Medical Pharmacology: Gastrointestinal Pharmacology Practice Questions
Choose the correct answer for each question.
Concerning management of inflammatory bowel disease using antitumor necrosis factor treatment:
Abnormal regulation of the helper T cell type 1 (TH1) and regulatory T cells (Tregs) this characteristic in inflammatory bowel disease, particularly Crohn's disease.
An important, key proinflammatory cytokine in inflammatory bowel disease is tumor necrosis factor (TNF).
Both
Neither
Mediation of the effects due to soluble (and membrane-down) tumor necrosis factor (TNF):
Tumor necrosis factor (TNF) binds to TNF receptors localized on TH1 cells, fibroblasts, and innate immune cells.
Binding of TNF to its receptor aactivates NF-κB which promotes transcription, growth as well as expansion.
TNF receptor activation rresults in proinflammatory cytokine release from macrophages and T cells.
A & B
B & C
A & C
A, B & C
Which one(s) of the following represent monoclonal immunoglobulin(s) developed for management of chronic inflammatory diseases.
Certolizumab pegol (Cimzia)
Adalimumab (Humira and others)
Infliximab (Remicade)
A & B
B & C
A & C
A, B & C
Monoclonal immunoglobulins:
Certolizumab pegol is humanized fragment antigen bound to a polyethylene glycol polymer (pegylated).
Adalimumab is a fully humanized antibody.
Both
Neither
Infliximab (chimeric antibody) is 75% human and 25% mouse.
True
False
Adalimumab, infliximab and certolizumab pegol bind to soluble and membrane bound TNF-α.
True
False
Binding of anti-TNF-α monoclonal antibodies neutralizes soluble and membrane-bound TNF-α by inhibiting TNF-α binding to its receptors
True
Falls
Monoclonal anti-TNF-α antibodies:
Clinically used for management of moderate-to-severe Crohn's disease.
Antibody preparations can be used not only for induction but also for maintenance of remission in children and adults.
Both
Neither
Adverse effect(s) associated with anti-TNF-α monoclonal antibodies.
Humanized antibodies (adalimumab and certolizumab) are less likely to promote an immune response against them compared to infliximab.
A & B
A & C
A, B & C
Vedolizumab (Entyvio), a humanized monoclonal antibody prevents lymphocyte accumulation to the intestinal mucosa. This agent may be used in treating moderate-to-severe Crohn's disease and ulcerative colitis.
True
False
Ustekinumab (Stelara), monoclonal antibody, prevents activation of certain receptors on lymphocytes. This drug may be effective in both induction and remission maintenance in Crohn's disease.
