Drugs and the Immune System

Question 0

What is an inflammatory reaction?

Answer 0

Events in the tissue in response to a pathogen or noxious substance.

Question 1

Give a 3-step overview of the innate response?

Answer 1

1) tissue macrophages and dendritic cells recognise PAMPs in invader via surface receptors.
2) pro inflammatory cytokines are released causing vascular dilation and exudation of fluid which contained the components of an enzymes cascade.
3) immune response

Question 2

What are the two components of a the inflammatory reaction?

Answer 2

Innate- no immunological response.

Specific, adaptive, immunological response.

Question 3

When does the specific immune response begin?

Answer 3

After pathogen recognition in the innate system.

Question 4

What are carried to lymph nodes via lymphocytes?

Answer 4

Antigens

Question 5

What cells are involved in the specific immune response, and give the three main groups?

Answer 5

Lymphocytes; B cells, T cells and natural killers.

Question 6

Give the two phases of response?

Answer 6

Induction and effector

Question 7

Give the two steps of induction?

Answer 7

Antigen presented to T cells by the APC. Interaction between T and B called and a large clone of cells respond

Question 8

What do cloned cells do in effector?

Answer 8

Become plasma antibodies ( B cells) or cell mediated immune responses or some become antigen-sensitive memory cells.

Question 9

Give the four stages of the humoral response?

Answer 9

1) Fab portion binds the antigen.
2) Fc portion activates the complement cascade.
3) Fc portions forms links to neutrophils and macrophages.
4) Fc portion of LgE binds to the mast cells and basophils causing the release of basophils.

Question 10

What do antibodies do in the immune system and how do they do this?

Answer 10

They increase effectiveness and specificity by stimulating the complement sequence phagocytosis of bacteria by Fc portion and direct natural killer cells via Fc portion.

Question 11

What do antibodies not do?

Answer 11

Reach pathogens within the cells

Question 12

What two main cells does the cell mediated response use?

Answer 12

Cytotoxic T cells (which kill virally infected cells) and T helper cells (which activate macrophages and stimulate the proliferation of TH1 and Tc cells.

Question 13

What does the autocrine effect of cytokines lead to?

Answer 13

Cell mediated (Th1) or antibody mediated (Th2) responses.

Question 14

What is the full name for type 1, 2, 3 and 4 unwanted inflammatory and immune responses?

Answer 14

1- immediate or anaphylactic hypersensitivity
2- antibody mediated cytotoxic hypersensitivity
3- complex mediated hypersensitivity
4- cell mediated hypersensitivity.

Question 15

What are analgesics drugs effective against?

Answer 15

Mild-moderate, localised or wide-spread pain

Question 16

What are antipyretic drugs effective against?

Answer 16

High temperatures and fever

Question 17

How do antipyretic drugs work?

Answer 17

They prevent prostanoid synthesis

Question 18

What are the three major effects?

Answer 18

Antipyretic, anti-inflammatory and analgesic.

Question 19

How do anti-inflammatory drugs work?

Answer 19

They inhibit cox2 which decreases PGE2 and PGI2 synthesis.

Question 20

What can anti-inflammatory lead to?

Answer 20

Long term tissue damage

Question 21

What COX is constitutively active?

Answer 21

COX1, in many tissues but particularly the kidney, stomach, vessels and blood

Question 22

What are the unwanted effects of NSAIDS?

Answer 22

Decrease in COX1

Question 23

What are the general side effects of NSAIDs?

Answer 23

GI tract damage, irritant, renal disease, prolonged labour, hypersensitivity reactions and inhibition of blood clotting

Question 24

Give three examples of NSAIDs?

Answer 24

Paracetamol, salicylates, and proprionic acids

Question 25

Give an example of a proprionic acid?

Answer 25

Aspirin

Question 26

How are the major effects distributed in salicylates, paracetamol and proprionic acids

Answer 26

Equally in both salicytes and proprionic acid but more analgesic/antipyretic and less anti-inflammatory in paracetamols.

Question 27

What are examples of COX2 drugs?

Answer 27

Refecoxib and celecoxib

Question 28

What are COX2 drugs mainly used as?

Answer 28

Anti-arthritics

Question 29

What side effects to COX2 drugs cause?

Answer 29

Hypertension and reduction in renal filtration.

Question 30

How is histamine synthesised?

Answer 30

From histidine by histidine carboxylase.

Question 31

Where and how is histamine released?

Answer 31

From mast cells via exocytosis during inflammatory/allergic reactions. Basic drugs can also cause release, eg. Morphine.

Question 32

What are the three main histamine receptors?

Answer 32

H1: vascular permeability, contraction of smooth muscle
H2: stimulate gastric acid secretion and increase cardiac rate
H3: per synaptic site and inhibit neurotransmitter release.

Question 33

How are eicosaniods generated differently to histamine?

Answer 33

They are not pre formed and stored they are made as and when they are needed

Question 34

What do eicosanoids include?

Answer 34

Prostanoids (which includes prostaglandins), thromboxane and leukotrines.

Question 35

What prostanoids are there?

Answer 35

PGI2, PGE2, PGE2, PGF2 alpha, TXA2

Question 36

Which prostanoid plays a major role?

Answer 36

PGE2

Question 37

What are the effects of PGE2?

Answer 37

Vasodilation, potentiate actions of histamine, to increase vascular permeability, produce fever and pain and bronchoconstriction