Regal- Anti-inflammatory and Immunosuppressive Learning Exercises Flashcards
What are the symptoms associated with hives?
Wheal and flare
Redness (vasodilation)
Swelling (edema- increased vascular permeability)
Pain
What inflammatory mediators are associated w/ Redness?
Histamine (mast cells/basophils)
PGE
PGI
Kinins
Which inflammatory mediators are associated with swelling?
Histamine
cytokines
leukotrienes
kinins
Which inflammatory mediators are associated w/ pain?
Kinins
PGE2,I2
LTB4
What mediator is associated with the intrinsic pathway and what does it do?
Kalikrein- converts:
kininogens–>kinins
FActor XII–> XIIa
Histamine stimulates what receptor?
R on smooth muscle cells/basophils/mast cells
H1, H1–are primary targets
What receptors do PGE and PGI stimulate?
EP
IP
What receptors do kinins stimulate?
Bradykinin
B1 and B2
A 24 year old woman comes to your office w/ hives covering her arms and legs.
What hypersensitivity mechanism could explain her symptoms?
Allergy-type I hypesensitivity
Describe the pathological process of type I hypersensitivity?
Pollen crosslinks IgE> Activates MC> Release of: Histamine PGD2 TCR/D4/E4
Why might an anti-histamine be ineffective in treating her symptoms?
Anti-histamine will only effect histamine and not the other mediators/production of hives.
If a pt has already tried taking anti-histamines to treat hives, what would you prescribe next and why?
Diphenhydramine- only effects histamine
Steroids- broad anti-inflammatory effects
Amalizumab
What is amalizumab?
Anti-IgE Ab–> has a broader effect than most drugs without compromising ability to combat infection
What drugs affect ACh?
Atropine
Diphenhydramine
Fexofenadine
What inflammatory mediators can cause bronchoconstriction?
ACh Histamine Bradykinin Leukotrienes PGs
How do increasing amts of Ach effect bronchoconstriction (dose response curve)?
As ACh increases, bronchoconstriction increases than plateaus
What is atropine?
Competitive antagonist
What does atropine do the the DRC?
shifts curve right
What are the adverse effects of atropine?
Dry mouth
What receptor do antihistamines effect?
H1 antagonists
What are the two older antihistamines and what do they do?
Diphenhydramine
Chlorepheniramine
Shift curve right but less than atropine
What are the adverse effects of older antihistamines?
Drying secretions
sedation
GI upsets
What distinguishes new antihistamines from old?
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
What are the four examples of non-sedating anti-histamines?
Centinizoline
Fexofenadine
loratadine
What does fexonfenadine do to the DRC?
Nothing
What drugs effect histamine?
Atropine Diphenhydramine Fexofenadine Ibuprofen prednisone
What does atropine do to the DRC?
nothing
What is diphenhydramine?
competitive antagonist of H1 receptor
What does diphenhydramine do to the DRC?
shifts curve right
