Week 8: Immune+ Pharmacology Review

Vocabulary flashcards covering key terms, drugs, mechanisms, and side effects from Week 8 Immunology, Antihistamine, and NSAID/Acetaminophen pharmacology.

Immunosuppressant

Any drug that dampens the immune response, commonly used to prevent organ transplant rejection.

Calcineurin inhibitor

Drug class that blocks calcineurin, reducing interleukin-2 production; includes cyclosporine and tacrolimus.

Cyclosporine

Fungal-derived calcineurin inhibitor used for transplant rejection prophylaxis; high risk for nephrotoxicity, hypertension, and infection.

Tacrolimus

Soil-bacteria–derived calcineurin inhibitor, slightly more potent and more toxic than cyclosporine; monitor serum creatinine closely.

Nephrotoxicity

Kidney damage manifested by rising BUN/creatinine; major dose-limiting adverse effect of calcineurin inhibitors.

Anaphylactic shock

Acute, severe allergic reaction causing vasodilation, bronchoconstriction, hypotension, and tachycardia; treat with epinephrine and fluids.

Glucocorticoids (corticosteroids)

Steroid hormones (-sone/-solone) that also provide immunosuppression; share side-effects such as hyperglycemia and infection risk.

Biologics (Monoclonal antibodies)

Immune modulators ending in –mab; block specific cytokines, are refrigerated, and carry infection risk.

Methotrexate

DMARD that inhibits folic-acid enzymes, slowing DNA synthesis; given with folic acid to protect healthy cells.

DMARD

Disease-Modifying Anti-Rheumatic Drug that slows progression of autoimmune diseases rather than just treating symptoms.

Interleukin-2 (IL-2)

Cytokine that stimulates T-cell proliferation; production blocked by calcineurin inhibitors.

H1 receptor

Histamine receptor that mediates vasodilation, capillary permeability, bronchoconstriction, itch, and pain.

H2 receptor

Histamine receptor on gastric parietal cells that increases stomach acid secretion.

First-generation H1 antagonists

Sedating antihistamines (e.g., diphenhydramine, hydroxyzine, promethazine) that readily cross the blood-brain barrier.

Second-generation H1 antagonists

Non-sedating antihistamines (e.g., loratadine, fexofenadine, cetirizine) that poorly cross the BBB.

Anticholinergic side effects

Dry mouth, blurred vision, urinary retention, constipation, tachycardia—seen strongly with first-gen antihistamines.

Beers List

Compilation of drugs potentially inappropriate for older adults; includes first-gen antihistamines and nonselective NSAIDs.

Promethazine

First-generation antihistamine also used as anti-emetic; strong sedative and anticholinergic profile.

Diphenhydramine

Prototype first-generation antihistamine (Benadryl); causes marked drowsiness and cognitive impairment with long-term use.

Hydroxyzine

Potent first-generation antihistamine that can dry respiratory secretions; use cautiously in asthma.

Loratadine

Second-generation antihistamine (Claritin) with minimal sedation; safe for daytime use.

Fexofenadine

Second-generation antihistamine (Allegra); absorption reduced by fruit juice via OATP1A2 inhibition.

Cetirizine

Second-generation antihistamine (Zyrtec) that may cause mild drowsiness in some patients.

COX inhibitor

Drug that blocks cyclooxygenase enzymes, reducing prostaglandin and thromboxane synthesis.

NSAID

Non-steroidal anti-inflammatory drug that provides analgesic, antipyretic, and anti-inflammatory effects.

COX-1

Constitutive enzyme protecting gastric mucosa, supporting renal blood flow, and promoting platelet aggregation.

COX-2

Inducible enzyme at injury sites causing pain, fever, and inflammation; inhibition linked to thrombotic risk.

Nonselective NSAID

Drug (e.g., ibuprofen, naproxen) that inhibits both COX-1 and COX-2 enzymes.

Selective COX-2 inhibitor

Drug (celecoxib) that preferentially inhibits COX-2; lowers GI risk but raises cardiovascular risk.

Aspirin

Acetylsalicylic acid; irreversible COX inhibitor providing analgesia, fever reduction, anti-inflammation, and permanent platelet inhibition.

Ibuprofen

Propionic acid NSAID (Advil, Motrin) used for pain and inflammation; reversible platelet inhibition.

Naproxen

Longer-acting propionic acid NSAID (Aleve); similar profile to ibuprofen but dosed twice daily.

Celecoxib

Prescription-only selective COX-2 inhibitor (Celebrex); highest NSAID risk for thrombotic events.

Triple effect of NSAIDs

Suppression of inflammation, pain relief, and fever reduction; aspirin adds antiplatelet action.

Analgesic

Medication that relieves pain without causing loss of consciousness.

Antipyretic

Drug that lowers an elevated body temperature.

Anti-inflammatory

Action of reducing swelling, redness, and pain by limiting inflammatory mediator production.

Platelet inhibition

Reduction of platelet aggregation; irreversible with aspirin, reversible with other NSAIDs.

GI bleeding

Serious adverse effect of NSAIDs and aspirin due to COX-1 gastric mucosa inhibition.

Reye's syndrome

Rare but fatal pediatric encephalopathy and liver failure linked to aspirin use during viral illnesses.

Tinnitus

Ringing in the ears; early sign of aspirin (salicylate) toxicity.

Maximum acetaminophen dose

4,000 mg (4 g) in 24 hours for adults to avoid liver toxicity.

N-acetylcysteine (NAC)

Antidote for acetaminophen overdose; must be given within 8 hours to prevent liver injury.

Acetaminophen

Analgesic-antipyretic without significant anti-inflammatory or antiplatelet effects; hepatotoxic in overdose.

Fruit juice–fexofenadine interaction

Apple, orange, or grapefruit juice inhibits OATP1A2, cutting fexofenadine absorption by up to 70%.

Thrombotic events (NSAIDs)

Myocardial infarction or stroke risk heightened by NSAID use, especially in cardiovascular patients.

Hepatotoxicity

Liver damage; notable with high-dose acetaminophen or long-term NSAID use.

Salicylate poisoning

Severe aspirin overdose causing metabolic acidosis, hyperventilation, convulsions, and possible death.

Baby aspirin

81 mg low-dose aspirin used for cardioprotection with lower GI bleeding risk.

Grapefruit (CYP450 inhibitor)

Food that inhibits intestinal CYP3A4, raising calcineurin-inhibitor levels and toxicity risk.

Hypertension (calcineurin inhibitor SE)

Blood-pressure elevation resulting from renal vasoconstriction caused by cyclosporine/tacrolimus.

Hyperglycemia (immunosuppressant SE)

Elevated blood glucose often seen with tacrolimus and corticosteroid use.

OATP1A2 transporter

Intestinal uptake protein inhibited by certain fruit juices, reducing fexofenadine absorption.

Nephrotoxic interactions

Concurrent NSAIDs or aminoglycosides with calcineurin inhibitors exacerbate kidney toxicity.