoxic cells
Suppressor T cells
Suppressor T cells regulate?
critical for regulating immune reactions
Human immune system does not react
to one’s own antigens
Immunologic tolerance
When self-tolerance fails, activated T
cells and antibodies attack the
individual’s own cells and tissues =
autoimmunity
What is Self-tolerance?
ability to recognize self antigens
acquired during fetal life
What is immune tolerance?
is the body’s ability to discriminate between
self antigens and non-self antigens
Two factors are necessary for development of
Autoimmunity
- Inherited susceptibility genes
- –Major histocompatibility complex (MHC) genes - Environmental triggers
• infection
• high fever
• trauma
What T cells are activated when infection is a trigger for autoimmune disease?
activate antigen-specific T
lymphocytes and self-reactive T lymphocytes
Adverse gastrointestinal effects of Aspirin
Ulceration and bleeding
Adverse Effects on Special senses of Aspirin
Tinnitusis sign of toxicity to aspirin
Requires decrease in dose
Adverse Effects on Respiratory system of Aspirin
Toxic levels may cause central respiratory paralysis =
respiratory acidosis
Adverse Effects on the kidney of Aspirin
Retention of sodium and water
May cause hyperkalemia and edema in some patients
Contraindicated in aspirin/NSAID allergic patients(cross-sensitivity)
celebrex (Celecoxib)
Interleukin 1b and tumor necrosis factor
alpha are
proinflammatory cytokines
Excessive production of cortisol
Cushing’s Disease (primary disorder)
Insufficient production of cortisol
Addison’s disease (primary disorder)
What happens in Medication-Induced Adrenal Insufficiency
Secondary disorder taking glucocorticoid medications (exogenous steroids) suppresses the body’s own production of endogenous steroids
Associated with chronic steroid use
Secondary Adrenal Insufficiency
Condition usually does not produce
symptoms unless patient is significantly
stressed (or not enough circulating cortisol)
Signs and Symptoms of Adrenal Crisis
Profuse sweating Hypotension Weak pulse Dyspnea Cyanosis
Mechanism of Action of Steroids
Anti-inflammatory effects
Peripheral leukocytes
Increases in concentration in neutrophils
decrease in lymphocytes (T and B cells), monocytes, eosinophils and
basophils
Inhibition of phospholipase A
Decreases production of both prostaglandins and
leukotrienes from arachidonic acid
Steroid Prep most likely to cause
adrenal suppression
oral steroids
Alternate day therapy is used for patients
who must take
steroids for longer than 1
month
Any medication dosage that exceeds this
amount may cause suppression
20-30 mg
hydrocortisone equivalent
Adverse Events Associated with Chronic Steroid Use avoid taking these two things together…
avoid aspirin and NSAIDS
Oral Side Effects of Steroids
Candidiasis = most common
Poor wound healing= long-term use
Masking of oral infections= anti-inflammatory
Xerostomia
Steroids in dentistry are used for…
For reduction of pain and swelling
Treatment of inflammatory pathologies of oral mucosa
Avoid steroids with
Avoid in pregnant/lactating women
Use with extreme caution in pediatric
patients
Geriatric patients more susceptible to
hypertension and osteoporosis side effects
Determination of the lethal dose
= LD50 Dose of a particular drug that kills 50% of the mice who take it.
Determination of effectiveness =
Dose of a drug that causes an effect in 50%
of the total numbers of mice that received it
The margin of safety is…
LD50 divided by the ED50
A small TI represents
a small (or “narrow”) therapeutic window = requires monitoring
detoxication Typically uses which enzymes?
cytochrome P450 liver
enzyme system to create water soluble
molecules to allow for elimination
What is selective toxicity?
- Attack targets that are unique to the
pathogen/cancer cell that are not present in the
host - Attack targets in the pathogen or cancer cell that
are similar but not identical to those in the host - Attack targets in the pathogen/cancer cell that are
shared by the host, but that vary in importance
between the pathogen and the host-selective action: more important to pathogen than host
P 53 surpasses tumors by?
– Active DNA repair proteins
– Hold cell cycle at G1/S regulation point so that
DNA repair proteins will fix damage, then cell
allowed to continue cell cycle
– Can initiate apoptosis is damage is irreparable
– Induce growth arrest
What kinetics do tumor cells express?
First order
These types of cancer masses don’t respond well to chemotherapy, and require?
Tumors
Radiation or surgery
What is the “triple cocktail” ?
Antiretrovirals for HIV
2 nucleoside reverse transcriptase inhibitors
with a protease inhibitor
What kinds of things do heavy mettles do to animal cells?
– Disrupt enzymatic and transport processes – Loss of energy production – Loss of ion regulation – Potential carcinogenesis
most common
arsenic containing mineral
arsenopyrite
Arsenic (As) Local effects
dermatological
signs of Arsenic poisoning
Vasodilation of capillaries (arsenic binds to contractile mechanism so cannot contract)
– Rosy complexion
– Edema
– No wrinkles
Gi effects of arsenic
very unpleasant death (vomiting leads to fluid loss and CV collapse)
What poisoning is able to diagnosed this
poisoning due to smell.
Garlic Breath
Arsenic (As)
What is Argyria?
Silver and silver containing compounds become absorbed into circulatory system and deposited into body tissues
Gold salts are toxic to…
Liver and Kidneys
Gold toxicity manifests as…
dermatitis, metallic taste in
mouth, proteinuria, GI symptoms,
aplastic anemia
Antidote to gold poisoning…
dimercaprol or penicillamine
Exposure to Mercury causes?
Tremors, impaired cognitive skills, and
sleep disturbance in workers with chronic
exposure to mercury vapor even at low
concentrations in the range 0.7–42 μg/m3
Mercury toxicity occurs at what concentrations?
1.1 to 44 mg/m3 resulted in chest pain,
dyspnea, cough, hemoptysis, impairment
of pulmonary function, and evidence of
interstitial pneumonia
With continuing exposure what develops?
fine tremor develops and may escalate to violent
muscular spasms. Tremor initially involves
the hands and later spreads to the eyelids,
lips, and tongue.
This kind of mercury causes…
– Neurotoxicity with neuropsychiatric effects
– Acute poisoning = pneumonitis
elemental mercury
This kind of mercury causes corrosive to oral cavity
and gut
– Used in dental amalgam
– Kidney damage
Inorganic mercury
Why is lead toxic?
Enzyme inhibitor in the production of
heme
Accumulates in CNS
GI, CV effects
