24 - Pharmacology - Drugs For Inflammation & Immune Modulation

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Inflammation

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Nonspecific body defense that occurs in response to an injury or antigen

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Nonspecific body defense that occurs in response to an injury or antigen

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Inflammation

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Signs of Inflammation

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swelling, pain, redness, warmth

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Chemical mediators of inflammation

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histamine, leukotrienes, bradykinin, complement, prostaglandins

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Histamine

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A key chemical mediator of inflammation; chemical released by mast cells in response to an antigen; causes dilation of blood vessels, smooth muscle contractions, tissue swelling and itching. Histamine directly stimulates pain receptors.

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A key chemical mediator of inflammation; chemical released by mast cells in response to an antigen; causes dilation of blood vessels, smooth muscle

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Histamine

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mast cells

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connective tissue cell located in tissue spaces that releases histamine during injury

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anaphalaxis

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an acute allergic response to an antigen that results in severe hypotension and may cause death if untreated.

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connective tissue cell located in tissue spaces that releases histamine during injury

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mast cells

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an acute allergic response to an antigen that results in severe hypotension and may cause death if untreated.

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anaphalaxis

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Bradykinin

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A chemical mediator of inflammation. Present in an inactive form in plasma and mast cells; vasodilator that causes pain; effects are similar to those of histamine.

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A chemical mediator of inflammation. Present in an inactive form in plasma and mast cells; vasodilator that causes pain; effects are similar to those of histamine.

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Bradykinin

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Complement

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A chemical mediator of inflammation. Series of at least 20 proteins that combine in a cascade fashion to neutralize or destroy an antigen.

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Leukotrienes

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A chemical mediator of inflammation. Stored and released by mast cells; effects are similar to histamines.

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Prostaglandins

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A chemical mediator of inflammation. Present in most tissues; stored and released by mast cells; increase capillary permeability, attract white blood cells to site of inflammation, and cause pain

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A chemical mediator of inflammation. Series of at least 20 proteins that combine in a cascade fashion to neutralize or destroy an antigen.

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Complement

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A chemical mediator of inflammation. Stored and released by mast cells; effects are similar to histamines.

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Leukotrienes

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A chemical mediator of inflammation. Present in most tissues; stored and released by mast cells; increase capillary permeability, attract white blood cells to site of inflammation, and cause pain

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Prostaglandins

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Steps in acute inflammation

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Vasodilation (redness, heat)
Vascular permeability (edema)
Cellular infiltration (pus)
Thrombosis (clotting)
Stimulation of nerve endings (pain)

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cyclooxygenase (COX)

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Key enzyme in the prostaglandin metabolic pathway that is blocked by aspirin and other NSAIDS

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Key enzyme in the prostaglandin metabolic pathway that is blocked by aspirin and other NSAIDS

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cyclooxygenase (COX)

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Salicylism

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poisoning due to aspirin and aspirin like drugs. Causes symptoms such as ringing in the ears, dizziness, headache, and sweating.

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Adverse effects of Glucocorticois

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Suppression of the normal functions of the adrenal gland (adrenal insufficiency), elevated blood glucose, mood changes, cataracts, peptic ulcers, electrolyte imbalances, and osteoporosis. Can also mask infection and suppress immune system.

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Alternate day therapy

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taking a drug every other day in order to minimize adverse effects.

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Cushing's syndrome

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condition caused by excessive corticosteroid secretion by the adrenal glands or by over dosage of corticosteroid medication.

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condition caused by excessive corticosteroid secretion by the adrenal glands or by over dosage of corticosteroid medication.

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Cushing's syndrome

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taking a drug every other day in order to minimize adverse effects.

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Alternate day therapy

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poisoning due to aspirin and aspirin like drugs. Causes symptoms such as ringing in the ears, dizziness, headache, and sweating.

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Salicylism

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Antigens

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Foreign substances that cause a specific immune response. Proteins such as those present on the surfaces of pollen grains, bacteria and viruses are the strongest.

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Lymphocyte

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The primary cell of the immune system that interacts with antigens

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Humoral immunity

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a specific body defense mechanism involving the production and release of antibodies

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a specific body defense mechanism involving the production and release of antibodies

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Humoral immunity

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Foreign substances that cause a specific immune response.

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Antigens

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The primary cell of the immune system that interacts with antigens

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Lymphocyte

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B cell

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type of lymphocyte that is essential for the humoral immune response

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type of lymphocyte that is essential for the humoral immune response

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B cell

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Immune Response Humeral Immunity

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Humoral immunity is initiated when antigen encounters a type of lymphocyte known as a B cell. The antigen activates the B cell which then divides rapidly to form many copies or clones of itself. Most cells in this clone are called plasma cells. The primary function of the plasma cell is to secrete antibodies also called immunoglobins.

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Plasma cells

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type of cell derived from b cells that produces antibodies

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antibody

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Protein produced by the body in response to an antigen; immunoglobin

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immunoglobins (Ig)

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protein produced by the body in response to an antigen; antibody

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t cells

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type of lymphocyte that is essential for the cell mediated immune response.

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type of cell derived from b cells that produces antibodies

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Plasma cells

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Protein produced by the body in response to an antigen; used interchangeably with the term immunoglobin

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antibody

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type of lymphocyte that is essential for the cell mediated immune response.

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t cells

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helper t cells

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have a CD4 receptor. Responsible for activating the most other immune cells, including B cells.

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cytotoxic t cells

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have a CD8 receptor; travel throughout the body directly killing certain bacteria, parasites, virus infected cells and cancer cells.

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Cytokines

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Hormone like proteins produced by T cells . Some kill foreign organisms directly and others act as messengers to the immune system, stimulating T cells, B cells and other white blood cells to rid the body of foreign agents.

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Type of Cytokines released by activated T cells.

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Interleukins
gamma interferon
tumor necrosis factor (TNF)

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Biologic Response Modifiers

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natural substances that are able to enhance or stimulate the immune system.

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have a CD4 receptor. Responsible for activating the most other immune cells, including B cells.

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helper t cells

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have a CD8 receptor; travel throughout the body directly killing certain bacteria, parasites, virus infected cells and cancer cells.

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cytotoxic t cells

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organisms directly and others act as messengers to the immune system, stimulating T cells, B cells and other white blood cells to rid the body of foreign agents.

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Cytokines

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natural substances that are able to enhance or stimulate the immune system.

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Biologic Response Modifiers

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Vaccination (Immunization)

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the process of introducing a foreign substance into the body to trigger immune activation before the patient is exposed to the real pathogen.

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the process of introducing a foreign substance into the body to trigger immune activation before the patient is exposed to the real pathogen.

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Vaccination (Immunization)

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vaccine

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preparation of microorganism particles that is injected into a patient to stimulate the immune system with the intention of preventing disease

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boosters

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an additional dose of a vaccine given months or years after the initial dose to increase the effectiveness of the vaccine.

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titer

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measurement of the amount of a substance in the blood

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preparation of microorganism particles that is injected into a patient to stimulate the immune system with the intention of preventing disease

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vaccine

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measurement of the amount of a substance in the blood

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titer

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an additional dose of a vaccine given months or years after the initial dose to increase the effectiveness of the vaccine.

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boosters

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Toxoids

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Types of vaccines that contain bacterial toxins that have been chemically modified to be incapable of causing disease.

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Types of vaccines that contain bacterial toxins that have been chemically modified to be incapable of causing disease.

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Toxoids

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Active Immunity

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The type of immune response induced by the real pathogen or its vaccine. The body produces its own antibodies in response to exposure.

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Passive Immunity

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Occurs when preformed antibodies are transferred or donated from one person to another. Examples of agents are Gamma globulin for hep, snake antivenoms, sera used to treat botulism, tetanus, rabies.

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transplant rejection

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when the immune system recognizes a transplanted tissue as being foreign and attacks it

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immunosupressant

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any drug, chemical or physical agent that lowers the natural defense mechanism of the body

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when the immune system recognizes a transplanted tissue as being foreign and attacks it

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transplant rejection

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any drug, chemical or physical agent that lowers the natural defense mechanism of the body

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immunosupressant

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Patient Teaching Regarding Anti Inflammatory Medications

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Take NSAIDS with food to decrease stomach irritation. Avoid drinking alcohol when taking high doses of NSAIDS because it increases stomach irritation. If ringing in the ears, bruising, bleeding, dizziness, headache occurs, discontinue use of aspirin and contact health care provider. Take glucocorticoids exactly as prescribed because improper use may lead to serious adverse effects.

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Patient Teaching Regarding Vaccines

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Maintain records. Keep immunizations current. Check for allergy to additives in vaccines. Never take cyclsporine with grapefruit juice.

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Patient Teaching Regarding Immunosuppressants

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Reduce risk of illness by avoiding crowds, avoiding those that are ill, and washing hands frequently. Keep scheduled doc and lab appointments - CBC, electrolytes, hormone & urine studies. Immediately report an elevation in temperature, unusual bleeding, sore throat, mouth ulcers, and fatigue to health care provider.