Pharmacological Aspects Of Immunology Flashcards

1
Q

Where does aspirin come from?

A

White willow

Used to treat fever and joint pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Prostacyclins govern?

A

Vasodilatation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How many scripts for NSAIDS each year in UK?

A

25 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Aspirin usage limited by?

A

GI toxicity
Tinnitus
Reye’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What Is aspiring used for?

A

Anti-platelet effect, prevention of stroke and mi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

COX2 is induced in

A

Inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cox 1 is?

A

Expressed in all tissues

Hence inhibtion will result in anti platelet activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cox 3 possibly only found in?

A

CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many people use no prescription NSAIDs?

A

20-30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aspirin limited for?

A

Tinnitus
Reye’s syndrome (hepatic failure in children)
GI toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is aspirin good for?

A

Anti platelet effect stroke and MI, prevention and treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why GI toxicity in NSAID?

A

Prostaglandins E2 and I2, decrease acid production, increase mucus production and blood supply, which is inhibited by NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

NSAID in GI can cause

A

Ulcers
Bleeding
Irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Relative risk of upper GI bleeding with NSAID?

A

4.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which NSAID has a relative risk of 23.5 for bleeding?

A

Azapropazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Biggest risk factor for GI bleed?

A

Previous GI bleed

17
Q

NSAID side effect?

A
Nephrotoxicity, 
Reduced grr
Papillary necrosis
Hyperkamaemia
Sodium retention
18
Q

Acute renal failure percentage?

A

0.5-1

19
Q

Bronchospasm happens how often?

A

10%, cox is inhibited, so shunts arachnids if acid to the leukotrienes pathway

20
Q

Gastroprotection with NSAID would be with?

A

Proton pump inhibitors e.g omeprozal

21
Q

Why at high doses is paracetamol bad?

A

Usually through phase II conjugation reaction, but when that is saturated then through phase I oxidation,

NAPQI, which is hepatic necrosis

22
Q

How to treat paracetamol overdose?

A

N-acetylcysteine, glutathione precursor

23
Q

What was the controversy with cox 2 selective inhibitors?

A

Increased risk of MI

24
Q

How do steroids affect the cell?

A

Steroid receptors in a complex with heat shock protein in cytoplasm.

Steroid crosses cell. Binds to receptor and can cross nuclear membrane

Bind to specific gene regulatory sequences and activate transcription.

25
Q

Steroids don’t affect

A

Immunoglobulin level and complements

26
Q

Which steroid is good for its anti inflammatory properties?

A

Prednisolone

27
Q

Cerebral oedema drug?

A

Dexamethasone

28
Q

Early side effects of steroid?

A

Glucose intolerance
Weight gain
Mood changes
Suppression of ACTH release

29
Q

Later side effects of steroid therapy?

A
Proximal muscle weakness
Osteoporosis 
Body shape changes
Skin changes
Cataracts
Adrenal suppression
30
Q

If you withdraw steroids immediately will get?

A

Adrenal crisis in infection/ surgery- especially Addison’s patients.

31
Q

DMARDs?

A

Steroid sparing

Suppress inflammation

32
Q

Methotrexate is a competitive inhibitor of?

A

Dihydrofolate reductase

Folate is needed for purine synthesis in DNA

33
Q

Azathioprine inhibits?

A

Tmpt thin-ursine s methyltransferase, inhibits purine synthesis

Widely used for transplants

34
Q

Cyclosporine action/

A

Inhibits calcineurin, which reduces t lymphocyte activity