Brainscape's Knowledge GenomeTM

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


See full index

226 > Anti-Allergy Drugs > Flashcards

Anti-Allergy Drugs Flashcards

1
Q

Systemic Allergies

A
  • hayfever & rhinitis
  • asthma (allergic/extrinsic component)
  • dermatitis (contact+)
  • food/GI allergies
  • anaphylaxis
  • Allergies to inhaled substances
  • Contact allergies
  • Ingested (food) allergies
  • Drug allergies
  • Insect allergies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of ocular allergies

A
  • hayfever allergic conjunctivitis – seasonal, most common (98%)
  • vernal (kerato)conjunctivitis – chronic, relatively rare (<2%)
  • giant papillary conjunctivitis – not a true allergic reaction- contact
    lens repeated mechanical irritation
  • atopic keratoconjunctivitis - chronic, relatively rare (<2%)
  • contact dermatitis
  • blepharoconjunctivitis – staphylococcus aureus infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Systemic Allergic Responses

A
  • Allergic rhinitis
  • Contact dermatitis
  • Local/Generalized swelling & hyperemia
  • Anaphylaxis
  • Wheezing (asthma-like symptoms)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypersensitivity Reactions: Type I (immediate or anaphylactic)

A
  • antigen - IgE antibody reaction (mast cells/basophils)
  • rapid response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Type II (cytotoxic/complement dependent)

A

antigen interaction with cell-bound antibodies
(drug induced autoimmune reactions)

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

Type III (toxic complex/immune complex)

A

precipitation of antigen-antibody complex
(serum sickness, arthus/vasculitis)

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

Type IV (cell-mediated/delayed)

A
  • interaction antigen with sensitized T-lymphocytes
  • mediator release including cytokines/chemokines
  • slow reaction (24 - 48 hours)

Ex) contact dermatitis, drug reactions

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

Common Allergic Mediators

A

*histamine
* serotonin
* heparin
* Prostaglandins (PGD2)
* cytokines (TNF-a, TNF-b, IL-2)
* leukotrienes (SRSA, LTD4, CysLT1)
* eosinophilic chemotactic factor (Eotaxin)
* platelet activating factor (PAF)
* complement cascade
* IgE

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

Early Phase (seconds-minutes) allergic mediators

A

Mast Cell Degranulation: Histamines, Prostaglandins, Leukotrienes

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

Late Phase (6 hrs-48 hrs) allergic mediators

A

Leukocyte (Eosinophils), Lymphocyte infiltration

Central role of T-lymphocytes in prolonged/chronic responses “Adaptive Immune Response”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Th1 and Th2 Helper Lymphocytes Responses

A

Th1: cellular response, delayed response
Th2: humoral response, B-cells, antibodies, allergen recognition, cytokine release

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

Main Drug Classes of Anti-Allergy Drugs

A
  • Decongestants
  • Antihistamines
  • Mast Cell Stabilizers
  • Anti-IgE monoclonal antibodies
  • Anti-inflammatory drugs (Steroids, NSAIDS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ocular & Upper Respiratory Allergies: Common Symptoms

A

Ocular Allergies
* itchy eyes
* watery eyes*
* congestion*
* swelling
* mucous discharge
* papillary hypertrophy - also generalized irritation

Allergic Rhinitis
* runny nose/rhinorrhea
* congestion
* stuffiness
* mucous discharge

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

Decongestants Options - Symptomatic

A

alpha-adrenergic (sympathomimetic) agonists
Phenylephrine (more a1-selective)
* Imidazoles (more a2 -selective, potent, minimal miosis, reduced
rebound congestions)
* Naphazoline (max effect at 0.02%)
* Oxymetazoline (potent)
* Tetrahydrozoline (tachyphylaxis)

  • vasoconstriction (WHY?)
    • reduced hyperemia
    • decongestant action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when to use decongestants?

A

conjunctival hyperemia
mild allergies (conjunctival, nasal)
-avoid where possible avoid where possible for rebound congestion (nasal spray addiction)

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

Adverse reactions & Contra-indications of anti-allergy drugs

A

adverse reactions
-rebound congestion, less problematic imidazoles
-conjunctival reactions
-mydriasis

contrindications
-cardiovascular disease
-hyperthyroidism
-diabetes

17
Q

Potential drug interactions

A
  • Monoamine Oxidase (MAO) inhibitors (depression) +
  • Trycyclic Antidepressants TCAs (depression) +
  • atropine (ocular) +
  • methylphenidate (ADS, Ritalin) + “sympathectomizing drugs” (e.g. reserpine, neuronal blockers; hypertension)
  • a-adrenergic antagonists (benign prostatic hyperplasia)
  • beta blockers (variable)
  • general anesthesia (variable)
18
Q

Histamine & Allergies Effects

A

Triple response of histamine (red, flush, wheel)
* capillary dilatation (heat & flare)
* vasodilatation (precapillary beds)
* vasoconstriction (venules)
* edema/chemosis (swelling)
* itch

19
Q

Antihistamines for Allergies: Receptors & Potential Sites of Action

A

H1 receptors (mainly on smooth muscles)
* blood vessels (sm M)*
* bronchi (sm M)*
* GI (sm M)
* CNS/nerves
* mucous membranes

H2 receptors
* blood vessels*
* heart
* GI parietal cells (regulates stomach pH)
* mast cells (feedback inhibition)
* CNS

20
Q

Pharmacology of H1 antagonists

A
  • Inhibit Allergic Reactions
    • itch, pain
    • capillary dilatation, edema
  • Sedation (1st generation, not 2nd generation)
    * Sleep aids
    * Excitation in some children
  • Antinausea and antiemetic actions (1st generation)
    * Diphenhydramine, Promethazine, Meclizine
  • Antiparkinsonism effects
  • Antimuscarinic actions
    * atropine-like effects
  • Adrenergic receptor blocking actions
  • Serotonin blocking actions
  • Local anesthesia
    * Block sodium and potassium channels
  • Other actions
    * Inhibit mast cell release, glycoprotein transporters
21
Q

Specific Features of Newer Topical Ophthalmic Anti-HA Drugs

A

adjunct mast cell stabilizer action
* azelastine
* epinastine
* olopatadine (also basophils?)
* ketotifen (decreases eosinophil chemotaxis)
* alcaftadine

22
Q

Main Side-Effects of Topical Anti-HA Products

A
  • burning, stinging
  • Pupil dilatation (except olopatadine)
  • Allergies (long term use, formulation)
  • Headache (newer products)
  • Safety newer products not fully established (all category C)
    * Young children(<3yr)
    * Pregnant women (teratogenic effects)
23
Q

Uses of Oral Antihistamines

A
  • augment topical therapy (especially if severe)
  • generalized allergic response
  • lid myokymia (topical & oral)-anti-muscarinic activity
  • anti-nausea (CNS activity)

2nd generation
* less anti-muscarinic activity
* less lipid soluble
* additional activities?

24
Q

Side-effects of Oral Anti-HA Drugs

A

mediated by
* H 1, 2, 4 receptors elsewhere
* other receptors (muscarinic, adrenergic, serotonin)
* common effects (anti-HA +/- antimuscarinic)
* sedation (potential excitation in young children)
* GI & urinary disturbances
* dry throat, mouth, bronchi
* palpitations & dysrhythmias
* ocular antimuscarinic effects (example?)
* nonsedating (2nd Generation) Anti-HA tend to have:
* low anticholinergic activity (dry mouth, fatigue, drowsiness 5-20%)
* minimum anti-emetic activity
* Headaches (cetirizine 16%)

25
Q

Drug Interactions: Oral Drugs

A
  • alcohol!!
  • other CNS depressants - sedatives, opioids, analgesics
  • additive with
    * anticholinergics
    • adrenergic agonists
      * MAOIs
      * Phenothiazines (TCA)
  • inhibition
    * adrenergic antagonists
  • TD50
    * grapefruit juice & P450 inhibitors
26
Q

Contra-indictaions of anti-allergy drugs

A

-nursing, pregnant
-GI, UT disease, narrow angles
-cardiac safety -cardiac toxicity, additive effects antifungals, macrolides

27
Q

mast cell stabilizer drugs

A
  • cromolyn sodium
  • lodoxamide tromethamine
  • nedocromil sodium
  • pemirolast
28
Q

Mast Cell Stabilizers effects

A
  • prevent release of mediators from mast cell
  • calcium mechanism
  • mechanisms for anti-allergy effect
  • inhibition of sensory nerve firing (chloride channel)
  • inhibition eosinophil accumulation
  • reduced IgE production (B lymphocytes)
  • generally no intrinsic AH/VC/anti-inflammatory action
29
Q

New versus Old Mast Cell Stabilizers

A
  • newer ones generally more potent than cromolyn
    * Lodoxamide – 2,500 more potent that cromolyn
  • additional actions
    * nedocromil - direct antagonism (HA, Leukotrienes)
  • pemirolast - inhibition eosinophils (chemotaxis, mediator release)
30
Q

Ophthalmic & Other Applications: Mast Cell Stabilizers

A
  • seasonal allergies (including asthma)
  • keratoconjunctivitis
  • conjunctivitis
  • GPC (compatibility with contact lenses?)
  • most useful in generally allergic patients (ocular allergy + e.g. asthma, eczema hay fever)
  • reduce/terminate corticosteroid therapy
31
Q

Adjunct, Newer & Alternative Treatments

A
  • Anti-IgE antibodies
  • NSAIDs
  • Corticosteroids
  • Immunosuppressive drugs
  • Leukotriene receptor antagonists, CysLT1
  • Homeopathic options
  • Immunotherapy

226 (11 decks)

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