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Chapter 54. Drug Hypersensitivity Reactions

Student Questions

The haptenation hypothesis states that:

A. a drug alone can be recognized as foreign by the immune system.

B. a drug must bind to a "self" protein to be recognized by the immune system.

C. the drug covalently binds directly to T-cell receptor.

D. the drug has to be metabolized to be recognized by the immune system.

Answer: B

Option A: Incorrect. This is the pharmacologic interaction hypothesis.

Option B: Correct. The haptenation hypothesis states that the drug becomes covalently bound to a normal "self" protein. The combination of the drug bound to the protein is then large enough to be recognized as foreign by the immune system, leading to an immune response.

Option C: Incorrect. This is the pharmacologic interaction hypothesis.

Option D: Incorrect. This is the pro-hapten hypothesis.

The pharmacologic interaction hypothesis states that:

A. covalent binding to self protein is necessary.

B. a drug must be metabolized to be recognized by the immune system.

C. a drug or metabolite binds directly to T-cell receptor.

D. a metabolite of a drug cannot be involved in this hypothesis.

Answer: C

Option A: Incorrect. Covalent binding to self protein is not necessary in this hypothesis.

Option B: Incorrect. Drug or a metabolite can bind directly to T-cell receptor in this hypothesis.

Option C: Correct. In this hypothesis, drug or metabolite binds directly to T-cell receptor.

Option D: Incorrect. Metabolite or drug can bind directly in this hypothesis.

Some of the most common life-threatening drug reactions are predominantly cutaneous; this is thought to be due to:

A. drug metabolism in the liver.

B. keratinocytes acting as a site of drug metabolism.

C. keratinocytes not being able to metabolize drugs.

D. similarities between hepatocytes and keratinocytes.

Answer: B

Option A: Incorrect. This explains why the liver is involved in adverse drug reactions.

Option B: Correct. Drug metabolism by keratinocytes is believed to be the cause of severe skin related drug reactions.

Option C: Incorrect. Keratinocytes are believed to play a role ...

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