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- The β-adrenoreceptor was the first of this type to be characterized and others seem to be similar.
Monoamine oxidase inhibitors are drugs that irreversibly inhibit the action of the enzyme monoamine oxidase. Monoamine oxidase exists in two forms: MAO-A and MAO-B.
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Large molecules such as vaccines, insulin and dextrans can provoke immune reactions themselves but most drugs are too small to be antigenic on their own. In some patients, something that cannot be predicted is that a drug or drug metabolite can combine with tissue proteins to form an antigenic conjugate. In this situation, the patient shows a response, which can be described under one of the classical definitions of allergic response (that is, type see below). Such reactions require initial exposure to the drug to cause sensitization, after which, subsequent exposure to the same drug triggers an immunological reaction. Although drug allergy is unpredictable, it is more likely to occur in individuals with a history of atopic disease, for example asthma. The allergen, whether it is a drug, pollen or dust mite, causes production of immunoglobulin E antibodies on first exposure.
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Because propranolol is extensively metabolized affected individuals show exaggerated and prolonged responses to this drug. Another example is the metabolism of isoniazid, a drug used to treat tuberculosis.
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Resistance to cancer chemotherapy can occur and for this reason combinations of drugs with different mechanisms of action provide the best chance of a successful cure.
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