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What is the primary action of antihistamines in treating allergic reactions?
What is the primary action of antihistamines in treating allergic reactions?
Which of the following drugs is classified as a sedative (1st generation) antihistamine?
Which of the following drugs is classified as a sedative (1st generation) antihistamine?
What type of hypersensitivity reactions are antihistamines primarily used to treat?
What type of hypersensitivity reactions are antihistamines primarily used to treat?
Which drugs are mainly used for treating bronchoconstriction in asthma?
Which drugs are mainly used for treating bronchoconstriction in asthma?
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What role do steroids play in asthma treatment?
What role do steroids play in asthma treatment?
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Which of the following is NOT a group of drugs used to treat airways inflammation in asthma?
Which of the following is NOT a group of drugs used to treat airways inflammation in asthma?
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What is the primary method of administration for most corticosteroids used in asthma treatment?
What is the primary method of administration for most corticosteroids used in asthma treatment?
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Which of the following effects do leukotriene receptor antagonists target in asthma management?
Which of the following effects do leukotriene receptor antagonists target in asthma management?
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What role does sodium cromoglicate play in asthma treatment?
What role does sodium cromoglicate play in asthma treatment?
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Which class of drugs primarily suppresses functions of inflammatory cells in asthma?
Which class of drugs primarily suppresses functions of inflammatory cells in asthma?
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What mechanism do leukotrienes contribute to in asthma pathophysiology?
What mechanism do leukotrienes contribute to in asthma pathophysiology?
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What describes the primary action of corticosteroids used in asthma treatment?
What describes the primary action of corticosteroids used in asthma treatment?
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Corticosteroids are structurally related to which natural hormone?
Corticosteroids are structurally related to which natural hormone?
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Which of the following is an example of a leukotriene receptor antagonist?
Which of the following is an example of a leukotriene receptor antagonist?
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Which side effect is specifically associated with long-term use of corticosteroids?
Which side effect is specifically associated with long-term use of corticosteroids?
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What is the primary anti-inflammatory action of NSAIDs attributed to?
What is the primary anti-inflammatory action of NSAIDs attributed to?
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Which of the following is NOT a glucocorticoid effect?
Which of the following is NOT a glucocorticoid effect?
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Which of the following NSAIDs is categorized as a selective COX-2 inhibitor?
Which of the following NSAIDs is categorized as a selective COX-2 inhibitor?
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Long-term corticosteroid use can lead to which of the following conditions?
Long-term corticosteroid use can lead to which of the following conditions?
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What negative effect can corticosteroids cause in children?
What negative effect can corticosteroids cause in children?
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Inhibition of which enzyme is responsible for the production of prostaglandins from arachidonic acid?
Inhibition of which enzyme is responsible for the production of prostaglandins from arachidonic acid?
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Which side effect is associated with mineralocorticoid effects of corticosteroids?
Which side effect is associated with mineralocorticoid effects of corticosteroids?
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Which condition is primarily a side effect of prolonged corticosteroid usage?
Which condition is primarily a side effect of prolonged corticosteroid usage?
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What effect does ibuprofen have on the body?
What effect does ibuprofen have on the body?
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What role do prostaglandins from COX-1 play in the body?
What role do prostaglandins from COX-1 play in the body?
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Which of the following is a significant side effect of COX-2 inhibitors?
Which of the following is a significant side effect of COX-2 inhibitors?
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Which cytokine plays a central role in many autoimmune diseases such as rheumatoid arthritis?
Which cytokine plays a central role in many autoimmune diseases such as rheumatoid arthritis?
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What is one of the important side effects associated with TNF antagonists like Infliximab?
What is one of the important side effects associated with TNF antagonists like Infliximab?
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Which class of drugs was initially introduced for cancer treatment but also showed immunosuppressive activities?
Which class of drugs was initially introduced for cancer treatment but also showed immunosuppressive activities?
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Which of the following conditions can cytotoxic immunosuppressive drugs be used to treat?
Which of the following conditions can cytotoxic immunosuppressive drugs be used to treat?
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Study Notes
Immunotherapy
- Manipulation of the immune response to treat disease
- Can involve enhancing immunity (e.g., vaccination) or suppressing immune responses (e.g., treatment of allergic or autoimmune diseases)
Antihistamines
- Block H1 histamine receptors
- Inhibit histamine-mediated vascular permeability and smooth muscle constriction
- Reduce sensory nerve stimulation (itching, sneezing, etc.)
- Histamine is produced mainly by mast cells
Antihistamines Clinical Uses:
- Type I (immediate/IgE-mediated) hypersensitivity reactions (e.g., hay fever, perennial rhinitis, acute type I allergic reactions)
- Urticaria/angioedema
- Anaphylactic reactions should be treated with i.m. adrenaline
Antihistamines Types:
- Sedative (1st generation): Chlorphenamine, diphenhydramine
- Non-sedative (2nd generation): Cetirizine, terfenadine, loratidine
- Can be given topically (e.g., nasal or eye drops) or systemically
Asthmatic Drugs
- Approximately 40 million community prescriptions per year
- Major pathogenic effect in asthma is bronchoconstriction
- Beta 2 adrenoreceptor agonists (e.g., salbutamol) and other bronchodilators are the mainstay of treatment
- In many cases, especially in children, there is an inflammatory or allergic component
Steroids
- Major class of anti-inflammatory and immunosuppressive drugs
- Commonly given by inhaler (beclometasone, budesonide, and fluticasone), topically, or systemically
Leukotriene Receptor Antagonists
- Leukotrienes are involved in inflammatory reactions
- Leukotriene receptor antagonists (Montelukast, Zafirlukast) block leukotriene effects
- Particularly helpful in exercise-induced asthma
Cromoglicate
- Stabilizes the mast cell membrane, preventing mast cell degranulation
- Mode of action is not completely understood
Asthma
- Bronchoconstriction treated with B2 agonists & others and steroids.
- Allergy or inflammation treated with leukotriene receptor antagonists and sodium cromoglicate.
Anti-inflammatory Drugs
- Block or suppress functions of non-specific inflammatory cells (monocytes, macrophages, granulocytes) or proinflammatory mediators
- May have immunosuppressive properties (inhibition of specific immune cells or their mediators)
Steroids
- Structurally related to the glucocorticoid steroid hormone, cortisol
Side Effects of Corticosteroid Drugs (Especially in Long-Term Use):
- Glucocorticoid effects: diabetes, Cushing's syndrome, adrenal suppression
- Mineralocorticoid effects: osteoporosis, hypertension
- Immunosuppressive effects: increased susceptibility to infections, impaired wound healing
- Others: emotional disturbance, enlarged sella turcica, obesity
Non-steroidal Anti-inflammatory Drugs (NSAIDs)
- Wide group of drugs with analgesic and anti-inflammatory properties
- Main anti-inflammatory properties due to inhibition of cyclooxygenase
NSAID Mechanism of Action
- Arachidonic acid is broken down into prostaglandins by COX-1 and COX-2
- Prostaglandins from COX-1 contribute to GI mucosal protection and hemostasis
- Prostaglandins from COX-2 act as mediators of pain, inflammation, and fever
NSAIDs ADRs:
- Major side effect of (older) NSAIDs is gastrointestinal toxicity
- Newer, selective COX-2 inhibitors do not have this side effect
- COX-2 inhibitors have been found to have cardiovascular side effects
TNF (Tumor Necrosis Factor)
- Induces necrosis of tumor cells
- Has a wide range of proinflammatory actions
- Plays a central role in the pathogenesis of autoimmune diseases (rheumatoid arthritis, Crohn's disease)
TNF Functions
- Increases inflammation, cell infiltration, angiogenesis, CRP in serum, and articular cartilage degradation
TNF Antagonists:
- Infliximab: humanized monoclonal antibody against TNF
- Etanercept: TNF receptor fusion protein
- Treat severe rheumatoid arthritis and Crohn's disease
- Side effect: reactivation of latent tuberculosis
Immunosuppressive Agents:
- Corticosteroids
- Cytotoxic and anti-proliferative agents: introduced for cancer treatment
- Used to treat autoimmune diseases and inhibit organ transplant rejection
Immunological Diseases Treated with Cytotoxic Drugs:
- Organ transplant rejection
- Rheumatoid arthritis
- Systemic lupus erythematosus
- Membranous and membranoproliferative glomerulonephritis
- Inflammatory bowel disease
Immunoglobulin (Ig)
- Intravenous immunoglobulin (IVIg) has immunomodulatory properties
Immunomodulatory Properties of Intravenous Immunoglobulin:
- Mechanism of action not fully understood
- Uses: replacement Ig therapy for antibody deficiencies, treatment of Kawasaki disease, idiopathic thrombocytopenia, Guillain-Barré syndrome
Monoclonal Antibodies:
- Rituximab: targets B-cell antigen
- Infliximab: targets TNF-α
- Omalizumab: targets IgE
Mechanisms of action of Therapeutic Monoclonal Antibodies:
- Neutralizing the target antigen
- Inducing complement-mediated or antibody dependent (NK-mediated) cytotoxicity
- Blocking cellular interactions
- Inducing apoptosis in target cells
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Description
This quiz focuses on the manipulation of the immune response through immunotherapy and the role of antihistamines in treating allergic reactions. It covers the different types of antihistamines, their clinical uses, and how they function in blocking histamine effects. Test your understanding of these crucial pharmacological concepts.
