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PHARMA - 2 > LESSON- 1 INFLAMMATION > Flashcards

LESSON- 1 INFLAMMATION Flashcards

1
Q

is a complex dynamic response of tissues to damaging (noxious) stimuli.

A

Inflammation

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2
Q

It is a basic component of many disease processes

A
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3
Q

An inflammatory stimulus may be

A

physical
biological
chemical

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4
Q

comprises interrelated vascular and cellular changes in affected tissues, which are aimed at removing or neutralizing the offending stimulus, and repairing injured tissues.

A

Acute inflammation

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5
Q

The response under such circumstance may then produce damage, which may constitute a disease process

A

(e.g. anaphylaxis, autoimmune hemolytic anemia and lupus erythematous)

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5
Q

The acute inflammatory reaction has two main components:

A

(a) Innate non-immunological, and
(b) Acquired immunological

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5
Q

Signs of Acute Inflammation

A

PAIN
ALTERED FUNCTION
redness
increased temperation
swelling

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6
Q

Components of Inflammatory Reaction

A
  1. An innate non-immunological response
    -Vascular events
    -Cellular events
  2. The acquired specific immune response
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7
Q

Circulating neutrophils initially adhere to the swollen endothelial cells

A

margination

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8
Q

then actively migrate through the basement membrane vascular epithelium, passing into the area of tissue damage

A

emigration

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9
Q

Later, small numbers of blood —
migrate in a similar way.

A

monocytes (or macrophages) and lymphocytes

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10
Q

This migration process, called

A

chemotaxis

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11
Q

is caused by the attraction of leukocytes to chemical substances (—- ) produced in the site of tissue damage.

A

chemotoxins

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12
Q

Functions of Acute Inflammation

A
  1. To dilute the offending noxious stimuli
    (weakens the enemies)
    2.To eliminate damaging agents
    (gets rid of the enemies)
    3.Removal of inflammatory tissue debris
    (cleans up the battlefield)
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13
Q

These events however constitute a continuum of inflammatory events of the cells involved in the inflammation some
- are normally present in tissues while

A

-vascular endothelial cells, —mast platelets, and
- tissue macrophages

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14
Q

gain access into the tissue from the blood.

A

platelets, and leukocytes

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15
Q

During inflammation the endothelial cells of the small arterioles are “activated” to secrete:

A

a. Nitric oxide (NO) and prostacyclin
b. Endothelin, plasminogen activator
c. express intercellular adhesion molecules (ICAM)

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16
Q

leukocytes are classified into:

A

(a) Polymorphonuclear cells (neutrophils, basophils and eosinophils), and
(b) Mononuclear cells (monocytes and lymphocytes).

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17
Q

Endothelial cell function also involved in

A

angiogenesis (formation of new blood vessels

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18
Q

angiogenesis occur

A

wound repair,
chronic inflammation
cancer

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19
Q

are characterized by having nuclei with varying shapes (banded, lobed or segmented).

A

Polymorphonuclear cells (PMNs)

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20
Q

are the first of the leukocytes to enter the area of inflammation – the “first line” of defense

A

neutrophils

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21
Q

but are predominantly found in tissues rather than in the circulating blood.

A

Mast cells

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22
Q

Like neutrophils, they also adhere to endothelium, and migrate into the tissue in response to specific chemotaxic substances

A

chemokines

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22
Q

. Mast cell’s membrane contains surface receptors for both

A
  • immunoglobulin E (IgE)
  • for complement components C3a and C5a
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22
Q

Involved primarily in blood coagulation,
also play a role in inflammation

A

Platelets

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22
Q

the neutrophils used to be called macrophages,

A

little eaters

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22
Q

Other substances released by mast cells include:

A

(a) Heparin or (heparan)
(g) Peroxidases
(i) Prostaglandins

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22
Q

in inflamed areas release inflammatory neuropeptides when appropriately stimulated. Type C and Aծ fibers transmit pain impulses to the central nervous system.

A
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22
Q

In the tissue, monocytes are transformed into macrophages (literally

A

“big eaters”,

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22
Q

Platelet-derived growth factor contributes to the repair processes following tissue damage.

A
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22
Q

enter the area of inflammation at a later stage, several hours after the polymorphs

A

monocytes

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22
Q

platelets also called

A

thrombocytes

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22
Q

They kill target cells of NK

A
  • virus-infected cells and - —-cancer cells that lack the major histocompatibility complex (MHC) molecules
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22
Q

cells are specialized lymphocytes that are active in non-immunological reactions.

A

Natural killer (NK)

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22
Q

The inflammatory exudate is composed of

A

fluids, electrolytes, proteins, cellular elements and some inflammatory mediators

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22
Q

Components of Exudate

A

Fluid
Fribin
Neutrophils
Macrophages

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22
Q

containing salts and high concentration of proteins including immunoglobulins

A

fluid

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22
Q

from the white blood cell population

A

neutrophils

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22
Q

which are phagocytic cells derived from blood monocytes, and
A few lymphocytes

A

macrophages

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22
Q

in the acute inflammatory exudates carries nutrients, mediators and immunoglobulins.

A

fluids

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23
Q

may dilute or buffer any locally produced toxins

A

fluids and salt

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24
Q

Can diffuse into the area of inflammation to support the macrophages.

A

glucose and oxygen

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24
Q

The fluid is constantly circulating to the local lymph nodes and assists in later development of a

A

specific immune response

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25
Q

Immunoglobulins in the exudates may act as

A

opsonins

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25
Q

main groups of lymphocytes

A

B- cell
t-cells
natural killers cells

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26
Q

Responsible cell-mediated immune reactions

A

t cells

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26
Q

Responsible for body production- the humoral immune response

A

b cells

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26
Q

Specialized non-T and non-B lymphoid cells that are active in non-immune innate response

A

natural kiler cells

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27
Q

The antigenic molecules are presented to the lymphocytes by the

A

antigenic-presenting cells

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28
Q

This phase involves how the cells, which are produced in the induction phase, act to eliminate antigens. This action may be

A

cell mediated

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28
Q

The production of — during first exposure to antigen greatly accelerates and makes more effective the immunological response to subsequent exposure.

A

memory cells

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28
Q

Antibodies or immunoglobulins have two functions;

A
  • to recognize and interact
  • activate one or more. host defense system
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29
Q

The tissue reacts through vascular and cellular changes. These changes are mediated by substances, which are collectively called .

A

autocoids

30
Q

are substances present in the body and act near the sites of their synthesis. They are sometimes called

A

local hormones

31
Q

derived from the amino acid histidine

A

histamine

31
Q

which the blood of animals is relatively histamine

A

Goat and Rabbits

32
Q

the of this animals is low in histamines

A

blood of horse, dog cat and rat

33
Q

neurons in the brain.

A

histaminergic

33
Q

Non-mast-cell histamine is secreted by — in the stomach

A

histaminocytes

34
Q

activates phospholipase C in the mast cell membrane, which catalyzes the breakdown of membrane phospholipids

A

antigen-antibody complex

34
Q

Histamine is stored mainly by mast cells, which are abundant in the

A

gastrointestinal mucosa, bronchial mucosa, and skin.

35
Q

histamine is released as a result of interaction of the

A

antigen and the antibody IgE
on the surface of mast cells (or basophils

35
Q

Some physiological roles of histamine

A

 Histamine secreted by histaminocytes in the stomach regulates gastric acid secretion (excessive secretion causes hyperacidity and ulceration)
 Histamine secreted by histaminergic neurons in the brain act as neurotransmitter in the CNC (involved in motion sickness)
 Histamine secreted by mast cells acts as mediator of early inflammatory reactions

36
Q

Intradermally injected histamine produces the so-called

A

triple response

37
Q

triple response to histamine

A

reds spot
flare
wheal

38
Q

A few millimeters around the site of injection is due to immediate direct vasodilator effect of histamine.

A

Red spot

39
Q

A bright red irregular outline from the original red spot due to reflex dilatation of the adjacent small vessels.

A

flare

40
Q

A localized edema due to leakage of plasma fluid through the abnormality permeable walls of the small blood vessels.

A

wheal

41
Q

histamine also causes
not pain

A

pruritis

42
Q

Mediates most inflammatory and are antagonized by the classical anti-histamine

A

h1

43
Q

selective antagonist of H1

A

Mepyramine

43
Q

Has a role in gastric acid secretion; an action blocked by specific H2 antagonists

A

H2

44
Q

H2 Selective Antagonist

A

Cimetidine

45
Q
  1. Prevent release of histamine by inhibiting the responses of sensitized cells basophils to specific antigen.
    what drugs use ?
A

Epinephrine

45
Q

Description is still incomplete

A

H3

46
Q

selective antagonist of H3

A

Thloperamide

47
Q

The vasodilation and increased vascular permeability in response to histamine is mediated by both

A

H1 and H2 receptors on mast cells and basophils

48
Q
  1. Physiologically antagonize histamine effects. drugs use?
A

epinephrine
Theophylline

49
Q

is poorly absorbed from the gut, and is usually given inhalation as nebulized solution or powder

A

cromolyn sodium

50
Q

is better absorbed than cromolyn sodium.

A

nedicromyl

51
Q

These xanthine derivatives are bronchodilators used in the management of attack of bronchospasm.

A

theophylline and aminophylline

52
Q

unwanted effect of of Theophylline and aminophylline

A

anorexia
Nausea and vomiting

53
Q

By acting on specific adrenergic receptors,
it causes peripheral vasoconstriction, bronchodilation and cardiac stimulation; effects that counter histamine effects.

A

epinephrine

54
Q

classical or H1 antihistamines are not as widely used in animals as in people because of two reasons:

A

antihistamines effectiveness in animals and
glucocorticoids are more effective

55
Q

the most abundant precursor of eicosanoids (eicosa – 20, may be derived by elongation of dietary linoleic acid (18 carbons), and is usually esterified to second carbon (C2) of cell membrane phospholipids

A

Arachidonic acid

56
Q

The prostaglandins (PG) are also called

A

prostanoids

57
Q

because they share the chemical features of a hypothetical substance 20-carbon prostanoic acid with a five-member cyclopentane ring and two hydrocarbon side-chains.

A

prostaglandins

57
Q

Prostaglandins are not stored in tissues, but are rapidly formed and released when tissue is damaged.

A
58
Q

Two major enzyme systems
use in arachidonic substance

A

cyclo-oxygenage and lipoxygenase

58
Q

Arachidonic acid is converted by cyclo-oxygenase (COX; also called

A

Endoperoxide

59
Q

A constitutive enzyme, which sub serve a number of physiologic role.

A

cyclooxygenase-1

59
Q

are unstable and may be converted to their corresponding hydroxyl fatty acid, known for short

A

HETE

60
Q

is a powerful chemotactic agent for bit neutrophils and macrophages.
It also increase the formation of membrane adhesion molecules and production of toxic oxygen products and release of granules enzyme.

A

LTB₄

61
Q

are rapidly metabolized (bio transformed) in the lungs by prostaglandin dehydrogenase.

A

Prostanoids, PGE and PGF

61
Q

The factors that inhibit prostaglandins dehydrogenase include:

A

*nitrate
*IRRADIATION
*bacterial Endotoxins

62
Q

are a heterogeneous group of compound which are often chemically unrelated.

A

Non-steroidal Anti-inflammatory Drugs
(NSAID)

62
Q

is converted to 20-hydroxy LTB₄ by special membrane-bound P450 enzyme, which occur in neutrophils

A

Leukotrienes LTB₄

62
Q

NSAID’s are used as:

A

analgesic
antipyretic
anti inflammatory

62
Q

is used to reduce thromboembolus (intravascular clot) formation associated with heartworm disease in dog and with hypertrophic cardiomyopathy in cats.

A

aspirin

63
Q

The prototype of these agents is aspirin, hence they are also called

A

aspirin like drugs

64
Q

are used systemically in the management of non-ulcerative keratitis (inflammation of cornea) in the horse.

A

Flunixin and Phynebutazone

65
Q

Elimination is most rapid in herbivores, slowest in carnivores and intermediate in omnivores

A

aspirin

66
Q
  • Similar to aspirin, but less commonly used
  • Do not use in animals less than 30 days old.
A

sodium salicylate

67
Q

Used externally as a counter-irritant.

A

oil of wintergreen

67
Q
  • Recommended in horses for treatment of inflammatory conditions involving pain and lameness, such as “tying up” syndrome
A

naproxen

68
Q
  • A simple derivative of phenylpropoinic acid
  • Metabolized in the liver and may cause gastrointestinal irritation and bleeding but less frequently than with aspirin.
A

Ibuprofen

69
Q
  • Inhibits both the cyclooxygenase and some lipoxygenase.
A

ketoprofen

70
Q
  • Usually not included with NSAIDs for it is devoid of anti-inflammatory effects but retains antipyretic and analgesic effects
A

paracetamol

71
Q
  • Used to treat acute or chronic osteoarthritic disease in the horse and chronic musculoskeletal disease in the dog, slow onset action
A

meclofenamic acid

72
Q
  • Effective for the most colic cases excluding severe bowel distension or displacement.
  • Useful in treatment of endotoxin shock
A

flunixin maglumine

73
Q
  • Not to be given in dogs of fetal effect
  • In horsed it causes CNS disorder
A

indomethacin

74
Q
  • Frequently beneficial in the treatment of soft-tissue or non-articular rheumatism including capsulitis, laminitis and bursitis.
  • Most widely used in horses
A

phenylbutazone

75
Q
  • Widely used to treat equine colic and other condition of GI spasm or hypermobility in both large and small animals
A

Dipyrone

76
Q
  • Inhibits chondrocyte and synoviacyte synthesis of PGE₂
A

entodoplac

77
Q
  • It is a metabolite phenylbutazone has similar properties as phenylbutazone
A

oxyphenbutazone

78
Q
  • Rapidly absorbed in the stomach and reaches 80% of its peak plasma concentration in 1 hour
  • The long half-life (45 h) of his compound permits once a day or longer dosing interval
A

piroxicam

79
Q
  • A new NSAIDs similar to Ibuprofen, specifically used to treat arthritis in dog.
A

caprofen

80
Q

is a polar lipid released from leukocytes and causes platelets to aggregate

A

Platelets activiting factors

81
Q

are polypeptide production released by connective tissue and activated lymphocytes and monocytes.

A

cytokines

82
Q

oxide is a small molecule that is locally synthesized by endothelium and macrophage through the activity of the enzyme, nitric oxide synthesis.

A

nitric oxide

83
Q

is a nonpeptide

A

brachykinin

84
Q

has an additional lysine and amino terminal.

A

kallidin

85
Q

are activated by protease enzyme kallikrein.

A

kinins

86
Q

initially activated on exposure to collagen, cleave pre-kallikreins into active kallikreins.

A

factor XII (Hageman factor)

87
Q

has been used in treatment of acute pancreatitis and carcinoid syndrome

A

aprotinin

87
Q

Bradykinin acts on at least three types of receptors:

A
  1. B1
  2. B2, and
  3. B3
88
Q

Complement can be activated either by:

A
  1. The Classical Complement Activation Pathway or
  2. The Alternative Complement Activation Pathway
88
Q

is a collective term referring to heat labile factor in the extra cellular fluids

A

complement

88
Q
  • This dissociation is regulated by a serum protein called
    which acts to stabilize the C3bBb complex
A

properdin

89
Q

is initiated by activation of Hageman factor (Factor XII).

A

blood clotting

90
Q

The best “anti-inflammatory” agent in such clinical setting

A

heparin ( anti coagulant )

91
Q

derived from endothelium by the action of bradykinin generates plasmin, a thrombolytic enzyme.

A

plasminogen activator

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