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Pharm Exam 3 > Immune 1 > Flashcards

Immune 1 Flashcards

1
Q

Pathogen associated molecular patterns (PAMPs)

A

a limited number of molecular patterns common to a wide variety of pathogens

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2
Q

What tissues initiate the acquired immune system?

A

Lymphoid tissue

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3
Q

What targets antigens?

A

A cell-mediated
A humoral adaptive response

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4
Q

Hypersensitivity

A

resulting immune response is too strong - poison ivy or asthma attack

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5
Q

Atopy

A

The tendency to develop an allergy, or hypersensitivity, is greatly determined by inheritance (referred to as atopy)

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6
Q

What is the key to a healthy immune response?

A

A key to a healthy immune response is the body’s ability to recognize its own cells and the cells of a foreign microbe

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7
Q

What happens to create adaptive immunity to an antigen?

A

gene rearrangement leads to an irreversible change in the DNA of the lymphocyte, all of the progeny of that cell inherits gene encoding having the same receptor specificity, which in turn is the reason why adaptive immunity is specific and long-lived

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8
Q

Rubor

A

redness

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9
Q

tumor

A

swelling

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10
Q

dolor

A

pain

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11
Q

calor

A

warmth

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12
Q

functio leasa

A

loss of function

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13
Q

What does the adaptive immune system split into once reaching an inflammatory response?

A

Humoral immunity
Cellular immunity

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14
Q

Widespread invasion and inflammation can lead to large amount of cytokine release, what does this cause?

A

fever, tachycardia, and organ failure, possibly leading to shock or death

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15
Q

Antibodies

A

large protein molecules released from the lymphocytes that bind with and help destroy an offending antigen by marking it for destruction

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16
Q

What part of the immune system are B cells?

A

Humoral

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17
Q

immunoglobulin (Ig)

A

An antibody that is a protein

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18
Q

4 kinds of IgG are found where?

A

Blood

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19
Q

IgA is found in?

A

Seromucous secretions

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20
Q

IgM is found in?

A

blood

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21
Q

IgD is found in?

A

Lymphocytes

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22
Q

IgE is found in?

A

skin and external surfaces

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23
Q

What cells manage cellular immunity?

A

T cells

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24
Q

What kind of hypersensitivity is allergic rhinitis?

A

IgE type 1 hypersensitivity

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25
Q

What leads to allergic rhinitis sxs?

A

Mast cell degranulation caused by attaching of IgE antibodies

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26
Q

Allergic rhinitis tx

A

Oral antihistamines - can cause systemic effect
Spray antihistamines - bypass systemic effects

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27
Q

Nasal spray antihistamine examples

A

azelastine nasal (Astelin, Astepro) and olopatadine nasal (Patanase)

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28
Q

Tx steps for allergic rhinitis

A

Antihistamines
IN Steroids
Nasal mast cell stabilizers, decongestants, anticholinergics, and leukotriene receptor antagonists also used

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29
Q

IN steroids compared to antihistamines

A

Slower to act than antihistamines (1-2 wks to work)

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30
Q

Why are systemic steroids not used in allergic rhinitis?

A

Because of their systemic adverse effects, only recommended in intractable allergic rhinitis not responding to other therapy

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31
Q

IN Steroid examples

A

beclomethasone
budesonide
flunisolide
fluticasone
mometasone
triamcinolone

32
Q

IN steroids SE

A

Headaches, pharyngeal candidiasis, pharyngitis, nasopharyngeal irritation, epistaxis, and septal perforation

33
Q

Nasal Mast Cell Stabilizer do what?

A

Prevent the release of histamine from mast cells by stabilizing their membranes

34
Q

What is cromolyn and what is it used for?

A

Mast cell stabilizer - Prophylactic and must be used prior to allergic antigen exposure

35
Q

Nasal Mast Cell Stabilizer SE

A

Bad taste

36
Q

Decongestants do what?

A

Sympathomimetics - vasoconstriction in the superficial mucosal blood vessels, decreasing swelling of the nasal mucosa and rhinorrhea

37
Q

Decongestants available

A

Available in a myriad of OTC formulations
Oxymetazoline (nasal)
Pseudoephedrine (Oral)

38
Q

Topical decongestant use >3-4 days can cause what?

A

rhinitis medicamentosa, which is a rebound effect

39
Q

What do anticholinergics do to tx allergic rhinitis?

A

reduce nasal hypersecretion and congestion

40
Q

Topical anticholinergics for allergic rhinitis?

A

ipratropium bromide (Atrovent)

41
Q

Leukotriene Receptor Antagonists example

A

Montelukast (Singulair)

42
Q

Pharm tx of allergic conjunctivitis

A

Topical vasoconstrictors
Antihistamines
Mast cell stabilizers

43
Q

What do topical vasoconstrictors do to tx allergic conjunctivitis?

A

can reduce eye redness and ocular itching by stimulating alpha-adrenergic receptors

44
Q

What do antihistamines do to the allergic response?

A

Antihistamines: compete with histamine on H1 effector cells inhibiting the release of histamine

45
Q

hydroxypropyl cellulose class

A

artificial lube

46
Q

tetrahydrozoline hydrochloride class

A

vasoconstrictors

47
Q

azelastine hydrochloride class

A

antihistamine

48
Q

emedastine difumarate class

A

antihistamine

49
Q

levocarbastine hydrochloride class

A

antihistamine

50
Q

ketorolac tromethamine class

A

nsaid

51
Q

diclofenac sodium class

A

nsaid

52
Q

ketoifen fumarate class

A

mast cell

53
Q

cromolyn sodium class

A

mast cell

54
Q

olopatadine hydrochloride class

A

mast cell

55
Q

lodoxamide tromethamine class

A

mast cell

56
Q

dexamethasone class

A

steroid

57
Q

prednisolone class

A

steroid

58
Q

Prolonged use of topical ocular meds must be monitored becasue?

A

Associated w/ glaucoma

59
Q

What immune response is AD related to?

A

IgE production

60
Q

Mainstay AD flare tx

A

Mainstay of pharmacological treatment for flare-ups is the topical corticosteroids - Using the lowest potency topical steroid for the shortest duration is always best

61
Q

2nd line tx for AD flare

A

Calcineurin inhibitors, tacrolimus (Protopic ointment), and pimecrolimus (Elidel cream) are topical immunosuppressive agents considered to be second-line agents

62
Q

What can creams cause?

A

Contact dermatitis

63
Q

Why are creams preferred over the more potent ointments?

A

Creams are less greasy

64
Q

When using topical steroids, where should they NOT be applied?

A

Untreated skin or bacterial infections

65
Q

Topical Calcineurin Inhibitors examples

A

Pimecrolimus and Tacrolimus
Cyclosporine (oral)

66
Q

Topical Calcineurin Inhibitors MOA

A

Inhibit calcineurin, which blocks T-cell activation and the subsequent release of inflammatory causing cytokines

67
Q

Calcineurin Inhibitors uses

A

Atopic dermatitis
Prevention of organ rejection in transplant
Crohn disease
Graft-versus-host disease
Myasthenia gravis
Rheumatoid arthtitis

68
Q

Calcineurin Inhibitors SE

A

Hypertension
Redness and burning sensations of the skin
Infection, neoplasm
Nephrotoxicity

69
Q

What happens to Calcineurin Inhibitors when taken w/ food?

A

Absorption is decreased

70
Q

Calcineurin Inhibitors black box warning

A

Tacrolimus - cancer and serious infections
Cyclosporine - HTN and nephrotoxicity

71
Q

Statins + Calcineurin Inhibitors

A

Leads to increase in concentrations of many drugs (statins)

72
Q

Calcineurin Inhibitors require what when taken long term?

A

Drug level monitoring

73
Q

Goal of allergen immunotherapy

A

With immunotherapy, the goal is to induce a tolerance for the allergen

74
Q

Which type of allergies is immunotherapy most effective for?

A

Most beneficial for those who have IgE-mediated allergic rhinitis, asthma, or insect hypersensitivity

75
Q

Immunotherapy does not work for these types of allergies?

A

Not helpful in atopic dermatitis, urticaria, or in food/antibiotic allergies

Pharm Exam 3 (7 decks)

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