Pathophysiology Exam 2

Drug

Artificial substance that alters body's biological activity

Field of pharmacology that researches drug action

pharmacodynamics

Field of pharmacology that researches drug induced responses in the body

pharmacodynamics

Field of pharmacology that researches what the body does with the drug

pharmacokinetics

Field of pharmacology that researches body site concentration of drugs

pharmacokinetics

Field of pharmacology that researches the most appropriate use of drugs for treatment of disease

pharmacotherapeutics

Field of pharmacology that researches the harmful effects of drugs

Toxicology

Alpha-glucosidase inhibitors MOA

Slows intestinal carbohydrate digestion/absorption:

Inhibits intestinal alpha glucosidase (brush border enzyme)

Inhibits pancreatic alpha amylase (breaks down carbs)

Miglitol is an example of a:

Alpha-glucosidase inhibitor

Metformin is an example of a:

Biguanide

Biguanide MOA

Inhibits hepatic gluconeogenesis

Increases insulin sensitivity of cells

What does the liver do if someone does not eat carbs for an extended period of time?

Liver releases glucose if carb consumption stops for an extended period of time

Liver takes amino acids and uses them to create glucose

The process by which the liver creates glucose

Hepatic gluconeogenesis

Beta cells in the pancreas produce:

Insulin

Alpha cells in the pancreas produce:

glucagon

Januvia is an example of a:

Dipeptidyl peptidase-4 (DPP-4) inhibitor

Dipeptidyl peptidase-4 (DPP-4) inhibitor MOA

Increases production of insulin

Halts the process that keeps glucagon levels high

What does DPP-4 do?

Breaks down incretin

What does incretin do?

stimulates insulin release from beta cells

Inhibits glucagon release

Glucagon is produced by the pancreas to stimulate liver to:

Convert glycogen into glucose

Function of glucagon

Increase blood glucose

High glucagon =

Low insulin

High insulin =

Low glucagon

Ozempic is an example of a:

Glucagon-like Peptide-1

Glucagon-like Peptide-1 MOA

Mimics incretin and promotes insulin secretion

Invokana is an example of a:

Sodium Glucose Transporter 2 (SGLT2) inhibitor

Sodium Glucose Transporter 2 (SGLT2) inhibitor MOA

Inhibits renal tubule SGLT2

Thus promotes discharge of glucose via urine

Thiazide diuretic MOA

inhibit reabsorption of Na+ and Cl- from distal convoluted tubules in kidneys

Reduce blood volume

Calcium Channel Blockers MOA

Blockage of calcium-ion entry into smooth muscle in arterial walls

If the smooth muscle receptors are blocked from calcium, they cannot contract

Reduces intensity of vasocontraction, relaxing the arterial vessels

Thereby dropping blood pressure

ACE inhibitor MOA

Block conversion of angiotensin I to angiotensin II

ARB MOA

Blocks angiotensin receptor thereby inhibiting vasoconstriction and aldosterone secretion

Beta blocker MOA

Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. Beta blockers cause the heart to beat more slowly and with less force, which lowers blood pressure.

Beta blockers also help widen veins and arteries to improve blood flow.

Many drugs used today are toxic to which organ?

Liver

Leading cause of liver failure and transplantation in US

Drug induced liver injury

The following are signs of:

Increase in vascular permeability
Tachycardia
Bronchoconstriction/Bronchospasm
Vasodilation

Anaphylaxis

Idiosyncratic drug effect

Adverse effects that cannot be explained

Paradoxic reaction

Drug synergism

Combined effect of 2 drugs is greater than the effect of either given alone

Drug Antagonism

One drug opposes the action of the other drug greatly reducing or canceling its effect

Drug potentiation

one drug increasing the effect of another

Immunosuppressive drug used to prevent kidney transplant rejection

Azathioprine

Rituxan use

Monoclonal antibody Highly specific and will bind only to one site

Synthetic antibody that facilitates the destruction of B-cells (CD20+)

Useful in treating diseases in which the pathology involves excessive numbers of B cells and/or dysfunctional B cells

Made by taking one B cell and allowing it (artificially) to make tons of a specific protein that allows the immune system to attach to a pathogen

Possible to link up a cytotoxic agent to the antibody Thereby increasing the efficacy of the antibody

Considered an immunotherapy Immunotherapy is an adjunct therapy for treatment of cancer

Protects against injurious events

Immune system

Coordinated activities of the cells and molecules responsible for immunity

Immune response

Protects the hair follicle from bacterial colonization

Sebum

Complement proteins

Complement proteins are proteins that lyse the cell wall of an antigen. They are part of the nonspecific defense mechanisms of the immune system.

25-30 in the body

Link up with antibody tagged agent and permit the breakdown of the agent

List of phagocytic cells

neutrophils, monocytes [macrophages, dendritic cells], eosinophils, mast cells

Neutrophil function

Engulf bacteria

Elevated levels are indicative of infection

Innate because they will attack any bacteria it encounters

Eosinophil function

kill parasitic worms; complex role in allergy and asthma

Macrophage function

phagocytosis and antigen presentation

list the antigen presenting cells

dendritic cells, macrophages, B cells

List of monocytes

Macrophages and dendritic cells

List of lymphocytes

B cells, T cells, NK cells

List the innate immune cells

Neutrophils

Eosinophils

Macrophages

Dendritic cells

Mast cells

Natural killer cells

List the adaptive immune cells

B cells and T cells

List of T cells

Cytotoxic, Helper, Suppressor, Memory

Dendritic cell function

antigen uptake in peripheral sites, antigen presentation

Mast cell function

Release of granules containing heparin and histamine

Plays role in inflammation

Natural killer cell function

Non-selectively attacks non-self cells, especially body cells that have undergone mutation and become malignant, also attacks grafts and transplanted organs.

B cell function

produce antibodies

Where are B cells produced?

lymph nodes

Where are T cells produced?

thymus

Antibodies

Highly specific Y-shaped protein that will only attach to a specific antigen

Helper T cell function

Coordinate the immune system by secreting cytokines and activating B-cells

Cytotoxic T cell function

aka killer t cells -- recognize and destroy non-self cells by releasing perforin protein to lyse them

T suppressor cell function

Blocks the actions of some other types of lymphocytes, to keep the immune system from becoming over-active.

Memory T cell function

Antigen-experienced cells that mediate a faster and more potent response upon repeat encounter with antigen. These cells are long-lived and when developed following an infection can protect against subsequent infections with the same pathogen.

Number of lymph nodes in the body

500-600

List the lymphatic organs

Thymus, Spleen, Tonsils, Peyer's Patches, Lymph Nodes

Healthy User Bias

When the study population tends to be in better shape than the general population

Prostaglandins

A group of bioactive, hormone-like chemicals derived from fatty acids that have a wide variety of biological effects including roles in inflammation, platelet aggregation, vascular smooth muscle dilation and constriction, cell growth, protection of from acid in the stomach, and many more.

Primary source of antihistamines

Mast cells

Bradykinins

Chemicals produced by the body and responsible for inflammation and pain

Cytokines

Hormone-like chemicals facilitating communication between brain and immune system.

Bradykinins stimulate endothelial cells to release

Nitric oxide

Nitric oxide causes

Vasodilation, which improves blood flow and enhances oxygen delivery

How do ACE inhibitors and bradykinins interact?

ACE inhibitors inhibit the breakdown of bradykinin

Remains longer due to the ACE

Bradykinin releases nitric oxide

Nitric oxide causes vasodilation

Tissue residents of the immune system

Macrophages

Dendritic cells

Mast cells

5 classes of antibodies

IgG, IgM, IgA, IgD, IgE

Major Histocompatibility Complex (MHC)

Group of genes that code for proteins found on the surfaces of cells that help the immune system recognize foreign substances.

Distinguishes between self and nonself

MHC class I proteins

Found on all nucleated cells of the body

Recognized by cytotoxic T cells

MHC class II proteins

Found only on antigen presenting cells (macrophages, B cells, and dendritic cells)

MCH I presents:

Intracellular peptide fragments

MHC II presents:

Extracellular peptide fragments