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Immunology > Walsh > Flashcards

Walsh Flashcards

1
Q

Kinin Cascade

A

Responsible for the pain involved in inflammation. Also Causes vasodilation, increased permeability of blood vessels, and most importantly it stimulates pain receptors.

  • Bradykinin
  • – PGs potentiate the action of bradykinin
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2
Q

Prostaglandins

A

Derived from arachidonic acid

  • belongs to the eicosanoid family, which includes PGs, Thromboxanes, and Leukotrienes
  • exert their effects locally and they will have different effects in different parts of the body
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3
Q

Prostanoids

A

PGs and Thromboxanes

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4
Q

PGE2 and PGF2alpha

A

Promotes gastric mucus secretion and inhibits gastric acid secretion
- protects stomach lining

Mnemonic - eliminating farts, not really applicable but it’s a good way to remember that it has too do with the stomach.

PGE2 is also the main Prostanoid Involved In inflammation
- vasodilation, vascular permeability, increased sensitivity to bradykinin, pain neuromodulation in spinal cord, fever

  • So, PGE2 is good in the stomach but will cause ill effects elsewhere
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5
Q

PGI2

A

Otherwise known as Prostocyclin

- Inhibits platelet aggregation in the clotting process, vasodilation

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6
Q

TXA2 - Thromboxane A2

A

Promotes platelet aggregation

- the name has thrombus in it so it makes sense

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7
Q

How does PGE2 get to the site of the injury?

A

Macrophages and monocytes will secrete PGE2 at the site of injury.

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8
Q

What enzyme is responsible for making PGE2?

A

COX2

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9
Q

What does COX-1 do?

A

Housekeeping functions

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10
Q

How do NSAIDs work

A

Reduce the production of PGE2 and therefore reduce swelling, pain, fever, and platelet aggregation
- they inhibit COX-II

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11
Q

Side effects of NSAIDs? Why?

A

Stomach discomfort because COX-1 and COX-2 are isozymes and NSAIDs are not specific to one of the COX enzymes. Therefore, COX-1 is being inhibited as well. COX-1 is responsible for eh other action of PGE2 - gastric mucus and minimizing gastric acid.

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12
Q

Why might people taking NSAIDs cause allergies and asthma?

A

Because while you are Blocking COX, you are forcing the other pathway, through 5-lipoxyganse,, and. Make leukotrienes.

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13
Q

5-lipoxygenase

A

Enzyme in the other half of the arachidonic acid pathway that makes leukotrienes

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14
Q

Why does aspirin Works longer than other NSAIDs

A

It binds covalently (irreversibly) to COX-1 and COX-2 in platelets

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15
Q

Effect of eating a lot of Omega-3 fatty acids

A

Reduces platelet aggregation and reduces inflammatory diseases

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16
Q

Rofecoxib

A

VIOXX

- selective COX-2 inhibitor so tat it only deals with inflammation and platelets but not stomach stuff.

17
Q

Celecoxib

A

CELEBREX

- selective COX-2 inhibitor

18
Q

WHy is there a cardiovascular risk for VIOXX and some of the other COX-2 inhibitors?

A

Because it causes an increase in the amount of TXA2 relative to PGI2, which will cause clots to form and MI. This is because TXA2 is more made my COX-1 and PGI2 is more made by COX-2.

19
Q

Why is a baby aspirin good for your heart?

A

It actually decreases MI risk because it causes you to have more PGI2 than TXA2. This is because TXA2 is made in the RBCs which don’t have a nucleus whereas PGI2 is made in the endothelial cells. If you destroy COX-1 , the TXA2 won’t be made because the lack of nucleus doesn’t allow more to be made. You have to wait for a whole new batch to be made.

20
Q

Acetaminophen

A

Tylenol

  • reduces pain but not swelling so not technically an NSAID
  • reduces PGs in the hypothalamus
  • narrow therapeutic window and an overdose can kill the patient.
  • heptotoxicitiy can occur in 2-3 times the normal dose. The toxic metabolite is called N-acetyl-p-benzoquinone Imine (NAPQI).
  • Antidote for acetaminophen toxicity is N-Acetylcysteine (NAC)
21
Q

NAPQI

A

Toxic metabolite in liver during acetaminophen toxicity.

- it is a reducing agent that depletes the glutathione stores

22
Q

NAC

A

Antidote for acetaminophen overdose. It increases glutathione stores in the liver

23
Q

Why might alcoholics get liver injury more easily than regular people from Acetaminophen

A

They have upregulated CYP450 enzymes, which will make more of the NAPQI.
- they also already have bad livers.

24
Q

What are corticosteroids used for?

A

Anti-inflammatory effects - inhibits COX-2

- immunosuppressive effects also

25
Q

Side effects of corticosteroids

A

Most are the immunosuppressive effects

  • suppression of injury response, wound healing
  • suppression of response to infection
  • osteoporosis, muscle wasting
  • Moon Face (Cushingoid facies)
  • can increase blood sugar, increased fatty acid distribution
26
Q

Neutrophils

A

First WBCs to arrive on scene and remove debris by phagocytosis

Immunology (21 decks)

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