Allergy/Asthma Flashcards
Allergic Rxn R
H1R
2 Vascular Effects of H1R
Local vasodilation
Enhanced capillary permeability (edema, endothelial contraction)
Histamine Effects Pathway
H1R on endothelial -> Gq -> ^Ca -> activate NOS/Endothelials separate -> NO diffuses into VSM -> guanylate cyclase -> cGMP -> PKG -> inhibition of contraction
1st Gen H1R Antagonist
Diphenhydramine (Benadril), caused sedation and anti-ACh/motion sickness bc very lipid soluble so could get into brain
2nd Gen H1R Antagonists
Fexofenadine (Allegra) and Loratidine (Alavert, Claritin), w/ less side effect because less lipid soluble
2 Elements of Asthma
Inflammation -> remodeling and thickening of airway
Constriction -> contraction of muscles around airway
3 Possible Short Term Relief Asthma Med Types
Beta2 AR agonists
Theophyline
Anti-MR Agents
3 Possible Long Term Control Asthma Med Types
Inhaled corticosteroids
Inhibitors of mast cell degranulation
Antagonists of leukotriene pathway
Beta2 AR Agonists vs. Theophylline
Activate AC -> cAMP -> Bronchodilation vs. Inhibiting PDE which breaks down cAMP
Epi As Asthma Treatment
Nonselective AR agonist, increases cAMP and provides immediate relief but causes cardiac problems and eventual downreg so not used
Isoproterenol
Beta AR agonist, increases cAMP but has CV effects and Beta2s much preferred
2/3 Beta-2 AR Agonists and Difference b/w
Terbutaline/Albuterol - short acting/immediate relief
Salmeterol - long acting/slow onset prevention
Theophylline Benefit/Risk
Narrow therapeutic risk requires monitoring, but low cost
Ipratropium
MR antagonist that seems to have variable effectiveness
2 Corticosteroids for Long Term Control (& differences)
Prednisone and beclomethasone
Urgent vs. long term
Latter also aerosol and can lead to mouth infections