Immunosuppression and Inflammation

Question 1

Sodium cromoglycate

Answer 1

Used to treat conditions associated with mast cell degranulation. Inhibits mast cell degranulation. Mechanism of action unclear but may inhibit Cl- conductance that is required to maintain a negative enough membrane potential to enable sustained influxes of Ca.

Question 2

Salbutamol/salmeterol

Answer 2

Beta2-adrenoceptor agonists. Used in asthma to inhibit mast cells as well as causing bronchodilation.

Question 3

Theophylline

Answer 3

PDE inhibitor. Used in asthma to inhibit mast cells as well as causing bronchodilation.

Question 4

Omalizumab

Answer 4

Monoclonal antibody that recognises IgE. IgE with its high affinity receptor FceRI induces phosphorylation of adaptor protein linker for activation of T cells that cause activation of PLCbeta/IP3 mediated release.

Question 5

Mepyramine

Answer 5

First generation antihistamine. Rapidly permeates BBB so causes drowsiness. Used in creams for treatment of insect bites.

Question 6

Promethazine

Answer 6

First generation antihistamine. Used as a sedative, to treat motion sickness and severe morning sickness.

Question 7

Terfenadine

Answer 7

Second generation antihistamine. Does not cross BBB. But causes prolonged QT interval due to inhibition of KvII.I/hERG important for repolarisation of AP. In conditions of diminished p450 3A4 (e.g. due to grapefruit juice) gives enhanced risk of death.

Question 8

Fexofenadine

Answer 8

Third generation antihistamine. Active compound of terfenadine by p450 3A4.

Question 9

Loratadine

Answer 9

Third generation antihistamine. Non-drowsy and no cardiac side effects.

Question 10

What is administered in the case of anaphylactic shock and why?

Answer 10

Adrenaline. Counteracts systemic vasodilatation and reduction in tissue perfusion. Also relieves bronchospasm.

Question 11

Omeprazole

Answer 11

Inhibits proton pump. Used in treating gastric ulcers.

Question 12

Ranitidine

Answer 12

H2 receptor antagonist. Used in treating gastric ulcers.

Question 13

Clarithromycin/metronidazole

Answer 13

Antibiotics used to eradicate Helicobacter Pylori for treatment of gastric ulcers.

Question 14

Misoprostol

Answer 14

PGE1 analogue. Prescribed alongside NSAIDs in elderly patients at risk of developing gastric ulcers to act as EP1/2 receptors to enhance mucus secretion.

Question 15

Athrotec

Answer 15

Combination of NSAID diclofenac and mesoprostol (PGE1 analogue). Used to treat rheumatoid arthritis.

Question 16

C1-INH

Answer 16

Kallikrein inhibitor (C1 esterase inhibitor)

Question 17

Kalbitor

Answer 17

Kallikrein inhibitor. Used to treat hereditary angioedema.

Question 18

Tanezumab

Answer 18

Monoclonal antibody against Nerve Growth Factor.

Question 19

Telcagepant

Answer 19

CRGP antagonist currently in trials.

Question 20

Metoclopramide

Answer 20

D2 antagonist - emesis.

Question 21

Scopolamine

Answer 21

M1 antagonist - emesis.

Question 22

Mepyramine

Answer 22

H1 antagonist - emesis.

Question 23

Dramamine

Answer 23

H1 antagonist/M1 antagonist - emesis.

Question 24

‘setrons e.g. ondansetron

Answer 24

5-HT3 antagonist - emesis.