Flashcards in Drugs and the Immune System Deck (38):
Give a 3-step overview of the innate response?
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
What is an inflammatory reaction?
Events in the tissue in response to a pathogen or noxious substance.
What are the two components of a the inflammatory reaction?
Innate- no immunological response.
Specific, adaptive, immunological response.
When does the specific immune response begin?
After pathogen recognition in the innate system.
What are carried to lymph nodes via lymphocytes?
What cells are involved in the specific immune response, and give the three main groups?
Lymphocytes; B cells, T cells and natural killers.
Give the two phases of response?
Induction and effector
Give the two steps of induction?
Antigen presented to T cells by the APC. Interaction between T and B called and a large clone of cells respond
What do cloned cells do in effector?
Become plasma antibodies ( B cells) or cell mediated immune responses or some become antigen-sensitive memory cells.
Give the four stages of the humoral response?
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.
What do antibodies do in the immune system and how do they do this?
They increase effectiveness and specificity by stimulating the complement sequence phagocytosis of bacteria by Fc portion and direct natural killer cells via Fc portion.
What do antibodies not do?
Reach pathogens within the cells
What two main cells does the cell mediated response use?
Cytotoxic T cells (which kill virally infected cells) and T helper cells (which activate macrophages and stimulate the proliferation of TH1 and Tc cells.
What does the autocrine effect of cytokines lead to?
Cell mediated (Th1) or antibody mediated (Th2) responses.
What is the full name for type 1, 2, 3 and 4 unwanted inflammatory and immune responses?
1- immediate or anaphylactic hypersensitivity
2- antibody mediated cytotoxic hypersensitivity
3- complex mediated hypersensitivity
4- cell mediated hypersensitivity.
What are analgesics drugs effective against?
Mild-moderate, localised or wide-spread pain
What are antipyretic drugs effective against?
High temperatures and fever
How do antipyretic drugs work?
They prevent prostanoid synthesis
What are the three major effects?
Antipyretic, anti-inflammatory and analgesic.
How do anti-inflammatory drugs work?
They inhibit cox2 which decreases PGE2 and PGI2 synthesis.
What can anti-inflammatory lead to?
Long term tissue damage
What COX is constitutively active?
COX1, in many tissues but particularly the kidney, stomach, vessels and blood
What are the unwanted effects of NSAIDS?
Decrease in COX1
What are the general side effects of NSAIDs?
GI tract damage, irritant, renal disease, prolonged labour, hypersensitivity reactions and inhibition of blood clotting
Give three examples of NSAIDs?
Paracetamol, salicylates, and proprionic acids
Give an example of a proprionic acid?
How are the major effects distributed in salicylates, paracetamol and proprionic acids
Equally in both salicytes and proprionic acid but more analgesic/antipyretic and less anti-inflammatory in paracetamols.
What are examples of COX2 drugs?
Refecoxib and celecoxib
What are COX2 drugs mainly used as?
What side effects to COX2 drugs cause?
Hypertension and reduction in renal filtration.
How is histamine synthesised?
From histidine by histidine carboxylase.
Where and how is histamine released?
From mast cells via exocytosis during inflammatory/allergic reactions. Basic drugs can also cause release, eg. Morphine.
What are the three main histamine receptors?
H1: vascular permeability, contraction of smooth muscle
H2: stimulate gastric acid secretion and increase cardiac rate
H3: per synaptic site and inhibit neurotransmitter release.
How are eicosaniods generated differently to histamine?
They are not pre formed and stored they are made as and when they are needed
What do eicosanoids include?
Prostanoids (which includes prostaglandins), thromboxane and leukotrines.
What prostanoids are there?
PGI2, PGE2, PGE2, PGF2 alpha, TXA2
Which prostanoid plays a major role?