L80 - Anti-Allergic Drugs Flashcards

1
Q

Location of Mast Cells?

A

Everywhere

Particularly prevalent as body sites in contact with the external environment, Skin/Gut/Resp

Commonly found close to blood vessels/nerves/glands

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2
Q

What is required for allergen-induced mast cell degranulation?

A
  1. Cros slinkng of IgE bound Fc epsilon R1

2. Requires antigen specific IgE produced in atopic subjects (heritable trait)

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3
Q
Which is Allergenic?
Dust Mites
Pollen
Cats
Peanuts
A

Dust Mites

Now explain why…

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4
Q

How do mast cells immediately commnicate with the internal environment?

A

Histmaine
Heparin
Tryptase
TNF-alpha

Preformed Mediators

30-45 seconds

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5
Q

How does the mast cell rapidly communicate with the internal environemnt?

A

Cys-LTs
PGD2

peaks over 10-30minutes

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6
Q

How does the mast cell slowly communicate with it’s internal environment

A

IL-4
IL-5
GM-CSF

Late, T-cell and eosinophil dependent reaction

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7
Q

What is released immediately from mast cells and what does it act on and what are it’s results?

A

Histamines - Act on H1 receptors (and H2 actions in brackets)

Pain and itch (sensory nerve action)
Bronchospasm
Mucus secretion
vasodilation/hypotension
Increased ascular leak - hypovalemia
(Positive inotropic and chronotropic)
(Gastric acid secretion)
CNS - increased wakefulness
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8
Q

Where are the LTC4 and metabolites (LTD4 and LTE4) active?

A

CysLT1 receptor

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9
Q

Endogenous Inhibitors of mast cell activation?

A

PGE2, adrenaline, cortisol

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10
Q

What are glucocorticoids used for?

A

Inhibiting Mediator Production

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11
Q

What conditions may require Glucocorticoids?

A

Asthma, hypersensitivity/systemic anaphylaxis

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12
Q

What can H1 receptor antagonists be used for?

A

Inhibiting Mediator actions

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13
Q

What are indications for use of H1 receptor antagonists

A
itching
dermatitis
hayfever
anaphylaxis
bites and stings
motion sickness (muscarinic antagonist activity)
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14
Q

What are the 3 classes of H1 receptor antagonists?

A

Sedative

Non-Sedative

Newer Non-sedative

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15
Q

When are sedative H1 Receptors used?

A

May be neutral/beneficial in treatment of allergies, but sufficient to interfere with lifestyle

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16
Q

When are Non-sedative H1 Receptors used?

A

Lack anti-muscarinic activity and GIT effects but can cause rare, sudden ventricular arrhythmia (withdrawn)

17
Q

When are Newer non-sedative H1 Receptors used?

A

Redcued risk of unwanted cardiac effects