Immune 1 Flashcards by Wiktoria Galica

Pathogen associated molecular patterns (PAMPs)

a limited number of molecular patterns common to a wide variety of pathogens

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What tissues initiate the acquired immune system?

Lymphoid tissue

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What targets antigens?

A cell-mediated
A humoral adaptive response

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Hypersensitivity

resulting immune response is too strong - poison ivy or asthma attack

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Atopy

The tendency to develop an allergy, or hypersensitivity, is greatly determined by inheritance (referred to as atopy)

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What is the key to a healthy immune response?

A key to a healthy immune response is the body’s ability to recognize its own cells and the cells of a foreign microbe

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What happens to create adaptive immunity to an antigen?

gene rearrangement leads to an irreversible change in the DNA of the lymphocyte, all of the progeny of that cell inherits gene encoding having the same receptor specificity, which in turn is the reason why adaptive immunity is specific and long-lived

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Rubor

redness

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tumor

swelling

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dolor

pain

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calor

warmth

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functio leasa

loss of function

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What does the adaptive immune system split into once reaching an inflammatory response?

Humoral immunity
Cellular immunity

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Widespread invasion and inflammation can lead to large amount of cytokine release, what does this cause?

fever, tachycardia, and organ failure, possibly leading to shock or death

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Antibodies

large protein molecules released from the lymphocytes that bind with and help destroy an offending antigen by marking it for destruction

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What part of the immune system are B cells?

Humoral

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immunoglobulin (Ig)

An antibody that is a protein

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4 kinds of IgG are found where?

Blood

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IgA is found in?

Seromucous secretions

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IgM is found in?

blood

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IgD is found in?

Lymphocytes

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IgE is found in?

skin and external surfaces

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What cells manage cellular immunity?

T cells

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What kind of hypersensitivity is allergic rhinitis?

IgE type 1 hypersensitivity

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What leads to allergic rhinitis sxs?

Mast cell degranulation caused by attaching of IgE antibodies

Allergic rhinitis tx

Oral antihistamines - can cause systemic effect Spray antihistamines - bypass systemic effects

Nasal spray antihistamine examples

azelastine nasal (Astelin, Astepro) and olopatadine nasal (Patanase)

Tx steps for allergic rhinitis

Antihistamines IN Steroids Nasal mast cell stabilizers, decongestants, anticholinergics, and leukotriene receptor antagonists also used

IN steroids compared to antihistamines

Slower to act than antihistamines (1-2 wks to work)

Why are systemic steroids not used in allergic rhinitis?

Because of their systemic adverse effects, only recommended in intractable allergic rhinitis not responding to other therapy

IN Steroid examples

beclomethasone budesonide flunisolide fluticasone mometasone triamcinolone

IN steroids SE

Headaches, pharyngeal candidiasis, pharyngitis, nasopharyngeal irritation, epistaxis, and septal perforation

Nasal Mast Cell Stabilizer do what?

Prevent the release of histamine from mast cells by stabilizing their membranes

What is cromolyn and what is it used for?

Mast cell stabilizer - Prophylactic and must be used prior to allergic antigen exposure

Nasal Mast Cell Stabilizer SE

Bad taste

Decongestants do what?

Sympathomimetics - vasoconstriction in the superficial mucosal blood vessels, decreasing swelling of the nasal mucosa and rhinorrhea

Decongestants available

Available in a myriad of OTC formulations Oxymetazoline (nasal) Pseudoephedrine (Oral)

Topical decongestant use >3-4 days can cause what?

rhinitis medicamentosa, which is a rebound effect

What do anticholinergics do to tx allergic rhinitis?

reduce nasal hypersecretion and congestion

Topical anticholinergics for allergic rhinitis?

ipratropium bromide (Atrovent)

Leukotriene Receptor Antagonists example

Montelukast (Singulair)

Pharm tx of allergic conjunctivitis

Topical vasoconstrictors Antihistamines Mast cell stabilizers

What do topical vasoconstrictors do to tx allergic conjunctivitis?

can reduce eye redness and ocular itching by stimulating alpha-adrenergic receptors

What do antihistamines do to the allergic response?

Antihistamines: compete with histamine on H1 effector cells inhibiting the release of histamine

hydroxypropyl cellulose class

artificial lube

tetrahydrozoline hydrochloride class

vasoconstrictors

azelastine hydrochloride class

antihistamine

emedastine difumarate class

antihistamine

levocarbastine hydrochloride class

antihistamine

ketorolac tromethamine class

nsaid

diclofenac sodium class

nsaid

ketoifen fumarate class

mast cell

cromolyn sodium class

mast cell

olopatadine hydrochloride class

mast cell

lodoxamide tromethamine class

mast cell

dexamethasone class

steroid

prednisolone class

steroid

Prolonged use of topical ocular meds must be monitored becasue?

Associated w/ glaucoma

What immune response is AD related to?

IgE production

Mainstay AD flare tx

Mainstay of pharmacological treatment for flare-ups is the topical corticosteroids - Using the lowest potency topical steroid for the shortest duration is always best

2nd line tx for AD flare

Calcineurin inhibitors, tacrolimus (Protopic ointment), and pimecrolimus (Elidel cream) are topical immunosuppressive agents considered to be second-line agents

What can creams cause?

Contact dermatitis

Why are creams preferred over the more potent ointments?

Creams are less greasy

When using topical steroids, where should they NOT be applied?

Untreated skin or bacterial infections

Topical Calcineurin Inhibitors examples

Pimecrolimus and Tacrolimus Cyclosporine (oral)

Topical Calcineurin Inhibitors MOA

Inhibit calcineurin, which blocks T-cell activation and the subsequent release of inflammatory causing cytokines

Calcineurin Inhibitors uses

Atopic dermatitis Prevention of organ rejection in transplant Crohn disease Graft-versus-host disease Myasthenia gravis Rheumatoid arthtitis

Calcineurin Inhibitors SE

Hypertension Redness and burning sensations of the skin Infection, neoplasm Nephrotoxicity

What happens to Calcineurin Inhibitors when taken w/ food?

Absorption is decreased

Calcineurin Inhibitors black box warning

Tacrolimus - cancer and serious infections Cyclosporine - HTN and nephrotoxicity

Statins + Calcineurin Inhibitors

Leads to increase in concentrations of many drugs (statins)

Calcineurin Inhibitors require what when taken long term?

Drug level monitoring

Goal of allergen immunotherapy

With immunotherapy, the goal is to induce a tolerance for the allergen

Which type of allergies is immunotherapy most effective for?

Most beneficial for those who have IgE-mediated allergic rhinitis, asthma, or insect hypersensitivity

Immunotherapy does not work for these types of allergies?

Not helpful in atopic dermatitis, urticaria, or in food/antibiotic allergies

Immune 1 Flashcards

(75 cards)