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20003 > allergy and epilepsy drugs > Flashcards

allergy and epilepsy drugs Flashcards

1
Q

why is adrenaline used for anaphylaxis

A
  • alpha 1 antagonist for vasoconstriction
  • beta 2 bronchodilation
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2
Q

how does adrenalines work in anaphylaxis

A
  • functional antagonist
  • histamine release causes vasodilation and bronchoconstriction
  • counters this reaction
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3
Q

what is the mechanism of action of a type 1 (anaphylactic) reaction

A
  • IgE antibodies
  • mediated mast cell activation and degranulation
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4
Q

what are histamines

A
  • chemical messenger
  • in tissue with large number of mast cells (skin, bronchial tree mucosa, intestinal mucosa)
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5
Q

where is histamine stored

A

in the granules in the mas cells

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6
Q

how is histamine released

A
  1. rise in cytosolic Ca2+ from inflammation and allergic reaction
  2. IgE binds to mast cells and antigen binds to IgE
  3. histamine is released via exocytosis
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7
Q

what is the target of histamines for H1 receptors

A
  • bronchial and nasal exocrine glands
  • bronchial smooth muscle
  • intestinal smooth muscle
  • sensory nerve endings
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8
Q

what is the target of histamines for H1 and H2 receptors

A
  • cardiovascular system
  • skin
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9
Q

what is the target of histamines for H2 receptors

A

stomach

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10
Q

what do the bronchial and nasal exocrine glands do when stimulated by H1 receptors

A

increased production of mucus

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11
Q

what do the bronchial smooth muscles do when stimulated by H1 receptors

A

contraction of bronchioles

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12
Q

what do the intestinal smooth muscle do when stimulated by H1 receptors

A

contraction

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13
Q

what do the sensory nerve endings do when stimulated by H1 receptors

A

itching and pain

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14
Q

what does the cardiovascular system do when stimulated by H1 and H2 receptors

A
  • decreased BP
  • positive chronotropism
  • positive inotripism
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15
Q

what does the skin do when stimulated by H1 and H2 receptors

A

triple response: reddening, wheal, flare

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16
Q

what does the stomach do when stimulated by H2 receptors

A
  • stimulation of HCl secretion
17
Q

how do first generation H1 receptor blockers work

A
  • penetrate the CNS as lipid soluble to cause sedation
  • interact with other receptors (unwanted adverse effects)
18
Q

what do second generation H1 receptor blocking agents do

A
  • specific for H1 receptors
  • do not penetrate the blood brain barrier
19
Q

what are the therapeutic uses for H1 receptor blocking agents

A
  • allergic rhinitis
  • allergic conjunctivitis
  • urticaria
  • nausea
  • insomnia
  • motion sickness
  • increased food intake
  • anaphylactic reactions
20
Q

what are the adverse effects of H1 receptor blocking agents

A
  • central: sedation, dizziness, fatigue
  • antimuscarinic: dry mouth, blurred vision, constipation, urine retention
21
Q

what is status epilepticus

A
  • prolonged state of seizures
  • sustained contraction of respiratory muscles
22
Q

what is the management of status epilepticus

A
  • assess respiratory status
  • oxygen
  • vital signs
  • IV access
  • IV benzodiazepine
23
Q

what is the mechanism of action of benzodiazepines

A
  • increase GABA activity
  • this is an inhibitory neurotransmitter in the CNS
  • reduces excitability of neurones, calming the brains
24
Q

how does GABA inhibition have an effect

A
  1. GABA
  2. GABAa opens chloride channels
  3. allows for a calcium influx
  4. is an anion so is negatively charged = hyperpolarised cell
  5. causes inhibition to stop firing
25
Q

what are short acting benzodiazepines

A
  • triazolam
  • midazolam
26
Q

what are intermediate acting benzodiazepines

A
  • lorazepam
  • alprazolam
27
Q

what are long acting benzodiazepines

A
  • clonazepam
  • diazepam
28
Q

how is diazepam administered

A
  • IV
  • IO
  • rectal
29
Q

who is lorazepam administered

A
  • IV
  • IO
30
Q

how is midazolam administered

A

intranasal spray

31
Q

what are the side effects of benzodiazepines

A
  • drowsiness
  • incoordination
  • lethargy
  • slurred speech
32
Q

what do anti-epileptic drugs work on

A
  1. action on ion channels - Na or Ca2
  2. enhance GABA transmission
  3. inhibits glutamate transmission
  4. other mechanisms

20003 (17 decks)

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