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Pharmacology > Immunomodulators (year 2) > Flashcards

Immunomodulators (year 2) Flashcards

1
Q

what are the two ways to modulate the immune system?

A

immune suppression

enhance host immune response

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2
Q

what can be targeted to suppress immune response?

A

inflammatory response
allergic response
inappropriate immune response

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3
Q

when may we want to enhance the immune response?

A

infection
vaccination
against neoplasia

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4
Q

what are the 4 hypersensitivity reactions?

A

1 - IgE and MCT mediated
2 - IgG mediated
3 - immune complex
4 - cytotoxic T cell mediated

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5
Q

what do anti-inflammatory medications target?

A

block some effector mechanism of the innate immune system

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6
Q

what do immunosuppressive medications target?

A

reduce function of adaptive immune system by reducing lymphocyte proliferation or limit their effect

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7
Q

what are the three main groups of immunosuppressive drugs?

A

inhibit cytokine gene expression
inhibit IL2 production/action
inhibit DNA synthesis

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8
Q

what is the first line immunosuppressive treatment for many diseases?

A

glucocorticoids

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9
Q

where are glucocorticoids metabolised and excreted?

A

liver and excreted by kidney

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10
Q

are glucocorticoids protein bound?

A

yes

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11
Q

what is the mechanism of action of glucocorticoids?

A

bind to receptors in cytoplasm this transmits a signal to the DNA which then switches on/off genes

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12
Q

what are the functional outcomes of glucocorticoids?

A

stabilise mast cells to reduce degranulation
reduce pro-inflammatory cytokine production (IL2)
downregulate Fc receptor expression on macrophages
reduce antigen presentation

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13
Q

what are the three main glucocorticoids?

A

prednisolone
methylprednisolone
dexamethasone

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14
Q

what glucocorticoid is the longest acting and has the highest potency?

A

dexamethasone

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15
Q

what are the other effects of glucocorticoids?

A

stimulate gluconeogenesis
suppress inflammation
alter fat, protein and CHO metabolism
suppress HPA axis

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16
Q

what side effects do glucocorticoids cause?

A 
PUPD
lethargy
GI bleeding
hypercoagulability
polyphagia
weight gain
muscle loss
17
Q

what cells produce IL2?

A

Th (CD4) cells

18
Q

what does IL2 stimulate?

A

clonal proliferation
activation of T cells
B cell proliferation
activity of innate immune system (NK, macrophages)

19
Q

what are the two most common IL2 inhibitors?

A

ciclosporin

tacrolimus

20
Q

how is ciclosporin administered?

A

topical, oral, parenteral

21
Q

where is ciclosporin and tacrolimus metabolised and excreted?

A

liver and excreted in bile

22
Q

what are the adverse effects f ciclosporin and tacrolimus?

A

transient vomiting
opportunistic infection
increase risk of neoplasia

23
Q

what are the main DNA synthesis inhibitors?

A

azathioprine
mycophenolate mofetil (MMF)
leflunomide

24
Q

what does azathioprine inhibit?

A

purine synthesis - stops DNA and RNA synthesis

25
Q

what part of the immune response does azathioprine reduce?

A

Th1 mediated immunity

26
Q

how is azathioprine administered?

A

orally

27
Q

where is azathioprine metabolised to its active form?

A

liver

28
Q

what species should azathioprine not be used in?

A

cats

29
Q

what are the adverse effects of azathioprine?

A

hepatopathy
myelosuppression
GI signs
pancreatitis

30
Q

what does mycophenolate mofetil inhibit?

A

an enzyme crucial to purine synthesis in lymphocytes

31
Q

what response does mycophenolate mofetil reduce?

A

T cell differentiation
antibody response
dendritic cell maturation

32
Q

where is mycophenolate mofetil metabolised and excreted?

A

hepatic metabolism then excreted renally

33
Q

what are the adverse effects of mycophenolate mofetil?

A

diarrhoea

weight loss

34
Q

what are the actions of human immunoglobulin?

A

binds T and B cells to prevent proliferation and activation

block immune function

35
Q

what are the adverse effects of human immunoglobulin?

A

hypercoagulability
glomerulonephritis
transfusion reactions

Pharmacology (25 decks)

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