Regal- Anti-inflammatory and Immunosuppressive Learning Exercises

Question 1

What are the symptoms associated with hives?

Answer 1

Wheal and flare
Redness (vasodilation)
Swelling (edema- increased vascular permeability)
Pain

Question 2

What inflammatory mediators are associated w/ Redness?

Answer 2

Histamine (mast cells/basophils)
PGE
PGI
Kinins

Question 3

Which inflammatory mediators are associated with swelling?

Answer 3

Histamine
cytokines
leukotrienes
kinins

Question 4

Which inflammatory mediators are associated w/ pain?

Answer 4

Kinins
PGE2,I2
LTB4

Question 5

What mediator is associated with the intrinsic pathway and what does it do?

Answer 5

Kalikrein- converts:
kininogens–>kinins
FActor XII–> XIIa

Question 6

Histamine stimulates what receptor?

Answer 6

R on smooth muscle cells/basophils/mast cells

H1, H1–are primary targets

Question 7

What receptors do PGE and PGI stimulate?

Answer 7

EP

IP

Question 8

What receptors do kinins stimulate?

Answer 8

Bradykinin

B1 and B2

Question 9

A 24 year old woman comes to your office w/ hives covering her arms and legs.

What hypersensitivity mechanism could explain her symptoms?

Answer 9

Allergy-type I hypesensitivity

Question 10

Describe the pathological process of type I hypersensitivity?

Answer 10

Pollen crosslinks IgE>
Activates MC>
Release of:
Histamine
PGD2
TCR/D4/E4

Question 11

Why might an anti-histamine be ineffective in treating her symptoms?

Answer 11

Anti-histamine will only effect histamine and not the other mediators/production of hives.

Question 12

If a pt has already tried taking anti-histamines to treat hives, what would you prescribe next and why?

Answer 12

Diphenhydramine- only effects histamine
Steroids- broad anti-inflammatory effects
Amalizumab

Question 13

What is amalizumab?

Answer 13

Anti-IgE Ab–> has a broader effect than most drugs without compromising ability to combat infection

Question 14

What drugs affect ACh?

Answer 14

Atropine
Diphenhydramine
Fexofenadine

Question 15

What inflammatory mediators can cause bronchoconstriction?

Answer 15

ACh
Histamine
Bradykinin
Leukotrienes
PGs

Question 16

How do increasing amts of Ach effect bronchoconstriction (dose response curve)?

Answer 16

As ACh increases, bronchoconstriction increases than plateaus

Question 17

What is atropine?

Answer 17

Competitive antagonist

Question 18

What does atropine do the the DRC?

Answer 18

shifts curve right

Question 19

What are the adverse effects of atropine?

Answer 19

Dry mouth

Question 20

What receptor do antihistamines effect?

Answer 20

H1 antagonists

Question 21

What are the two older antihistamines and what do they do?

Answer 21

Diphenhydramine
Chlorepheniramine

Shift curve right but less than atropine

Question 22

What are the adverse effects of older antihistamines?

Answer 22

Drying secretions
sedation
GI upsets

Question 23

What distinguishes new antihistamines from old?

Answer 23

They’re non-sedating
Anti-cholineric effects–> won’t dry secretions
Don’t get into CNS because they’re pumped out by p-glycoprotein–> less sedation

Question 24

What are the four examples of non-sedating anti-histamines?

Answer 24

Centinizoline
Fexofenadine
loratadine

Question 25

What does fexonfenadine do to the DRC?

Answer 25

Nothing

Question 26

What drugs effect histamine?

Answer 26

Atropine
Diphenhydramine
Fexofenadine
Ibuprofen
prednisone

Question 27

What does atropine do to the DRC?

Answer 27

nothing

Question 28

What is diphenhydramine?

Answer 28

competitive antagonist of H1 receptor

Question 29

What does diphenhydramine do to the DRC?

Answer 29

shifts curve right