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SYSTEMIC PHARMACOLOGY > LESSON 1: INFLAMMATION & ALLERGY > Flashcards

LESSON 1: INFLAMMATION & ALLERGY Flashcards

1
Q

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

A

Inflammation

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2
Q

it comprises interrelated vascular & cellular changes in affected tissue;

A

acute inflammation

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3
Q

acute inflammation aims to?

A
  1. Remove
  2. Neutralized
  3. Repair
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4
Q

what are the 5 cardinal sign of inflammation?

A
  1. pain
  2. altered functions
  3. redness
  4. increase temperature
  5. swelling
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5
Q

PAIN is due to what?

A

stimulation of local receptors

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6
Q

this is due to reduced activity.

A

altered function

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7
Q

redness is due to what?

A

transient hyperemia

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8
Q

increase of temperature is caused by?

A

increase blood flow

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9
Q

swelling is cause by?

A

increase vascular permeability

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10
Q

what are the 2 main components of acute inflammation?

A
  1. Innate non-immunological response
  2. Acquired immunological response
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11
Q

in this event circulating neutrophils adhere to the swollen endothelial cells.

A

Margination

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12
Q

when margination happens this event will be the next, neutrophils actively migrate through the basement membrane vascular epithelium passing into the area of tissue damage

A

emigration

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13
Q

this migration process is called what??

A

chemotaxis

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14
Q

chemotaxis is caused by the attraction of _____ to chemotoxins produced in the site of tissue damage

A

luekocytes

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15
Q

give me the 3 function of acute inflammation

A
  1. to dilute (weakend)
  2. to eliminate (get rid)
  3. to remove inflammatory debris (clean)
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16
Q

leukocytes are classified into 2, what are those?

A
  1. Polymorphonuclear
  2. Mononuclear
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17
Q

the main cellular events in acute inflammation is caused by?

A

chemical mediator

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18
Q

during inflammation the endothelial cell of small arterioles are activated to secrete?

A
  1. Nitric oxide& prostcycline
  2. Endothelin, plasminogen activator, platelet-activation factor, thromboxane A2, angiotensin 2, cytokines
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19
Q

endothelial cell function also in _____ which occurs in wound repair, chronic inflammation & cancer.

A

Angiogenesis

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20
Q

what is the meaning of angiogenesis?

A

formation of new blood vessels

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21
Q

_______ is the first line of defense

A

neutrophils

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22
Q

_______ have the capacities similar to those of the neutrophils & release the number of potent granule that can damage multicellular parasites

A

eosinophils

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23
Q

______ are similar in many aspects of many mast cells; it secrete histamine. but found on circulating blood.

A

basophils

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24
Q

this _____ are like basophil but can only be found in tissue, it can be activated to secrete histamine.

A

mast cells

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25
Q

_____ enters the area of inflammation at a larger stage, several hours after the polymorphs; this is associated by chemokines.

A

monocytes/macrophages

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26
Q

macrophages bind with bacterial ________ that generate & release cytokines that act on vascular endothelial cells to further increased vascular permeability, attract other leukocytes & cause fever

A

lipopolysaccharide

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27
Q

this ______ involved primarily in blood coagulation & in inflammation.

A

platelets

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28
Q

platelets is also called _____?

A

thrombocytes

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29
Q

platelet or thrombocytes generate this 3 substance, what are these?

A
  1. Thromboxane A2
  2. Platelet-activating factor radicals
  3. pro-inflammatory cationic proteins
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30
Q

what are the neurons that are stimulated in an inflamed areas releasing neuropeptides.

A

Type C & Ab fibers

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31
Q

what are the functions of type c & ab fibers?

A
  1. transmit pain impulses to CNS
  2. generate chemical mediators (kinins, serotonin) during inflammation
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32
Q

_____ are cell that are specialized lymphocytes that are active in non-immunological reactions.

A

Natural killer cells

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33
Q

Natural killer cells kills what?

A
  1. target cells such as; virus-infected cells
  2. cancer cells
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34
Q

this____ molecules normally present in normal cells inhibit NK cells by acting on the inhibitory receptors on the NK cells themselves.

A

MHC

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35
Q

What are the components of exudate ?

A
  1. Fluid
  2. Fibrin
  3. Neutrophils
  4. Macrophages
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36
Q

this component of exudate contains salts & high concentratiom of proteins inlcuding immunoglobulins & mediators

A

Fluid

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37
Q

fluid is predominant in what type of exudate?

A

serous exudate

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38
Q

this component of exudate is a high molecular weight filamentous insoluble protein

A

fibrin

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39
Q

fibrin is predominant is what type of exudate

A

fibrinous exudate

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40
Q

in purulent exudates what cells are present ?

A
  1. Neutrophils, Macrophages, Lymphocytes
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41
Q

inflammatory exudates is composed of 5 substances what are those?

A
  1. fluid
  2. electrolytes
  3. proteins
  4. cellular elements
  5. inflammatory mediators
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42
Q

this 2 substances can diffuse into the area of inflammation to support the macrophages

A
  1. glucose
  2. oxygen
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43
Q

immunoglobulin in the exudates may act as?

A

opsonins

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44
Q

responsible for body production-the humoral immune response

A

B-Cells

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45
Q

responsible cell mediated immune reactions

A

T-cells

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46
Q

specialized non-T & non-B lymphoid cells that are active in non-immune innate response

A

Natural killer cells

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47
Q

This phase involves the production of B cells & T cells from uncommitted lymphocytes.

A

The induction phase of immunological response

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48
Q

the antigen molecules are presented to the lymphocytes by the?

A

Antigen-presenting cells (APC)

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49
Q

The APC engulf & process the antigen & present it to uncommitted ______ also known as t-helper precursor, in association with HMC

A

CD4 + T helper lymphocytes

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50
Q

the CD4 develop this _____, a cytokine which act on the same cells causing their proliferation, producing clones of activated T cells (Th0) give rise to 2 subsets which are the (Th1 & Th2)

A

Interleukins-2

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51
Q

IL-12 is produced by?

A

APC

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52
Q

IL-4 is produce by?

A

some Th0

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53
Q

what does Th1 controls?

A

it controls cell-mediated responses

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54
Q

Th1 secrete this______ which, activates CD8+ to become cytotoxic cells that kill virally infected host cells.

A

interferon-gamma (IFN-Y)

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55
Q

IL-4 is derived from ______ cells that inhibit Th1 function

A

Th2 cells

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56
Q

what does Th2 pathway controls ?

A

it controls antibody humoral-mediated responses

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57
Q

IFN-y is derived from ____, that inhibits Th2

A

Th1

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58
Q

this phase involves how the cells that is produce in induction phase, acts to eliminate antigens. This acts may be (antibody or cell mediated)

A

The effect phase of the immunological response

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59
Q

______ can form a link between a parasite & eosinophils, which are the able to damage or kill the parasite.

A

Antibody

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60
Q

______ can attach to mast cells & basophils to stimulate these cells to release histamine & other inflammatory mediators

A

IgE

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61
Q

2 FUNCTIONS OF ANTIBODY or IMMUNOGLOBULINS

A
  1. to recognize & interact with specific antigens
  2. to activate one or more, the host’s defense system
62
Q

the tissue reacts though ?

A

vascular & cellular changes

63
Q

are substance mediated by the body & act near the sites of their synthesis, & sometimes called local hormones

A

AUTOCOIDS

64
Q

histamine is derived from?

A

histidine

65
Q

blood of this 2 animals is relatively histamine

A

goat & rabbit

66
Q

while the blood of this 4 animals is relatively low in histamines.

A

horse, dog, cat, rat

67
Q

histamine is stored mainly in _____, which are abundant to:
1. Gastrointestinal mucosa
2. Bronchial mucosa
3. Skin

A

mast cells & basophils

68
Q

Non-mast-cell histamine is secreted by _____ in the stomach & by _____ neurons in the brain.

A

Histaminocytes & Histaminergic

69
Q

in allergy ______ is release as a result of interaction of the antigen & the antibody IgE on the surfaces of mast cells & basophils.

A

Histamine

70
Q

the prescence of _____ stimulates the production of IgE, which then binds to the surface of receptors in mast cells.

A

Antigen

71
Q

______ activates phospholipase C in the mast cell membrane, which catalyzes the breakdown of membrane phospholipids resulting in the relese of:
1. diacyglycerol
2. inositol-1,4,5-triphosphate

A

antigen-antibody complexes

72
Q

3 physiological roles of histamine

A
  1. Histamine secreted by histaminoyctes, regulates gastric acid secretions
  2. Histamine secreted by histaminergic neurons acts as neurotransmitter in the CNS
  3. Histamine secreted by mast cells act as mediators of early inflammatory reactions
73
Q

what are the 3 response to histamine?

A
  1. red spot
  2. Flare
  3. whale
74
Q

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

A

RED SPOT

75
Q

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

A

FLARE

76
Q

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

A

WHEAL

77
Q

______ histamine receptors mediates most inflammatory & are antagonized by the classical anti-histamines.

A

h1

78
Q

what is the agonist of h1 receptor

A

histamine

79
Q

what is the antagonist of h1 receptor

A

mepyramine

80
Q

______ receptor of histamine, that has a role in gastric acid secretions, an action blocked by specific H2 antagonist

A

H2 receptor

81
Q

what is the agonist of h2 receptor?

A

histamine dipamrit

82
Q

what is the antagonist of h2 receptor?

A

cimetidine

83
Q

what is the agonist of h3 receptor?

A

(R)- methyl histamine

84
Q

what is the antagonist of h3 receptor

A

thloperamide

85
Q

what are the drugs to use to prevent release of histamine by inhibiting the responses of sensitized cells basophils to specific antigen: E.T.C

A
  1. epinephrine
  2. theophyline
  3. chromolyn sodium
86
Q

drugs to for physiologically antagonize histamine effects: E.T.A

A
  1. epinephrine
  2. theophyline
  3. aminophyline
87
Q

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

A

Cromolyn sodium

88
Q

how many % of cromolyn sodium is absorb?.

A

10%

89
Q

how many % of cromolyn sodium is excreted in I bile & urine

A

50%

90
Q

is better absorbed than cromolyn sodium

A

Nedicromyl

91
Q

what is the mechanism of action of cromolym sodium?

A
  1. stabilized mast cells
    2, prevent histamine release
92
Q

these xanthine derivates are bronchodilators used in the management of attack of bronchopasm.

A

Theophylline ethylene diamine

93
Q

Theophylline ethylene diamine has a 3 positive effects:

A
  1. Chonotropic
  2. inotropic effects
  3. Mild diuretic effects
94
Q

Mode of action of Theophylline ethylene diamine:

A
  1. Inhibit phosphodiesterase, enzyme that catalysis the breakdown of cyclic AMP
  2. they cause relaxation on smooth muscle,
95
Q

unwanted effects of Theophylline ethylene diamine:

A
  1. Anorexia
  2. Nausea & vomitting
  3. Nervousness & tremors
  4. Sometimes-fatal cardiac arrythimias
96
Q

More significant clinical action of Theophylline ethylene diamine;

A
  1. Depression of release of certain neuropeptides
  2. Antagnosm of tachynin receptors
  3. Inhibition of platelet activating factor interaction w/platelets & eosinophils
97
Q

what are the drugs that inhibit microsomal cytochrome P450 enzymes: Ery,Cip,Allo,Flu,Cim

A
  1. Erythromycin
  2. Ciprofloxacin
  3. Ca2+ channel blockers
  4. Allopurinol
  5. Fluconazole
  6. Cimetidine
98
Q

what are the drugs the induce cytochrome P450
that derease the therapeutic effect of drugs.

A
  1. Phenobarbital
  2. Phenytoin
99
Q

this drug causes pheripheral vasoconstriction, bronchodillation & cardiac stimulation; effects that counter histamine effects.

A

Epinephrine

100
Q

2 reasons why H1 antihistamine are not widely used in animals:

A
  1. Antihistamine have varying effectiveness in animals
  2. glucocorticoids are available & are more effective
101
Q

Cyproheptadine also blocks?

A

5-HT receptors

102
Q

has weak alpha-adrenoreceptor blocking action

A

Promethazine

103
Q

a nontoxix metabolite of Terfenadine & is now available for use.

A

Fexofemadine

104
Q

How does arachidonic acid is released?

A
  1. Activated phospholipase C
  2. Increase in cytosolic Ca2, that will stimulates phospholipase A2 & release of arachidonic acid
105
Q

the prostaglandin are also called prostanoids, because they share the chemical features of hypothetical substance. What are those?

A
  1. 20 carbon prostanoic acid
  2. 5-member cyclopentane ring
  3. 2-hydrocarbon side chains
106
Q

are not stored in tissue but are rapidly formed & release when tissue is damaged.

A

Prostaglandins

107
Q

is invloved in the regulation of biosynthesis of prostaglandins by causing the release of the precursur arachidonic acid.

A

Phospholipase A2

108
Q

what are the 2 majory enzymes that use arachidonic acid as a substance:,

A
  1. Cyclooxygenase
  2. Lipoxygenase
109
Q

arachidonic acid is converted by ______ to cyclic endoperoxidase, (pgg2 & pgh2), these endoperoxidase have a short half-life of 30-45 sec.,

A

CYCLOOXYGENASE

110
Q

2 identified cyclooxygenase isoenzymes:

A
  1. COX-1
  2. COX-2
111
Q

inhibition of this _____ is believed to underline the most significant “side effects” of non-steroidal anti-inflammatory drugs. ex. aspirin drugs

A

COX-1 or cyclooxygenase -1

112
Q

on the other hand, is induced during inflammation, & inhibition of COX-2 accounts for the therapeutic action of NSAIDs

A

COX-2 or cyclooxygenase -2

113
Q

Arachidonic acid is also converted by lipoxygenase 3 HPETE namely:

A
  1. 15-HPETE
  2. 12-HPETE
  3. 5-HPETE
114
Q

what is the complete name of HPETE?

A

hydroperoxy-cicosatetraenoic acid

115
Q

unlike the 2 HPETE, this ____ serves as a substrate for the enzyme leukotriene synthase & is further transformed into various leukotrienes

A

5-HPETE

116
Q

what are the various leukotrienes in 5-HPETE

A
  1. LTA4
  2. LTB4
  3. LTC4
  4. lTD4, LTE4, LTF4
117
Q

_____ are leukotriens are the slow-acting substance of anaphylaxis (SRS-A), they are 1000x as potent as histamine in increasing vascular permeability.

A

LTC4 & LTD4

118
Q

What are the roles of (PG) prostglandin in inflammation:

A
  1. Metabolic effects
  2. Oppose the action of another PG
  3. Cause edema
  4. Function enhnace during phagocytosis
  5. PGE is chemotactic for leukocytes
  6. Produce fever themselvesm
  7. Do not cause pain, but can sensitize
  8. Chemical stimulation so that pain can be magnified.
119
Q

this causes vasodilation, inhibition of platelet aggregation, relaxation of gut & uterine muscle, modify pituitary hormone release.

A

PGD2 w/ receptor DP

120
Q

this causes myometrial contraction leutolysis bronchochonstriction

A

PGF2 w/ receptor F

121
Q

this causes vasodilation, inhibition of platelet aggregation, renin release & natriuresis

A

PGI2 w/ receptor IP

122
Q

this causes vasoconstriction, platelets aggregation & bronchoconstriction

A

TXA2 w/ receptor TP

123
Q

in PGE w/ receptor EP1 they causes:

A
  1. Bronchoconstriction
  2. Contraction of gut muscle stimulation of intestinal fluid secretion
124
Q

in PGE w/ receptor EP2 they causes:

A
  1. Stimulation of intestinal fluid secretion
  2. Relaxation of gut muscle
125
Q

in PGE w/ receptor EP3 they causes:

A
  1. Contraction of intestinal muscle
  2. inhibition of gastric acid secretion
  3. Increase gastric mucus secretion
  4. inhibition of lipolysis
  5. inhibition neurotransmitter release
  6. contractionof pregnant uterus
126
Q

is a powerful chemotactic agent for a bit neutrophils & macrophages.

A

LTB4, on specific LTB4 receptor

127
Q

LTB4 does?

A
  1. increase the formatiom of membrane adhesion molecules
  2. production of toxic oxygen products
  3. release of granules enzymes
128
Q

while LTD4 & LTC4 causes:

A
  1. increase respiratory mucus secretions
  2. reduced blood pressure
  3. coronary vessel constriction
  4. wheals & flare
  5. increase nasal vascular permeability
129
Q

PGE & PGF are rapidly metabolized in the lungs by _______. The depression of capacity of the lungs to metabolized PG’s may result in increased levels of PE2 & PGF2A

A

Prostaglandin dehydrogenase

130
Q

the factor that inhibit prostaglandin dehydrogenase include:

A
  1. Nitrate
  2. Irradiation
  3. Bacterial endotoxins
131
Q

are heterogenous group of compound which are often chemically unrelated.,

A

NSAID’s or Non-steroidal anti-inflammatory drugs

132
Q

what are the prototypes of NSAID’s ?

A

aspirin, hence they are called aspirin-like drugs

133
Q

what are the clinical used of NSAID’s?

A
  1. Analgesic
  2. Antipyretic
  3. Anti-inflammatory
134
Q

in veterinary medicine, NSAID’s are used for tx. of:

A
  1. acute inflammation of m. skeletal system
  2. non-immune inflammation of m.skeletal system & anaphylactic reaction in cattle
  3. equine colic
  4. acute resp. disease in calve & pigs
135
Q

______ is used to reduce thromboembolosus, fromation associated w/ heartworm disease in dog & w/ hypertrophic cardiomyopathies, it has the ability to prevent platelet aggregation.

A

Aspirin

136
Q

aspirin is usually administered orally & converted into?

A

salicylic acid

137
Q

similar to aspirin, less commonly used. cannot be given to animals less than 30 days old,

A

sodium salicylate

138
Q

used systemically in the management of non-ulcerative keratitis in the horse

A

flunixin & phenybutazone

139
Q

used externally as a counter-irritant

A

methylsalicylic acid

140
Q

recommended in horses for treatment of inflammatory conditions, involved in lameness & pain such as tying up syndrome:

A

Naproxen

141
Q

a simple derivative of phenylpropionic acid, metabolized in the liver & may cause gastro. irritation & bleeding.

A

ibuprofen

142
Q

inhibits both cylooxygenase & some lipoxygenase

A

ketroprofen

143
Q

it’s usually not included w/ NSAID’s for it’s devoid of anti-inflammatory effects but retain antipyretic 7 analgesic effects

A

paracetamol

144
Q

is a small molecule, a powerful cause of vasodilation & increase vascular permeability. important re-active oxygen intermediary, also mediate cell & bacterial killing

A

Nitric oxide

145
Q

is a polar lipid release from leukocytes & cause platelet aggregate

A

platelet activating factor

146
Q

are polypeptide production release by connective tissue & activated lymphocytes & monocytes

A

Cytokines

147
Q

is a non-peptode (arg-pro-pro-gly-phe-ser-pro-phe-arg)

A

bradykinin

148
Q

while this type of kinin systems has an additional lysine & amino terminal

A

kallidin

149
Q

is used in treatment of acute pancreatitis & carcinoid syndrome

A

aprotinin

150
Q

blood clotting is initiated by activation of ?

A

hageman factor (factor xii)

151
Q

what is the best anti-inflammatory agent ?

A

Heparin

SYSTEMIC PHARMACOLOGY (7 decks)

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