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Core Concepts in Pharmacology
Third Edition
CHAPTER
24
Drugs for Inflammation and
Immune Modulation
Core Concepts in Pharmacology, Third Edition
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Directory
Classroom Response System
Lecture Note Presentation
Core Concepts in Pharmacology, Third Edition
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Question 1
A patient is getting ready to go home from
the hospital and the health care provider and
patient are discussing the types of over-thecounter NSAID medications that are
available. The health care provider states
that an OTC medication that is not classified
as an NSAID is:
Core Concepts in Pharmacology, Third Edition
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Question 1 Choices
1.
2.
3.
4.
Aspirin
Ibuprofen
Acetaminophen
Motrin
Core Concepts in Pharmacology, Third Edition
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Question 1 Answer
1.
2.
3.
4.
Aspirin
Ibuprofen
Acetaminophen
Motrin
Core Concepts in Pharmacology, Third Edition
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Question 2
The patient has been taking aspirin for
several days for headache. While assessing
the patient, the health care provider
discovers that the patient is experiencing
ringing in the ears and dizziness. The most
appropriate action by the nurse is:
Core Concepts in Pharmacology, Third Edition
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Question 2 Choices
1. To question the patient about history of
sinus infection
2. To determine if the patient has mixed the
aspirin with other medications
3. To tell the patient not to take any more
aspirin
4. To tell the patient to take the aspirin with
food or milk
Core Concepts in Pharmacology, Third Edition
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Question 2 Answer
1. To question the patient about history of
sinus infection
2. To determine if the patient has mixed the
aspirin with other medications
3. To tell the patient not to take any more
aspirin
4. To tell the patient to take the aspirin with
food or milk
Core Concepts in Pharmacology, Third Edition
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Question 3
The most common adverse effect of NSAIDs
is:
Core Concepts in Pharmacology, Third Edition
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Question 3 Choices
1.
2.
3.
4.
Edema
Rash
GI upset
Bleeding
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Question 3 Answer
1.
2.
3.
4.
Edema
Rash
GI upset
Bleeding
Core Concepts in Pharmacology, Third Edition
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Question 4
The patient taking glucocorticoids is at risk
for:
Core Concepts in Pharmacology, Third Edition
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Question 4 Choices
1.
2.
3.
4.
Bleeding
Respiratory distress
Dehydration
Infection
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Question 4 Answer
1.
2.
3.
4.
Bleeding
Respiratory distress
Dehydration
Infection
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Learning Outcomes
1. Identify common signs and symptoms of
inflammation.
2. Outline the basic steps in the acute
inflammatory response.
3. Describe the central role of histamine in
inflammation.
4. Outline general strategies for treating
inflammation.
Core Concepts in Pharmacology, Third Edition
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Learning Outcomes
5. Compare and contrast the humoral and
cell-mediated immune responses.
6. For each of the drug classes in the Drug
Snapshot, identify representative drugs,
explain the mechanisms of drug action,
primary actions related to inflammation
and/or the immune system, and
important adverse effects.
Core Concepts in Pharmacology, Third Edition
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Learning Outcomes
7. Categorize drugs used in the treatment
of inflammation, allergies, and immune
disorders based on their classifications
and mechanisms of action.
8. For each of the major vaccines, give the
recommended dosage schedule
Core Concepts in Pharmacology, Third Edition
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Core Concept 24.1
Inflammation is a body defense that limits
the spread of invading microorganisms
and injury.
Core Concepts in Pharmacology, Third Edition
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Inflammation
• Occurs in response to many different
stimuli
– physical injury, exposure to toxic chemicals,
extreme heat, invading microorganisms, or
death of cells.
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Inflammation
• Purpose of inflammation - contain the
injury or destroy the microorganism
– Removing cellular debris and dead cells,
repair of the injured area can move at a faster
pace
• Proceeds in the same manner regardless
of cause
• Signs of inflammation - swelling, pain,
warmth, and redness of the affected area.
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Core Concept 24.2
The body reacts to injury by releasing
chemical mediators that cause
inflammation.
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Chemical Mediators
• Released by damaged tissue releases
• Act as “alarms” to notify the surrounding
area of the injury
• Include
– Histamine, leukotrienes, bradykinin,
complement, and prostaglandins.
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Figure 24.1 Steps in acute inflammation Source: Pearson Education/PH College
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Table 24.2 (continued) Selected Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
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Core Concept 24.3
Inflammation may be treated with
nonpharmacologic and pharmacologic
therapies.
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Treatment of Inflammation
• Cause of the inflammation is identified and
treated.
• mild symptoms, nonpharmacologic
therapies such as ice packs and rest
should be used whenever applicable.
• Topical drugs
– fewer adverse effects
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Treatment of Inflammation
• Used for - skin and mucous membranes of
the mouth, nose, rectum and vagina
• Two primary drug classes
– Nonsteroidal anti-inflammatory drugs
(NSAIDs)
– Glucocorticoids (also called corticosteroids)
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Common Diseases
•
•
•
•
•
•
Allergic rhinitis
Anaphylaxis
Ankylosing spondylitis
Contact dermatitis
Crohn’s disease
Glomerulonephritis
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Common Diseases
•
•
•
•
•
Hashimoto’s thyroiditis
Peptic ulcer disease
Rheumatoid arthritis
Systemic lupus erythematosus
Ulcerative colitis.
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Core Concept 24.4
NSAIDs are the primary drugs for the
treatment of mild inflammation.
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Core Concept 24.5
Glucocorticoids are effective in treating
severe inflammation.
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Core Concept 24.6
The immune response is obtained through
activation of the humoral and cell-mediated
immune systems.
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Figure 24.2 Steps in the humoral and cell-mediated immune responses Source: Pearson Education/PH College
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Core Concept 24.7
Vaccines are biological agents used to
prevent illness.
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Vaccination Immunization
• Process of introducing a foreign substance
into the body to trigger immune activation
before the patient is exposed to the real
pathogen
• Goal is to induce long-lasting immunity to
a pathogen without producing an illness in
an otherwise healthy person
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Vaccination Immunization
• Four methods of producing safe and
effective vaccines include the following:
• Attenuated (live) vaccines
• Inactivated (killed) vaccines
• Toxoids
• Recombinant vaccines
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Figure 24.3 Mechanisms of active and passive immunity
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Core Concept 24.8
Biologic response modifiers are used to
boost the immune response.
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Biologic Response Modifiers
• Interferons (IFNs)
– Cytokines secreted by lymphocytes and
macrophages
– Slow the spread of viral infections
– Enhance the activity of existing leukocytes.
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Biologic Response Modifiers
• Interleukins
– Levamisole (Ergamisole) stimulate B cells, T
cells, and macrophages in patients with colon
cancer
– Bacille Calmette-Guéin (BCG) vaccine (TICE,
TheraCys) is an attenuated strain of
Mycobacterium tuberculosis, used for the
pharmacotherapy of certain types of bladder
cancer.
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Core Concept 24.9
Immunosuppressants are primarily used to
avoid tissue rejection following organ
transplant.
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Concept Review 24.3
• Why are oral glucocorticoids usually used
concurrently with the immunosuppressant
drugs following a transplant operation?
Core Concepts in Pharmacology, Third Edition
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