Quiz 2 Flashcards
All of the Cells in the Hematopoietic System develop from what cell in the bone marrow?
The pluripotent hematopoietic stem cell
What are the main cells of the lymphatic system?
T and B cells are the main cells of the lymphatic system
What is the function of T & B cells?
The function of T cells and B cells is to recognize specific “non-self” antigens, during a process known as antigen presentation
What is a controlled substance?
Controlled substances are drugs that have some potential for abuse or dependence
FDA regulates Controlled Substances
Name the Schedule for controlled substances
Schedule I: drugs with no currently accepted medical use and a high potential for abuse
Schedule II: drugs with a high potential for abuse; less than Schedule I drugs
Schedule III: drugs with a moderate to low potential for physical and psychological dependence
Schedule IV; drugs with a low potential for abuse and low risk of dependence
Schedule V: drugs with lower potential for abuse than Schedule IV
Schedule I for controlled substances, with examples
Schedule I: drugs with no currently accepted medical use and a high potential for abuse
- Most dangerous of all drug schedules w/ potentially severe psychological and/or physical dependence
Ex: Heroin, Ecstasy, LSD
Schedule II for controlled substances, with examples
Schedule II: drugs with a high potential for abuse; less than Schedule I drugs
- Can potentially lead to severe psychological or physical dependence and are also considered dangerous
ex: Morphine & Fentanyl , Oxycodone (OxyContin), Adderall and Ritalin (used for ADHD)
Morphine & Fentanyl
Oxycodone (OxyContin)
Adderall and Ritalin
Schedule II
Schedule III for controlled substances, with examples
Schedule III: drugs with a moderate to low potential for physical and psychological dependence
- abuse potential is less than that of Schedule I & II drugs but greater than Schedule IV drugs
ex: Ketamine, Anabolic steroids –Testosterone, Marijuana (cannabis)
Schedule IV for controlled substances, with examples
Schedule IV; drugs with a low potential for abuse and low risk of dependence
ex: Xanax, Valium, Ambien
Schedule V for controlled substances, with examples
Schedule V: drugs with lower potential for abuse than Schedule IV
- containing limited quantities of certain narcotics
- generally used for antidiarrheal, antitussive, and analgesic purpose
ex: Lomotil, Lyrica, Cough medicine
What are Adverse effects/reactions (ADRs)
- Any undesirable action - side effects - that can include
Undesirable effects, many of which
can be tolerated
These are generally reversible upon
drug discontinuation
They are dose related - Toxicity reactions
Resulting in cell and tissue damage
Permanent and generally intolerable
Factors that increase the risk of ADR are reactions
Increasing age of the child
Increasing number of drugs
Oncological treatment
ADRs Symptoms for Nervous System Name 3
Dizziness
Drowsiness
Depression
Delusions
Confusion
Headaches
ADRs Symptoms for eyes name 3
Eyelids & Conjunctiva are frequent targets for drug toxicity
Blurred/double vision
Increased Ocular Pressure
Damage to the retina and optic nerve
Erythema multiforme
Stevens-Johnson Syndrome: (Erythema multiforme in its most severe form)
ADRs Symptoms for Auditory-vetibular system
Dizziness
Vertigo
Other balance disorders
Hearing loss
Tinnitus
-Tinnitus and dizziness are the most common side effects of medications
What are the most common side effects of ADR for Auditory-vetibular system
Tinnitus and dizziness are the most common side effects of medications
ADRs Symptoms for SKIN
Acne
Alopecia
Herpes simplex
Sweating
Urticaria (hives)
What is an antigen?
antigen - a substance that elicits an immune response
What are the Immune System Components
Antigen-Specific
Systemic
Memory
Self/non-Self recognition
what Recognize and act against particular antigens
Antigen-Specific:
Antigen Specific
Immune System Component
Antigen-Specific: Recognize and act against particular antigens
Systemic
Immune System Component
Systemic: Not Confined to the initial infection but work throughout the body
Memory
Immune System Component
Memory : Recognizes and mounts an even stronger attack to the same antigen next time
Builds immunity; Vaccinations or Cold/flu
Self/Non-Self Recognition
Most Important Component of the immune system
Self/non-self recognition is achieved by every cell displaying a marker based on the major histocompatibility complex (MHC)
- MCH are group of genes that code for cell surface proteins essential for the immune system
Any cell not displaying this marker is treated as non-self and attacked
What is Not Confined to the initial infection but work throughout the body
Systemic
What Recognizes and mounts an even stronger attack to the same antigen next time
Memory
What is Achieved by every cell displaying a marker based on the major histocompatibility complex (MHC); Any cell not displaying this marker is treated as non-self and attacked
Self/Non-Self Recognition
autoimmune disease & examples
Sometimes the process breaks down and the immune system attacks the body’s own cell
Ex: multiple sclerosis (MS), sudden sensorineural hearing loss (SSNHL), rheumatoid arthritis
Sometimes the process breaks down and the immune system attacks the body’s own cell
autoimmune disease & examples
Allergies
There are instances when the immune response to innocuous substances is inappropriately overwhelming = Allergies
There are instances when the immune response to innocuous substances is inappropriately overwhelming
Allergies
Two Main Fluid Systems of Immune System
The Hematopoietic (blood) and Lymphatic Systems
Cells in the hematopoietic system
Erythrocytes or red blood cells (RBCs)
Leukocytes or white blood cells (WBCs)
Thrombocytes or platelets
What do Erythrocytes function and what system are they apart of?
Erythrocytes or red blood cells (RBCs) - Carry oxygen
Hematopoietic system
What do Leukocytes function and what system are they apart of?
Leukocytes or white blood cells (WBCs) ; Fight infections
Hematopoietic system
What do Leukocytes function and what system are they apart of?
Thrombocytes or platelets - Help control bleeding; clotting
Hematopoietic System
All these cell types in the Hematopoietic system develop from a common cell in the ________ ________ ; The _______ ____________ _______ _______
Bone Marrow ; The pluripotent hematopoietic stem cell
If all the cells in the hematopoietic system all develop from The pluripotent hematopoietic stem cell how do they become different?
They differentiate into these different cell types by interactions with dozens of glycoproteins called hematopoietic growth factors
Leukocytes; Function, types and location
Leukocytes or white blood cells (WBCs), are responsible for protecting the body from infection and part of the immune system
Granulocytes (containing large granules in the cytoplasm)
Agranulocytes (without granules)
What white blood cells contain granules
Granulocytes are WBCs with secretory granules & consist of
Neutrophils
Eosinophils
Basophils
What white blood cell do not contain granules
Agranulocytes are lymphocytes (single large nucleus, no granules)
Consisting of B cells, T cells, and monocytes
Lymphocytes circulate in the blood and lymph systems and make their home in the lymphoid organs
What are Lymphocytes?
Agranulocytes are lymphocytes (single large nucleus, no granules)
Consisting of B cells, T cells, and monocytes
Lymphocytes circulate in the blood and lymph systems and make their home in the lymphoid organs
What are the main cells of the lymphatic system
T and B cells are the main cells of the lymphatic system
______ is clear, transparent, and colorless
Lymph
what is Lymph?
Lymph is clear, transparent, and colorless
It flows in the lymphatic vessels alongside the blood vessels, bathing tissues and organs in its protective covering
Along the lymph vessels, there are lymph nodes that serve as filters of the lymphatic fluid
It is in the lymph nodes where ______ are usually presented to the immune system
Antigens
Along the lymph ________ , there are _____ ______ that serve as _______ of the lymphatic fluid
Along the lymph vessels, there are lymph nodes that serve as filters of the lymphatic fluid
It is in the_______ _______where antigens are usually presented to the immune system
Lymph nodes
What are the Primary Organs of the Immune System
Bone Marrow & Thymus Gland
What produces B Cells
Bone Marrow
What produces T Cells?
Thymus Gland
They are produced in the bone marrow and mature in the thymus
What cells are involved in humoral immunity (related to antibodies)
B Cells
________ ________ produces antigen-specific antibodies and is primarily driven by B cells
Humoral Immunity
Humoral immunity produces antigen-specific antibodies and is primarily driven by _____ cells
B Cells
Cell-mediated immunity does not depend on antibodies for its adaptive immune functions and is primarily driven by mature_____ cells
T Cells
_______ ________ does not depend on antibodies for its adaptive immune functions and is primarily driven by mature T cells
Cell-mediated immunity
T- Cells; Produced & Function
Thymus gland = T cells
They are produced in the bone marrow and mature in the thymus
T cells are involved in cell-mediated immunity
- Cell-mediated immunity does not depend on antibodies for its adaptive immune functions and is primarily driven by mature T cells
The function of T cells and B cells is to recognize specific “non-self” antigens, during a process known as antigen presentation
B- Cells; Produced & Function
Bone marrow = B Cells
B cells are involved in humoral immunity (related to antibodies)
- Humoral immunity produces antigen-specific antibodies and is primarily driven by B cells
The function of T cells and B cells is to recognize specific “non-self” antigens, during a process known as antigen presentation
What is the function of T & B cells?
The function of T cells and B cells is to recognize specific “non-self” antigens, during a process known as antigen presentation
Secondary organs for the immune system
Adenoids, tonsils, spleen, lymph nodes, appendix and Peyer’s patches (within the intestines)
WBCs originate in the bone marrow and then migrate to the other primary and secondary lymph organs
What cells originate in the bone marrow and then migrate to the other primary and secondary lymph organs
White Blood Cells
WBCs originate in the _____ ______ and then migrate to the other primary and secondary ______ ______
Bone Marrow; Lymph Organs
What are Immunoglobulins
Immunoglobulins are large y shaped proteins secreted by the plasma and are clones of primed B cells
Immunoglobulins are used by what?
Immunoglobulins used by the immune system to identify and neutralize foreign objects such as bacteria and viruses
Function of Immunoglobulins
Immunoglobulins used to identify & neutralize foreign objects like bacteria or viruse
- The antibody recognizes a unique molecule of the pathogen, called an antigen
What forms gamma gobulins?
Antibodies form gamma globulin part of the blood proteins
_______ inactivate_________ through various mechanisms
antibodies inactivate antigens through various mechanisms
Constituents of gamma globulin are (Types of immunoglobulins)
IgG - 76%
IgA - 15%
IgM - 8% (much larger than the other immunoglobulins)
IgD - 1%
IgE - 0.002%
Immunity can be either
Natural or artificial
Innate or acquired/adaptive
Active or passive
Active natural (contact with infection)
Develops slowly, is long term, and antigen specific
Develops slowly, is long term, and antigen specific
Active natural (contact with infection)
Active artificial (immunization-vaccines)
Develops slowly, lasts for several years, and is specific to the antigen for which the immunization was given
Develops slowly, lasts for several years, and is specific to the antigen for which the immunization was given
Active artificial (immunization-vaccines)
Passive natural
Develops immediately, is temporary, and affects all antigens to which the mother has immunity
(trans-placental mother-to-child)
Develops immediately, is temporary, and affects all antigens to which the mother has immunity
Passive natural (trans-placental mother-to-child)
Develops immediately, is temporary, and affects all antigens to which the donor has immunity
Passive artificial (injection of gamma globulin)
Passive artificial
Develops immediately, is temporary, and affects all antigens to which the donor has immunity
(injection of gamma globulin)
IgG
IgG dominates in the secondary immune responses
IgG is the only antibody that crosses the placental barrier to the fetus
Most common Immunoglobulin
It is responsible for the 3 to 6 month immune protection of newborns that is conferred by the mother
Mediates Type II & Type III reactions
Most common Immunoglobulin
IgG
only antibody that crosses the placental barrier to the fetus
IgG
dominates in the secondary immune responses
IgG
It is responsible for the 3 to 6 month immune protection of newborns that is conferred by the mother
IgG
dominates in primary immune responses
IgM
IgM
IgM dominates in primary immune responses
Less of them but much lager than other immunoglobulins
Mediates Type II reaction
Vaccines ______ the immune system’s _______, which are responsible for ______ the presence of a ________ and typically peak 10 to 18 days after the shot
Vaccines activate the immune system’s T cells, which are responsible for detecting the presence of a virus and typically peak 10 to 18 days after the shot
Vaccine___ __, to create _ that ____ the virus from being able to __________ and the________ _______ to destroy the infected cells
Vaccines also instruct B-cells to create antibodies that block the virus from being able to replicate and the T-killer cells to destroy the infected cells
Vaccines offer what type of Immunization
Vaccines offer Active Artificial Immunization
What is the goal of vaccines?
The aim of vaccines is to teach the body’s immune system to recognize and block viruses
True or false?
With all types of vaccines, the body is left with a supply of “memory” T-lymphocytes as well as B-lymphocytes that will remember how to quickly fight that particular antigen (virus) in the future
TRUE
mast cells & basophils (type of WBCs) do what
target cells in the immune system for immediate-type reactions
Where are mast cells found?
mast cells are found in connective tissue
contain histamine, an important chemical for fighting infections
What are basophils?
basophils are a type of white blood cell and contain histamine
What does mast cells and basophils have in common?
They both contain histamine an important chemical for fighting infections
Unfortunately, when released into the body inappropriately or in too high a quantity, histamine is a potentially devastating substance resulting in allergic reactions
It takes between 7 to 10 days of ______ exposure for the ____ _____ and _____ to become primed with IgE antibodies
It takes between 7 to 10 days of sensitizing exposure for the mast cells and basophils to become primed with IgE antibodies
A mast cell is part of the ______ ______ and contains granules rich in ______ and ________
A mast cell is part of the immune system and contains granules rich in histamine and heparin(anticoagulant to prevent blood clots)
What can happen if too much histamine is released into the body?
when released into the body inappropriately or in too high a quantity, histamine is a potentially devastating substance resulting in allergic reactions
How long does sensitizing take and what is it primed by?
It takes between 7 to 10 days of sensitizing exposure for the mast cells and basophils to become primed with IgE antibodies
What is an allergic Cascade?
If a second exposure occurs to the same allergen , it triggers a destructive domino effect within the system called the allergic cascade
True or false
Antigens combines with adjacent molecules of the IgG antibodies that have become attached to the mast or basophil cell surface
FALSE
IgE
Antigens combines with adjacent molecules of the IgE antibodies that have become attached to the mast or basophil cell surface
Name the 3 types of allergic reactions associated with drugs
Type I reaction medicated by IgE
Type II reaction mediated by IgG, IgM
Type III reaction mediated by IgG
Type I allergic reaction
Type I reaction mediated by IgE
- Most severe types of reactions
Anaphylaxis
Asthma syndrome
Dermatitis
Type II Allergic Reaction
Type II reaction mediated by IgG, IgM
- Hemolysis (break down) of red blood cells
(blood disorder)
Ex: some forms of anemia, blood
transfusion reactions, and some type
of tissue transplant rejection
Type III Allergic Reaction
Type III reaction mediated by IgG
Arthralgia (muscle/joint pain) and fever
Lymphadenopathy (swollen lymph glands
What Allergic reaction type mediated by IgE
Type I reaction mediated by IgE
What Allergic reaction type mediated by IgG, IgM
Type II reaction mediated by IgG, IgM
What Allergic reaction type mediated by IgG
Type III reaction mediated by IgG
What Allergic reaction type is Most severe types of reactions
Type I Most severe types of reactions
Anaphylaxis
Asthma syndrome
Dermatitis
What Allergic reaction type Hemolysis (break down) of red blood cells (blood disorder)
Type II reaction mediated by IgG, IgM
Hemolysis (break down) of red blood cells (blood disorder)
Ex: some forms of anemia, blood transfusion reactions, and some type of tissue transplant rejection
What Allergic reaction type occurs in Arthralgia or swollen lymph nodes?
Type III reaction mediated by IgG
Arthralgia (muscle/joint pain) and fever
Lymphadenopathy (swollen lymph glands
What is a life-threatening and can occur at any time within minutes to a couple of hours
Anaphylaxis
Anaphylaxis
Anaphylaxis is life-threatening and can occur at any time within minutes to a couple of hours
What is Anaphylaxis or anaphylactic shock
Anaphylaxis or anaphylactic shock is a severe, progressive, whole-body allergic reaction to a chemical that has become an allergen
Whay is a severe, progressive, whole-body allergic reaction to a chemical that has become an allergen
Anaphylaxis or anaphylactic shock
what happens when you are exposed to an allergen the first time?
After being exposed to a substance such as bee sting venom and suffering a mid allergic reaction, the person’s immune system becomes sensitized to it
What typically occurs the second time you are exposed to an allergen?
When the person is exposed to that allergen again, anaphylaxis happens quickly after; it is severe, and potentially life threatening
Occurs typically after the second time of being exposed to it
True or False
Anaphylaxis is an immune response; that occur after the first exposure to an allergen
FALSE
Anaphylaxis is an immune response; that occur after the second exposure because you need to be sensitized
What is Anaphylactoid?
Some drugsmay cause an anaphylactic-like (anaphylactoid) reaction when people are first exposed to them
These are systemic not immune system reactions that do NOT require prior sensitization to an antigen as required in true anaphylaxis
These are systemic not immune system reactions that do NOT require prior sensitization to an antigen.
Anaphylactoid; anaphylactic-like (anaphylactoid) reaction
True or false
Anaphylactoid is an immune response; because it happens on first exposure. is just as important & Serious as anaphylaxis
FALSE
Anaphylactoid is not an immune response; because it happens on first exposure. But just as important & Serious
How does treatment and response differ between Anaphylaxis vx anaphylactoid?
They are equally important & Serious
The symptoms, risk of complications, and treatment are the same for both types of reactions
Risks of anaphylaxis
history of any type of allergic reaction
for some it appears with no known cause usually because first exposure causes mild/no symptoms
True or False
anaphylactoid or an anaphylaxis/anaphylactic shock is an EMERGENCY medical condition!
TRUE
anaphylactoid or an anaphylaxis/anaphylactic shock is an EMERGENCY medical condition!
During anaphylaxis, tissues in different parts of the body release histamine and other substances, which causes the airways to tighten and leads to other symptoms such as (know at least 4)
Abdominal pain
Anxiety
Chest discomfort or tightness, wheezing, pulmonary edema
Cough and difficulty breathing
Difficulty swallowing due to swelling of the throat
Dizziness, light-headedness, unconsciousness
Skin redness, hives, itchiness, pale and blue skin (from lack of O2)
Nausea/vomiting and diarrhea
Weak and rapid pulse and low blood pressure
Abnormal heart rhythm
Slurred speech
Swelling of the face, eyes, and/or tongue
Mental confusion
Treatment for anaphylactoid or an anaphylaxis/anaphylactic shock
Epinephrine (adrenaline) to reduce body’s allergic response
Oxygen to help compensate for restricted breathing
Intravenous (IV) antihistamines and cortisone to reduce inflammation and swelling in order to open airways
A beta-agonist (such as albuterol) to relieve breathing symptoms
What are Teratogens?
Any substance, organism, or physical agent that can cause developmental abnormalities or birth defects in a developing embryo or fetus. Teratogens can interfere with normal development, leading to congenital malformations or functional deficits that can manifest at birth or later in life
_____ is any substance, organism, or physical agent that can cause developmental abnormalities or birth defects in a developing embryo or fetus. Teratogens can interfere with normal development, leading to congenital malformations or functional deficits that can manifest at birth or later in life.
Teratogen
What is Pharmacogenomics
is the study of the role of the genome in drug response – a combination of pharmacology & genetics
studies how the genetic makeup of a patient affects their response to drugs
_______ studies how the genetic makeup of a patient affects their response to drugs
Pharmacogenomics
True or False
A drug can still be approved by the FDA is that drug is proven to be a teratogen?
TRUE
Drugs that are teratogenic may still be approved by the FDA, if
- The therapeutic benefits outweigh the risk
- Physician labeling clearly contraindicates use during pregnancy
Drugs that are teratogenic may still be approved by the FDA, if
The therapeutic benefits outweigh the risk
Physician labeling clearly contraindicates use during pregnancy
How does the FDA monitor or teratogentity in drugs?
The FDA requires testing of all new drugs for teratogenic potential during the drug toxicity trails in animal studies.
Teratogen examples
Accutane; for severe cystic acne (99% teratogenic)
Thalidomide
Infections such as rubella (German measles)- She said this is one of the worst Teratogens
Environmental factors like radiation
The FDA new Pregnancy & Lactation Labeling Rule (PLLR) recommendations include 3 main categories
Fetal risk summary
- Characterizes the likelihood, from both
human and animal data, that a drug
increases the risk of four types of
developmental abnormalities
Clinical considerations
- Discussing fetal risk from inadvertent
exposure and prescribing decisions
based on drug effects on labor,
delivery, and fetus
Data
- Detailed discussion of available data;
human data appears before animal data
______ is the study of the role of the genome in drug response – a combination of pharmacology & genetics
Pharmacogenomics
Drug target receptors are sufficiently ______ in the population such that most __________ act as ________ on most people
Drug target receptors are sufficiently common in the population such that most medications act as intended on most people
Name inter-individual differences examples
In genes that can encode these drug targets
OR
In genes that encode proteins for drug metabolism
The genetic difference can what
These genetic differences can be highly significant for the success or failure of drug therapy
If one nucleotide in a specific position is exchanged with another nucleotide, the alteration is referred to as a
Single nucleotide polymorphism or SNP (pronounced “SNIP”)
Majority of nucleotide variations are SNPs
Other variations (mutations) include
Insertions, deletions, duplications, and translocations of one or more nucleotides or even entire chromosomes
What can affect protein amount or function by altering coding sequence of transcription or mRNA translation, which could be pharmacologically important
SNPs or other genetic variations can affect protein amount or function by altering coding sequence of transcription or mRNA translation, which could be pharmacologically important
Genetic polymorphisms in pharmacokinetics are common in ______ _______ that metabolize both ______ and _______ reactions
Genetic polymorphisms in pharmacokinetics are common in major enzymes that metabolize both phase I and II reactions
drugs with no currently accepted medical use and a high potential for abuse
most dangerous of all drug schedules with potentially severe psychological and/or physical dependence
Schedule I
Heroin
LSD
Ecstasy
Schedule I
drugs with accepted medical usewith a high potential for abuse
lead to severe psychological or physical dependence and are also considered dangerous
Schedule 2
drugs with a moderate to low potential for physical and psychological dependence
Schedule III
Ketamine
Anabolic steroids –Testosterone
Schedule III
drugs with a low potential for abuse and low risk of dependence
Schedule IV
Xanax
Valium
Ambien
Schedule IV
drugs with lowest potential for abuse
containing limited quantities of certain narcotics
generally used for antidiarrheal, antitussive, and analgesic purpose
Schedule V
Lomotil (for diarrhea)
Lyrica (for nerve pain/neuropathy)
Cough Medicine
Schedule V
True or False
Drug hypersensitivity and allergies are an adverse drug reaction
TRUE
______________ is a constellation of responses mounted by body to attacks from outside the body
Immune System
Drug hypersensitivity and allergies are an adverse drug reaction why do they occur?
They occur because of the body’s immune system
The immune system is a group of responses mounted by the body to attacks from outside the body
Develops immediately, is temporary, and affects all antigens to which the donor has immunity
Passive artificial (injection of gamma globulin)
