Allergy & pulmonary Flashcards
Where are H1 receptors located?
endothelial cells, bronchial airways, brain
What are the G coupled proteins of H1 & H2?
H1 - Gq mediated
H2- Gs mediated
Where does H2 receptors cause an effect?
increase gastric secretion
What are the effects seen with H1 activation?
increased nasal & bronchial mucus
increased vascular permeability
contraction of bronchial smooth muscle
neurotransmitter
What are the indications of antihistamines?
allergy
vestibular nausea or motion sickness
extrapyramidal by antipsychotics
What are the side effects of antihistamines?
increased drowsiness
antimuscarinic –> increased atropine side effects
block 5HT–> increased appetite and weight gain
blocks alpha 1–> dizziness & hypotension
cognitive impairment in elderly
What are the H1 receptor drugs?
Diphenhydramone & dimenhydrinate
chlorphenitamine
hydroxyZINE, mecliZINE, promethaZINE
What are the second generation antihistamines ?
fexofenadine
cetrizidine
laratidine
What are the benefits of 2nd generation antihistamines?
decreased side effects
what are the drugs given for acute asthma?
beta 2 agonist -“ROL” ( albuterol)
terbutaline
corticosteroids to decrease inflammation
What is the metabolism of Arachadonic acid AA
AA–> COX pathway or Lipooxygenase pathway
LOX pathway
increase LTB4, LTC4 LTD4, LTE4
regulators of inflammation
LTB4= chemoattractant –> increase neutrophils
C4 & D4= increase vascular permeability, mucus production, bronchoconstriction
What is the function of montelukast and zafirlukast?
decrease binding of LTD4 & C4 to CysLT1 receptor –> decreased bronchoconstriction
Zileuton
inhibitor of lipooxygenase –> decrease pathway events
What is the side effect of zileuton?
hepatotoxicity
What is the side effect of corticosteroids?
esophageal candida
What is the interaction of aspirin and asthma ?
aspirin inhibits the COX pathway which then sends all the AA into the LOX pathway –> increased leukotrienes
Salmeterol & formoterol
long acting beta 2 agnostic
given for moderate persistent asthma
given with corticosteroids
Theophylline
caffeine
methylxanthine
increase cAMP by inhibiting phosphodiesterase
increase air flow
administered orally
What is a side effect of methylxanthine?
CN effects
metabolized by p450
Omalizumab
monoclonal antibody directed at Fc portion of IgE preventing attachment to mast cells –> decreased degranulation
Cromolyn sodium
decrease mast cell degranulation
What is given for acute severe asthma attacks?
beta 2 agonist
corticosteroids ( given IV)
ipratropium
epinephrine
