Pharmacological Aspects Of Immunology

Question 1

Where does aspirin come from?

Answer 1

White willow

Used to treat fever and joint pain

Question 2

Prostacyclins govern?

Answer 2

Vasodilatation

Question 3

How many scripts for NSAIDS each year in UK?

Answer 3

25 million

Question 4

Aspirin usage limited by?

Answer 4

GI toxicity
Tinnitus
Reye’s syndrome

Question 5

What Is aspiring used for?

Answer 5

Anti-platelet effect, prevention of stroke and mi

Question 6

COX2 is induced in

Answer 6

Inflammation

Question 7

Cox 1 is?

Answer 7

Expressed in all tissues

Hence inhibtion will result in anti platelet activity

Question 8

Cox 3 possibly only found in?

Answer 8

CNS

Question 9

How many people use no prescription NSAIDs?

Answer 9

20-30

Question 10

Aspirin limited for?

Answer 10

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

Question 11

What is aspirin good for?

Answer 11

Anti platelet effect stroke and MI, prevention and treatment

Question 12

Why GI toxicity in NSAID?

Answer 12

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

Question 13

NSAID in GI can cause

Answer 13

Ulcers
Bleeding
Irritation

Question 14

Relative risk of upper GI bleeding with NSAID?

Answer 14

4.7

Question 15

Which NSAID has a relative risk of 23.5 for bleeding?

Answer 15

Azapropazone

Question 16

Biggest risk factor for GI bleed?

Answer 16

Previous GI bleed

Question 17

NSAID side effect?

Answer 17

Nephrotoxicity, 
Reduced grr
Papillary necrosis
Hyperkamaemia
Sodium retention

Question 18

Acute renal failure percentage?

Answer 18

0.5-1

Question 19

Bronchospasm happens how often?

Answer 19

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

Question 20

Gastroprotection with NSAID would be with?

Answer 20

Proton pump inhibitors e.g omeprozal

Question 21

Why at high doses is paracetamol bad?

Answer 21

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

NAPQI, which is hepatic necrosis

Question 22

How to treat paracetamol overdose?

Answer 22

N-acetylcysteine, glutathione precursor

Question 23

What was the controversy with cox 2 selective inhibitors?

Answer 23

Increased risk of MI

Question 24

How do steroids affect the cell?

Answer 24

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.

Question 25

Steroids don’t affect

Answer 25

Immunoglobulin level and complements

Question 26

Which steroid is good for its anti inflammatory properties?

Answer 26

Prednisolone

Question 27

Cerebral oedema drug?

Answer 27

Dexamethasone

Question 28

Early side effects of steroid?

Answer 28

Glucose intolerance Weight gain Mood changes Suppression of ACTH release

Question 29

Later side effects of steroid therapy?

Answer 29

``` Proximal muscle weakness Osteoporosis Body shape changes Skin changes Cataracts Adrenal suppression ```

Question 30

If you withdraw steroids immediately will get?

Answer 30

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

Question 31

DMARDs?

Answer 31

Steroid sparing Suppress inflammation

Question 32

Methotrexate is a competitive inhibitor of?

Answer 32

Dihydrofolate reductase Folate is needed for purine synthesis in DNA

Question 33

Azathioprine inhibits?

Answer 33

Tmpt thin-ursine s methyltransferase, inhibits purine synthesis Widely used for transplants

Question 34

Cyclosporine action/

Answer 34

Inhibits calcineurin, which reduces t lymphocyte activity