misc Flashcards
IgE receptors expressed where?
mast cells and eosinophils
how does immediate phase connect to late phase of asthma?
chemotaxis, chemokines propogate late phase
key players of cAMP cascade
what breaks down cAMP?
adenylate cyclase - increases cAMP - activates PKA - phospholipase C - decrease intracellular Ca2+ - bronchodilation
PDE
which therapy for as needed basis?
which for adjunctive therapy with asthma inadequately controlled by glucocorticoids?
short acting b2
long acting b2
theophlline/aminophylline MOA
inhibits PDE = prevent cAMP breakdown
competitive antagonist of adenosine receptor
metabolized by CYP450
how to reverse these effects:
bronchoconstriction
hyperresponsive airways
mucosal edema, hypersecretion
may reduce acute rxns in aspirin sensitive pts
antagonize CysLT1 receptors by montelukast/zafirlukast
glucocortiocids AE for asthma (3 for inhaled, 3 for oral)
inhaled:
oropharyngeal candidasis
dysphonia
adrenal suppression (children), beclomethasone, budesonide
oral
infection
hyperglycemia (gluconeogenesis)
osteoporosis (inhibit bone formation)
what is used for severe allergic asthma?
omalizumab
anaphylaxis, subq
inhaled anticholinergics AE
local dry mouth, nasal irritation, nose bleeds
long-acting inhibitor for PDE4
name?
treats what?
AE
roflumilast
COPD - adjunct for bronchodilators
GI symtpoms (diarrhea, nausea, ab pain), weight loss
ORALLY
what are the receptors on parietal cell?
ECL cell?
H2R
M3R
SST2R
SST2R
CCK2R
EP(2/3)R
what agents are antisecretory?
what agents are buffers?
cytoprotectants?
H2RAs
PPIs
Misoprostol
Antacids
Misoprostol
Bismuth Chelate
Sucralfate
PPIs should be avoided in which people
liver disease
pregnant/breastfeeding women
simeticone use?
anti-foaming agent relieves bloating with antacids
what is a u antagonist that is pegylated?
naloxegol for constipation (opioid related)
what does racecadotril inhibit?
inhibits enkephalinase (degrade enkephalins)
- leads to high enkephalins which are agonists of d receptors and inhibits intestinal secretion
- used with rehydration therapy
(treat diarrhea)
IBS diarrhea
eluxadoline (u and k agonist, d antagonist)
IBS constipation
linaclotide (agonist of guanylate cyclase C receptor, increases cGMP, increase Cl-, bicarb secreiton
IBS/IBD anti-inflamm (2)
methotrexate
sulfasalazine (olsalazine, mesalazine)
methotrexate MOA?
folic acid ant - cytotoxic and immunosuppressant
inhibit competitively DHFR - inhibit purine synth
IBS/IBD immunosuppressants
ciclosporin - AE?
azathioprine - AE, MOA?
name biologics and mode of action
inflix/adal/golim - SQ every 2 wks
vedo - a4b7 integrin on Th lymphocytes, prevent interaction with mucosal cell adhesion mol-1
uste - target p40 protein subunit, IL-12, IL-23
vitamin a deficiency leads to
night blindness
imiquimod AE
local skin rxns (burning, itching, swelling)
long-term skin rxn (pigmentation)
systemic (fatigue, diarrhea, flu like, headache)
ciclosporin cascade
binds to cyclophilin, inhibits calcineurin decreasing IL-2 synth
normally, high intra Ca2+ activates calcineurin which dephosphorylates NFAT. NFAT binds to response elements and turn on transc of IL-2, activating T cells
which cytokines are inflammatory and promoted by TNFa?
1/6/8
lorcaserin receptor?
5-HT2C receptor agonist increase POMC expression induces satiety
10mg twice daily or 20 mg extended release
bupropion/naltrexone AE
contraindicated?
- mood, increase suicide risk
- GI upset
- headache
- dry mouth
- increased heart rate and bp
contraindicated
- history of seizures
- eating disorders
- other opioid meds
- pregnancy
- withdrawal from barb, benzo, antiepileptics
