DRUGS FOR CONTROLLING INFLAMMATION, ALLERGIES & ORGAN REJECTION

Inflammatory Response
 Designed to protect the body from injuries & pathogens.
 Employs a variety of potent chemical mediators to produce the reaction that
helps to destroy pathogens & promote healing.
 As the body reacts to these chemicals, it produces signs and symptoms of a
disease such as swelling, fever, pain, and aches.
 The inflammatory response becomes a chronic condition and can result to
damage to the body, leading to increased inflammatory reactions.
Anti-inflammatory Agents
 They generally block or alter the chemical reactions associated with the
inflammatory response to stop one or more of the signs and symptoms of
inflammation.
Corticosteroids
 Used systematically to block the inflammatory and immune systems. Blocking
these important protective processes may produce many adverse effects
including decreased resistance to infection and neoplasms.
 It provides relief from inflamed areas of the body, lessens swelling, redness,
itching, and allergic reactions.

Allergies
 Body’s reaction to a substance it views as a harmful invader.
Allergens
 Substances that cause these reactions.
Allergic Reaction

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  Occurs when cells in the immune system interpret a foreign substance – the way
the body responds to the allergen.
How does allergic reaction work?
 The first time an allergy-prone person is exposed to a specific allergen (such as
pollen), the body responds by producing allergic (IgE) antibodies.
 As the mast cells destroy the allergens, a chemical called histamine is released
into the bloodstream.
 A large amount of histamine swells body tissues (inflammation), causes itching,
enlarges blood vessels, increases secretions and causes bronchospasm.
Types of Allergens & Treatment
1. Pollen
 It causes inflammation and swelling of the lining of the nose and
conjunctiva.
 Symptoms: sneezing, congestion, itchy, watery eyes.
 Treatment: OTC and prescription antihistamines, anti-leukotrienes, nasal
steroids, and nasal cromolyn.
2. Dust Mites
 Tiny organisms that live in dust and in the fibers of household objects such
as pillows, mattresses, carpet, and upholstery.
 Symptoms: similar to pollen.
 Treatment: medications to control nasal/eye and chest symptoms.
3. Molds
 Parasitic, tiny fungi with spores that float in the air like pollen. Molds can
be found indoors in damp areas.
 Treatment: medications to control nasal/eye and chest symptoms.
4. Animal Dander
 Allergic reactions can be caused by the proteins secreted by sweat glands
in an animal’s skin or by the proteins in an animal’s saliva.
 Treatment: medications to control nasal/eye and chest symptoms.
5. Certain food
 Food allergies develop when the body develop a specific antibody to a
specific food. An allergic reaction occurs within minutes of eating the food,
and symptoms can be severe.
 Symptoms: itching, hives, nausea, vomiting, diarrhea, breathing
difficulties, and swelling around the mouth.
 Treatment: avoid the food that can cause allergies.
Facts on treating allergies:
 Most minor allergy symptoms can be treated with antihistamines,
corticosteroids or decongestants.

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  Saline nasal rinses can be used for congestion-related allergy symptoms.
 Corticosteroid creams can treat skin rashes related to allergies.
 Immunotherapy is a long-term treatment option for chronic allergy
symptoms.
 Anaphylaxis is a medical emergency, and people should call 911 if they
suspect someone is having an anaphylactic reaction.
Types of antihistamine
They're usually divided into two main groups:
- The older first-generation antihistamines (sedating antihistamines)
They cause much more drowsiness and fatigue than the newer antihistamines. (In fact,
these antihistamines sometimes are used as sleeping pills.) Side effects can include
dizziness, poor coordination, dry mouth, nausea and vomiting, blurred vision, and
trouble urinating. One antihistamine in this group is diphenhydramine (Benadryl®).
Others are brompheniramine (Bromfed®, Dimetapp®), hydroxyzine (Vistaril®, Atarax®)
and meclizine (Antivert®).
- The newer second and third-generation (non-sedating antihistamines)
Are used much more frequently.Usually, they don't cause drowsiness. Antihistamines in
this group include cetirizine (Zyrtec®), loratadine (Claritin®), and fexofenadine
(Allegra®). In high doses, these antihistamines can still cause drowsiness and rapid
heart rate.

How to take antihistamines

Before taking an antihistamine, you should know:
- how to take it – including whether it needs to be taken with water or food, or how
to use it correctly (if eye drops or a nasal spray)
- how much to take (the dose) – this can vary depending on things such as your
age and weight
- when to take it – including how many times a day you can take it and when to
take it (older types should be taken before bedtime)
- how long to take it for – some types can be used for a long time, but some are
only recommended for a few days
- what to do if you miss a dose or take too much (overdose)
Follow these guidelines when using antihaistamines:
- Do NOT "double-up" on a dose.
- Do NOT take a dose sooner than you're supposed to.
- Do NOT take two different antihistamines at the same time.

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 - Read labels carefully.
Some antihistamines should not be used for children.
Some antihistamines can interact with other medicines. Check with your doctor or
pharmacist if you have questions.
Different products may contain the same ingredients. Taking them at the same time can
be dangerous.
- Take (or give) the right dose.
- Lock antihistamines up high, where children can't reach them. 
Children can drink liquid antihistamines, swallow too many pills, or even eat
antihistamine creams. Severe poisoning can occur this way
- Instead, talk to your doctor or pharmacist if you have trouble finding a drug that
works well for your allergy symptoms.
Antihistamines are safe when used as directed. Otherwise, there can be problems:
- Taking too much can be harmful for children and adults.
- Some people abuse the sedating antihistamines. They can cause seizures and
hallucinations.
- Some antihistamines are combined with pain medicine. Taking another pain
medicine at the same time could cause an overdose.
- Some antihistamines are combined with decongestants. Taking another
decongestant at the same time could cause an overdose.
How antihistamines work

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 ORGAN REJECTION
  
Organ rejection /Transplant rejection is a process in which a transplant recipient's
immune system attacks the transplanted organ or tissue.

Causes

Your body's immune system usually protects you from substances that may be

harmful, such as germs, poisons, and sometimes, cancer cells. These harmful
substances have proteins called antigens coating their surfaces. As soon as these
antigens enter the body, the immune system recognizes that they are not from that
person's body and that they are "foreign," and attacks them. When a person receives an
organ from someone else during transplant surgery, that person's immune system may
recognize that it is foreign. This is because the person's immune system detects that the
antigens on the cells of the organ are different or not "matched." Mismatched organs,
or organs that are not matched closely enough, can trigger a blood transfusion
reaction or transplant rejection. To help prevent this reaction, doctors type, or match
both the organ donor and the person who is receiving the organ. The more similar the
antigens are between the donor and recipient, the less likely that the organ will be
rejected. Tissue typing ensures that the organ or tissue is as similar as possible to the
tissues of the recipient. The match is usually not perfect. No two people, except
identical twins, have identical tissue antigens. Doctors use medicines to suppress the
recipient's immune system. The goal is to prevent the immune system from attacking
the newly transplanted organ when the organ is not closely matched. If these medicines
are not used, the body will almost always launch an immune response and destroy the
foreign tissue. There are some exceptions, though. Cornea transplants are rarely
rejected because the cornea has no blood supply. Also, transplants from one identical
twin to another are almost never rejected.

There are three types of rejection:

THE 3 TYPES OF ORGAN REJECTION

 Hyperacute rejection occurs a few minutes after the transplant when the
antigens are completely unmatched. The tissue must be removed right away so the
recipient does not die. This type of rejection is seen when a recipient is given the wrong
type of blood. For example, when a person is given type A blood when he or she is type
B.
 Acute rejection may occur any time from the first week after the transplant to 3
months afterward. All recipients have some amount of acute rejection.
 Chronic rejection can take place over many years. The body's constant immune
response against the new organ slowly damages the transplanted tissues or organ.

SIGNS AND SYMPTOMPS OF ORGAN REJECTION

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 Pain at the site of the transplant
 Feeling unwell
 Crankiness (in children)
 Flu-like symptoms
 Fever
 Weight changes
 Swelling

Immunosuppressants
Immunosuppressants are drugs or medicines that lower the body's ability to reject a
transplanted organ. Another term for these drugs is anti-rejection drugs. There are 2
types of immunosuppressants:

1. Induction drugs: Powerful antirejection medicine used at the time of transplant

2. Maintenance drugs: Antirejection medications used for the long term.

Think of a real estate mortgage; the down payment is like the induction drug and the
monthly payments are like maintenance drugs. If the down payment is good enough you
can lower the monthly payments, the same as for immunosuppression.
There are usually 4 classes of maintenance drugs:

 Calcineurin Inhibitors: Tacrolimus and Cyclosporine

 Antiproliferative agents: Mycophenolate Mofetil, Mycophenolate Sodium and
Azathioprine
 mTOR inhibitor: Sirolimus
 Steroids: Prednisone

What are immunosuppressants used for?

When you get a kidney transplant, your body knows that the new kidney is foreign (that
is, not originally part of your body). Your body will attack the new kidney and try to
damage or destroy it. The immunosuppressant drugs suppress your body's ability to do
this. The goal is to adjust these drugs to prevent rejection and to minimize any side
effects of the drugs.

Other Immunosuppressants
1. Lenalidomide
 Used to treat multiple myeloma (bone marrow cancer), either in
combination with another medicine or after stem cell transplant.
 Used to treat anemia in patients with myelodysplastic syndrome caused
by an abnormal chromosome.
 In people with this disorder, the bone marrow does not produce enough
healthy blood cells.

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 2. Omalizumab
 Used to treat moderate to severe asthma that is caused by allergies in
adults and children who are at least 6 years old.
 Used to treat chronic hives (idiopathic urticaria) in adults and children who
are at lest 12 years old, after antihistamines have been tried without
success.
 Not a rescue medicine for treating an asthma attack.
3. Azathioprine
 Used to prevent your body from rejecting a transplanted kidney.
 Used to treat symptoms of rheumatoid arthritis.
 Less effecting than cyclosporine; generally combines with it or used in
patients developing cyclosporine toxicity.
4. Pomalidomide
 Affects the immune system.
 Promotes immune responses to help slow tumor growth.
 Used to treat multiple myeloma.
 Usually given after at lest two other medications have been tried without
success.

Prepared by:
Awab, Abdelaziz
Lee, Kleah Raven
Inovejas, Mariella
Patino, Paolo
Tatel, Mikole
BSN II – A