Immune System

Question 1

Pharmacological effects of steroids.

Answer 1

Anti-inflammatory effects:
Inhibition of : accumulation of macrophages and leukocytes, phagocytosis, lysosomal enzyme release, release of chemical mediators of inflammation.

Question 2

Theraputic uses of steriods

Answer 2

replacement therapy
chronic inflammatory and immune diseases (RA, Lupus, Psoriasis, Crohn’s dx, Chronic Hepatitis, Asthma, Organ transplants, TMD, COPD

Do not have curative properites, just dec signs and symptoms (inflammation and pain)

Question 3

Acute adrenal Crisis

Answer 3

insufficient levels of cortisol.

low BP, dehydration, confusion, tachypnea, sweating of face and hands, shock, coma, seizures

Question 4

Adverse Effects of Steroids

Answer 4

Impaired and delayed wound healing

Fluid and Na retention

Question 5

Methotrexate

Answer 5

Class: Folate analog, inhibitor of gene expression, cytotoxic agent

Mechanism of action: antiinflammatory effects, apoptosis of CD4 and CD8 T cells
Indication: RA, Psoriasis, graft vs host disease, severe asthma

Pharmacological effects:

How this drug might effect dental treatment of patient
oAdverse effects you have to consider:
oContraindicated drugs:

oContraindications:

oWhich analgesic can the patient take:

Question 6

Medrol Dose Pak

Answer 6

Methylprednisolone

used to avoid adrenal crisis

Question 7

Mycophenolate Mofetil (CellCept)

Answer 7

Class: Inhibitor of inosine monophosphate dehydrogenase.

Mechanism of action:
Indication:
Pharmacological effects: dec lymphocyte activation and activity. Induces apoptosis of activated T-cells. Decreased expression of adhesion molecules. Decreased production of NO by neutrophils

How this drug might effect dental treatment of patient
oAdverse effects you have to consider: Mouth ulcers, gum hyperplasia, gingivitis, dry mouth, dysphagia
oContraindicated drugs:

oContraindications:

oWhich analgesic can the patient take:

Question 8

Cyclosporine

Tacrolimus (Prograf)

Answer 8

Class:Specific Lymphocyte signaling inhibitors
Mechanism of action: Inhibits synthesis of IL-2 in activated T-cells
Indication: immunosuppressive for graft survival, topical for oral lichen planus, psoriasis, RA
Pharmacological effects:

How this drug might effect dental treatment of patient
oAdverse effects you have to consider: Gingival hyperplasia
oContraindicated drugs:

oContraindications:

oWhich analgesic can the patient take:

Question 9

Diphenhydramine (Benadryl)

Answer 9

Class: Antihistamine

Mechanism of action:
Indication:
Pharmacological effects:

How this drug might effect dental treatment of patient
oAdverse effects you have to consider: dry mouth, constipation, blurred vision
oContraindicated drugs:

oContraindications:

oWhich analgesic can the patient take:

Question 10

Histamine vs. Anti-histamine

Answer 10

HIstamine: Agonist. Shifts the receptor into the active state.
Anit-histamine: Inverse agonist. Stabilizes the inactive conformation

Question 11

Adalimumab (Humira)

Answer 11

Class: antibody

Mechanism of action: binds to and inactivates tumor necrosis factor alpha
Indication:

Question 12

Basiliximab (Simulect)

Answer 12

Class: Antibodies, IL-2 receptor antagonist
MOA: IL-2Ralpha receptor on activated T-lymphocytes. Inhibits IL-2 activation of lymphocytes