Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

03 BP1 > 31 Anti-allergics > Flashcards

31 Anti-allergics Flashcards

1
Q

Histamine

A

Derivation: histidine
Storage: mast cells

Inc vasodilation, capillary permeability, smooth muscle contraction, mucus secretion, PANS

Physiologic antagonist: Epi
Pharmacologic antagonist: antihistamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CNS effects of histamine

A 
Control sleep-wake cycle
Inc BBB permeability
Neuroendocrine control (behavior, biological rhythms, energy metab, thermoreg, fluid bal, stress, repro)
Thyroid function
Cognition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

H1 antihistamines mechanism of action

A

Dec production of proinflammatory products
Dec granule products, cytokine release, superoxide radicals release, chemotaxis of eosinophils
Dec CAM expression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

First gen antihistamines

A

Use: urticaria, rash, pruritus, bronchoconstriction
Faster acting, more potent in short term

Mechanism: inverse agonists (stabilize inactive H1 receptor)
Side effect: drowsiness and sedation

Ethanolamines = most sedating (diphenhydramine, dimenhydrinate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Second gen antihistamines

A

Less sedation, longer duration
Mechanism: bind noncompetitively to H1 receptor for longer duration

Weaker sedation: Cetirizine, acrivastine,
True non-sedating: loratadine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Third gen antihistamines

A

Increased efficacy, less side effects

Levocetirizine = does not cross BBB
Desloratadine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cortisol

A

Hypothalamus: corticotropin-releasing hormone
Pituitary: secreted adrenocorticoropic hormone
Adrenals: cortisol

Regulators: CRH = pituitary, ACTH = adrenal gland, negative feedback
Stimulator: stress, circadian rhythm (high in daytime 7am, low in night time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Adrenal gland

A

Adrenal cortex
Zona glomerulosa = mineralocorticoids (aldosterone)
Zona fasciculata = glucocorticoids (cortisol)
Zona reticularis = androgens (estradiol, estrone, testosterone)

Adrenal medulla = catecholamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pathways of steroids

A

Androgens: progesterone -> estrone, estradiol, testosterone
Glucocorticoids: cholesterol -> cortisol/corticosterone
Mineralocorticoids: cholesterol -> mineralocorticoids

Adverse side effects = give steroids 1-2 weeks only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Glucocorticoid inhibitory effects

A 
B cell: inc apoptosis, dec BAFF, dec Ig
Neut: inc apoptosis, inc annessin A1
Macro: dec cell activity
DC: dec proliferation, dec cytokines, inc reg T-cell induction
Eos: inc apoptosis
Bas: dec histamine, dec basophils
Mast: dec mast, dec mediators
Th17: inc
Th2: dec cytokines, TCR signal
Th1: dec IL2, dec TCR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Glucocorticoid stimulatory effects

A

Treg: inc cells, inc IL2 receptors, inc IL10
Macrophages: low dose increases cell activity
Hypertension, peptic ulcer, hyperglycemia
Cataracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Corticosteroid effects

A

Dec eosinophils, cytokines (t-lymph, macro, epithelial cells), mast cells, DCs
Dec leakiness, mucus secretion
Inc B2 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Side effects of steroid use

A

Bones: inhibit osteoblasts, osteopenia, osteoporosis
CNS: mental status changes
Growth stunting: dec GH
GIT, pancreas: peptic ulcer, pancreatitis
Endo: Thyroid suppression, adrenal suppression, secondary sex charac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Indications for steroids

A 
Collagen/MSK: SLE, rheumatoid arthritis
Allergic rhinitis
Immunosuppression: organ transplant
Ocular disease
Skin disease: contact dermatitis
Pulmo: bronchial asthma
Renal: glomerulonephritis, nephrotic syndrome
Cerebral edema
Endotoxic shock
Hema diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Corticosteroid excess: Cushing’s syndrome

A

ACTH secreting pituitary edema -> bilateral adrenal hyperplasia

Manifestations: (Hey Suck His Cock For HellA Coin)
Hyperglycemia
Skin (striae/bruising)
Hypertension
Central/truncal obesity
Facial edema
Hirsutism, Amenorrhea
Closure of epiphyseal plate

Secondary cushingoid syndrome: excess cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Additives in steroid preparation that have IgE-mediated reactions (hypersensitivity)

A

Triamcinolone = carboxymethylcellulose
Hydrocortisone = parabens
Methylprednisone = polyethylene glycol
Triamcinolone, hydrocortisone, methylprednisone = benzyl alcohol

17
Q

Corticosteroid insufficiency: Addison’s disease (primary adrenal insufficiency)

A 
Manifestations: DDSS
Dec BP
Dec GFR -> less excretion of water
Skin pigmentation
Severe hypoglycemia
Hypovolemic shock
18
Q

Congenital adrenal hyperplasia

A

Defect in 21-a hydroxylase activity -> dec cortisol synthesis -> inc in ACTH -> adrenal hyperplasia (inc precursors but no end product) -> virilization and ambiguous genitalia

19
Q

Synthetic corticosteroids

A

Prednisolone: additional unsaturation of Ring A (inc glucocorticoid activity)
Fludrocortisone: better at glucocorticoid and mineralocorticoid (enhances aldosterone); excessive immunosuppression

20
Q

Aldosterone

A

Short and fast acting (HL: 15-20 min)
Action: promote absorption of Na in DCT and CCT (activate Na-K pumps and H2O channels)

Mechanism: hypotension -> renin -> aldosterone

21
Q

Hypoaldosteronism

A

Primary deficiency: rare, congenital adrenal hyperplasia, aldosterone synthase deficiency
Secondary deficiency: disease of pituitary/hypothalamus

22
Q

Synthetic mineralocorticoids

A

Deoxycorticosterone (DOC): aldosterone precursor, under control of ACTH
Fludrocortisone: mineralocorticoid and glucocorticoid activity

23
Q

Testosterone effects

A

Sperm motility and activation
Feedback suppression and gonadotropin secretion
Sex drive, differentiation
Sebum formation

Deficiency: erectile dysfunction, diabetes, muscle weakness

24
Q

Estrogen effects

A 
Normal brain dev; muscle development
Differentiation of sexual organs
Menstrual cycle
Vaginal lining thickness
Bone density

Excess: fatigue, dec libido, inc breast, loss of muscle, inc risk for stroke and HD, enlarged prostate
Deficiency: inc fracture risk, hot flashes, lipid changes, memory loss

25
Q

Leukotriene inhibitors

A

Controls immune response (arachidonic acid pathway)

5-lipoxygenase inhibitor (Zileuton): inhibits 5-lipoxygenase pathway, controller for asthma
LT4 receptor antagonist (Montelukast, Pranlukast, Zafirlukast): reversible antagonists of L-receptors; for allergic rhinitis and mild-mod asthma

26
Q

Mast cell stabilizers

A

Cromolyn Sodium, Nedocromil
Use: prophylaxis for allergic asthma

Mechanism: stabilizes chloride channels -> inhibit histamine release

27
Q

Corticosteroid drugs

A

Short-medium acting: cortisone, hydrocortisone, deflazacort
Intermed: prednisone, prednisolone, methylprednisolone, triamcinolone
Long: dexamethasone, betamethasone
Mineralocorticoid: fludrocortisone

28
Q

Corticosteroid agonists & antagonists

A 
Agonists: 
glucocorticoids (prednisone)
mineralocorticoids (fludrocortisone)
Antagonists: 
synthesis inhibitors (ketoconazole)
receptor antagonists (gluco: mifepristone; mine: spironolactone)
29
Q

Steroid synthesis inhibitors and antagonists

A

INHIBITORS
Aminoglutethimide: blocks cholesterol -> pregnenolone
Use: Cushing’s syndrome, metastatic breast cancer
Ketoconazole: blocks steroidogenesis needing CP450
Use: Cushing’s syndrome

ANTAGONISTS (cytoplasm)
Mifepristone: block gluco receptor
Use: ectopic ACTH secretions/adrenal carcinoma
Spironolactone: block mine receptor
Use: hyperaldosteronism, hirsutism in women

30
Q

Eplerenone

A

Mineralocorticoid antagonist
MOA: binds to aldosterone receptors -> block RAAS

Use: Hypertension

03 BP1 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions