Autacoids :( Flashcards
Histamine precursor and enzyme
Histidine
L-histidine decarboxylase
Histamine - stored in? Complexed with?
Mast cells and basophils
Complex with heparin-ATP in secretory granules (like suicide bombers)
Triple response of Lewis
Flush, wheal, flare
(Localized red spot) action and effect?
Flush
Relaxation of vascular smooth muscle
Vasodilation
(Swelling of edema) action and effect?
Wheal
Contraction of endothelial cells and post-capillary venule
Increased capillary permeability / leakage
(Brighter red halo) action and effect?
Flare
Local axon reflex
Indirect vasodilation
H1 distribution (2)
Smooth muscle endothelium, CNS
H1 rep antagonist (2)
Chlorphenamine, diphenhydramine
H2 distribution (4)
Parietal cells, cardiac muscle, mast cells, CNS
H2 rep antagonist (2)
Ranitidine (Zantac), cimetidine
Selective H2 blocker, acts on stomach
Ranitidine
H3 distribution
CNS: presynaptic, myenteric plexus, other neurons
H3 rep antagonist (3)
Thioperamide, cloben, burimamide
H4 distribution
Cells of hematopoietic origin (bone marrow)
H4 antagonist (2)
Thioperamide (JNJ7777120), zymosan
H receptors distributed widely in periphery and CNS
H1, H2
H1 activates _, -> _ pathway
H1 activates Gq/11 -> PLC-IP3-Ca pathway
H2 activates _, -> _ pathway
H2 activates Gs -> adenylyl cyclase-cAMP-PKA pathway
H3 and H4 activate _ -> inhibit
H3 and H4: Gi/o -> inhibit adenylyl cyclase
Betahistine used for?
anti-vertigo (*H3, H4)
H receptors involved in neurotransmission, inflammation, circadian rhythm, nausea (vomiting center), vertigo
H3, H4
H receptor confined largely to CNS
H3
H receptors for lab rat experiments
H3, H4
H1 blockers (5)
diphenhydramine (Benadryl) chlorphenamine hydroxyzine (urticaria) meclizine (Bonamine) promethazine (anesthesia; drug-drug -> arrythmia)
H1 blocker pharmacodynamics (4)
Blocks Type I hypersensitivity reaction
Incomplete block of vascular smooth muscle relaxation (H1 & H2 for complete suppression)
CNS: sedation, anti-emetic
Anti-cholinergic: dryness
Antihistamine actions not mediated by H-receptor, ex.
Anticholinergic, via muscarinic receptor
Scopolamine for anti-vertigo
Kinin
Precursors, catalyst
Precursors: HMW, LMW kininogen
Catalyst: Plasma and tissue kallikrein
Kinin metabolism inhibited by? Half life?
Kininase or converting enzyme
15 secs
Endogenous KKK systems supports which part of the clotting system
Intrinsic pathway
B1 receptor fxn
Contraction of arteries and most veins
B2 receptor fxn (2)
Vasodilation in arterioles (via EDRF) -> drop BP, inc heart rate
Contraction of endothelial cell sin venules -> inc capillary permeability, edema
Kallikrein inhibitor ex. (used in coronary by-pass)
Aprotinin
KKK antagonist therapeutic uses (3)
Cold, pain from burns, allergic asthma
Where is serotonin stored
90% enterochromaffin cells, rest in platelets, CNS
Serotonin biosynthesis
W (tryptophan-5-hydroxylase) -> 5-hydroxytryptophan (L-amino decarboxylase) -> 5-hydroxytryptamine
HT functions (4)
Central chemical transmitter for tryptaminergic neurons in the brain
Regulation of GI motility
Hemostasis
Precursor for melatonin
Ligand-gated 5-HT
5-HT3 (others: GPCR)
5-HT1A drug
action, prototype, clinical use
Buspirone
Partial agonist
Anxiety, depression
5-HT1B/1D
action, prototype, clinical use
Sumatriptan
Agonist
Migraine
5-HT2A/2C
action, prototype, clinical use
Risperidone
Antagonist
Migraine, depression, schizo
5-HT3
action, prototype, clinical use
Ondansetron
Antagonist
Chemo emesis, nociception, sympathetic inhibition, pain and itching
5-HT4
action, prototype (2), clinical use
Cisapride (banned), metoclopramide
Agonist
GI peristalsis
5-HT transporter
action, prototype (2), clinical use
Fluoxetine, sertraline
Inhibitor
Major depression, OCD
Non-selective serotonergic drugs
action, prototype (2)
Ergoamine, LSD
Agonist
Drug choice for migraine
Sumatriptan (5-HT1B/1D)
Serotonergic agonists
1A (partial) - buspirone
1B, 1D - sumatriptan
4 - cisapride, metoclopramide
5-HT2A antagonist (contracts vascular smooth muscle, platelet aggregation)
Ketanserin (lowers BP)
Non-selective serotonergic drug for prophylactic treatment of migraine and vascular headaches
Methysergide
Vasoconstrictors
Angiotensin II Vasopressin Endothelin Neuropeptide Y Urotensin
Vasodilators
Vasoactive intestinal peptide Substance P Calcitonin gene-related peptide Bradykinin Natriuretic peptide Neurotensin Adrenomodulin
Renin produced by? Fxn?
JG cells (kidney), angiotensinogen -> angiotensin I
Angiotensin is exclusively produced by ACE t/f?
F
Angiotensin II antagonist
Structures responsible for reduced agonist activity and increased receptor affinity?
Saralasin
Ala on 8th AA - reduced agonist activity
Sarcosin on 1st AA - inc receptor affinity
ACE inhibitor
Captopril
ARBs (angiotensin II blockers), ranked by affinity to AT1
CITyViLle
Candesartan > Irbesartan > Telmisartan >= Valsartan > Losartan
Renin inhibitor
Aliskiren
Also, beta blockers (but weaker)
Renin inhibitors vs ACE inhibitors
Renin inhibitors don’t affect kinin metabolism so no dry cough or angioneurotic edema (characteristic side effect of ACE inhibitors)
COX 1 vs COX 2
1 - good, constitutive, housekeeper, widely distributed throughout GIT
2 - bad, inducible, homewrecker
Aspirin not used anymore for pain relief but as (3)
Analgesic-antipyretic
Anti-inflammatory
Antiplatelet (inhibit Thromboxane A2)
Aspirin adverse effects
Ulcers (inhibit mucus formation) Bleeding neuropathy (reduced GFR due to less PGI?)
Probably dominate during allergic constriction of airways
LTC5, LTD4, LTE4
LTC4, LD4 in low vs high concentration
LOW - exudation of plasma in PCP
HIGH - reduce exudation of plasma by constricting ARTERIOLES
COX 2 agonists (4)
cytokines
IL-1
TNF1
growth factors
COX 2 antagonists (3)
cytokines
glucocorticoids
IL-4
PGE2 or PGF2a
induction of labor at term / aborifacients, cytotek
PGE1 analog
misoprostol
gastric cytoprotection
prevent gastric dry-up with NSAID
PGE1
alprostadil
impotence
PGE1 in some neonates with congenital heart disease
maintenance of PDA
PGI2
epoprostenol
primary pulmonary hypertension; anti-inflammatory
Nonselective COX inhibitors (8)
indomethacin diclofenac ibuprofen nabumetome aspirin
paracetamol
mefenamic acid
meloxicam
Selective COX 2 inhibitors (4)
rofecoxib
etodolac
nimesulide
celecoxib
aspirin vs nsaids
aspirin covalently modifies both cox 1 and 2 -> irreversible inhibition
cox 1 -> serine 530
cox 2 -> serine 516
nsaids - competitive inhibitors of COX
other therapeutic uses of nsaids (3)
indomethacin - postnatal closure of pda
relief of cramps in primary dysmenorrhea
emergic use: colon/breast cancer, alzheimer’s