Core Concepts in Pharmacology Ch 20

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inflammation: non-specific body defense occuring in response to injury or antigen
histamine: chemical released by mast cells in response to antigen

causes:
- dilation of blood vessels
- smooth muscle constriction
- tissue swelling
- itching
leukotrienes: causes effects similar to histamine

stored & released by mast cells
bradykinin: vasodilator that causes pain

effects similar to those of histamine
complement: series of proteins combined together in cascade fashion to neutralize or destroy and antigen
prostaglandins: causes:
- increased capillary permiability
- WBC attraction to inflammation site
- pain

stored & released by mast cells
mast cells: located in tissue spaces under epithelial membranes
(skin, bronchial tree, digestive tract, & along blood vessels)

detect foreign agents or injury & respond by releasing histamine
hyperemia: increase in blood supply to tissue causing redness, pain, and swelling
anaphylaxis: acute allergic response to antigen resulting in severe hypotension

may cause death if untreated
H1-receptors: cause:
- itching
- pain
- edema
- vasodilation
- bronchoconstriction

located in smooth muscle of vascular system
H2-receptors: causes secretion of large amounts of hydrochloric acid in stomach (where they're located)
antigens: foreign substances that elicit a specific immune response
lymphocyte: primary cell of immune system that interacts w/antigens
humoral immunity: body defense mechanism involving production & release of antibodies

initiated when antigen encounters a B cell (type of lymphocyte)
B cell: essential lymphocyte for humoral immune response

makes plasma cell 'clones' of itself
plasma cells: cell derived from B cells that produces antibodies
antibodies: AKA Ig

protein produced by body in response to antigen
immunoglobulins (Ig): AKA antibodies

proteins produced by the body in response to an antigen
memory B cells: remember previous antigen interaction
helper T cells: lymphocyte responsible for activating most other immune cells (includes B cells)

coordinates humoral & cell-mediated immune responses

target of human immunodeficiency virus
cytotoxic T Cells: lymphocyte that directly attacks & destroys antigens
cytokines: produced by WBCs (interleukins - leukotrienes - interferon - tumornecrosis factor) that guide immune response
memory T cells: T-lymphocyte that remembers previous exposure to antigen
allergic rhinitis: AKA hay fever

sneezing, itchy throat, watery eyes, & nasal congestion resulting from exposure to antigens
H1-receptor antagonists: AKA antihistamines

blocks effects of histamine in smooth muscle in bronchial tree
salicylism: poisoning due to aspirin & aspirin-like drugs

S/S: tinnitus - dizziness - headache - sweating
tinnitus: ringing in the ears
alternate-day therapy: drug taken every other day to minimize side effects
Cushing's syndrome: too much corticosteroids in blood
transplant rejection: immune system recognizes a transplanted tissue as foreign & attacks it
immunosuppressants: drugs given to dampen immune response
vaccines: biological products that prevent disease
vaccination: AKA immunization

receivinig a vaccine or toxoid to prevent disease
toxoid: substance chemically modified to remove harmful nature but is still able to elicit immune response from body
boosters: additional dose of vaccine given months/years after initial dose to increase effectiveness of vaccine
titer: measurement of amount of antibody produced by body after vaccine has been administered
diphenhydramine: AKA: Benadryl
CLASS: H1-receptor antagonist
ACTION: 1st gen. antihistamine - reduces inflammation - blocks H1 receptors w/i smooth muscle cells of resp tract & endothelial cells lining blood vessels in skin
A/E: signifcant drowsiness - CNS stimulation - dry mouth - tachycardia - mild hypotension
fexofenadine: AKA: Allegra
CLASS: H1-receptor antagonist
ACTION: 2nd gen. antihistamine - blocks effects of histamine at H1 receptor
A/E: drowsiness - upset stomach
fluticasone: AKA: Flonase
CLASS: intranasal glucocorticoid
ACTION: decreases local inflammation in nasal passage
A/E: nasal irritation & bleeding
beclomethasone: AKA: Beconase - Vancenase
CLASS: intranasal glucocorticoid
ACTION: decreases local inflammation in nasal passage
A/E: nasal irritation & bleeding
oxymetazoline: AKA: Afrin - NeoSynephrine
CLASS: sympathomimetic
ACTION: stimulates alpha-adrenergic receptor of sympathetic nervous system - causes small arterioles in nasal passages to constrict - produces drying of mucous membranes
A/E: rebound congestion - minor stinging - nasal dryness
pseudoephedrine hydrochloride: AKA: Sudafed
CLASS: sympathomimetic
ACTION: stimulates alpha-adrenergic receptor of sympathetic nervous system - causes small arterioles in nasal passages to constrict - produces drying of mucous membranes
A/E: rebound congestion
naproxen: AKA: Naprosyn - Aleve
CLASS: nonsteroidal anti-inflammatory drug (NSAID)
ACTION: inhibits prostaglandin synthesis through non-selective inhibition of COX-1 and COX-2 enzymes
A/E: GI upset - dizziness - drowsiness - prolonged bleeding time
prednisone: AKA: Meticorten - Prelone
CLASS: glucocorticoid
ACTION: suppresshistamine & prostaglandins - inhibit immunity by suppressing functions of phagocytes & lymphocytes - combined effects reduce inflammation
A/E: Chusing's syndrome - elevated glucose - gastriculcers - weakness - bruising
cyclosporine: AKA: Neoral - Sandimmune
CLASS: immunosuppressant
ACTION: inhibits helper T cells
A/E: reduction of urine flow - tremor - htn - ^ hepatic enzyme values
Long-term therapy with glucocorticoids may result in Chushing's syndrome. TRUE or FALSE: TRUE
The two major types of T-cells are called 1_____ T-cells and 2_____ T-cells.: 1 cytotoxic (CD-8)
2 helper (CD-4)
Drug classes used to prevent allergic rhinitis include 1_____, 2_____, and 3_____.: 1 antihistamines
2 glucocorticoids
3 sympathomimetics
The use of hydrocortisone would be contraindicated in a client experiencing which of the following? a. an active infection associated with inflammation b. pain associated with inflammation c. nasal congestion d. hypertension: a. an active infection assoicated with inflammation
Histamine is a very potent: a. vasodilator b. vasoconstrictor c. sympathomimetic d. cardiotonic agent: a. vasodilator
H2-receptors are found in the: a. bronchial tree b. stomach c. reproductive tract d. smooth muscle of the vascular system: b. stomach
Memory B-cells remember the initial antigen interaction and secrete high levels of antibodies in approximately: a. 2-3 hours b. 2-3 days c. 2-3 weeks d. 2-3 months: b 2-3 days
Glucocorticoids have joined antihistamines as first-line drugs in the treatment of allergic rhinitis. For theis disorder, glucocorticoids are administered via which route? a. oral b. topical c. IM d. intranasal: d. intranasal
Rebound congestion is most common with which class of medications? a. antihistamines b. intranasal sympathomimetics c. intranasal glucocorticoids d. NSAIDS: b. intranasal sympathomimetics
Oxymetazoline stimulates _____ receptors in the autonomic nervous system. a. alph-adrenergic b. beta1-adrenergic c. beta2-adrenergic d. cholinergic: a. alpha-adrenergic
Aspirin causes irreversible inhibition of: a. prostaglandin synthase b. mast cells c. HMG CoA reductase d. cyclooxygenase: d. cyclooxygenase
Which class of drugs has the potential to suppress the normal functions of the adrenal gland, if given for prolonged periods? a. NSAIDS b. H2-receptor antagonists c. immunosuppressants d. glucocorticoids: d. glucocorticoids
Which of the following drug classes is most effective at relieving severe inflammation? a. NSAIDS b. systemic glucocorticoids c. H2-receptor antagonists d. COX-2 inhibitors: b. systemic glucocorticoids
The primary adverse effects from cyclosporine occur in the : a. immune system b. lung c. GI tract d. kidney: d. kidney
Which of the following is NOT a type of vaccine suspension? a. live microbes b. killed microbes c. microbes that are alive but attentuated d. bacterial toxins: a. live microbes

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