Anti-inflammatories Flashcards

1
Q

What is the precursor to histamine?

A

Histadine

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2
Q

What are the roles of histamine?

A

Tissue repair
inflammation
vasodilation
allergic/anaphylactic reactions

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3
Q

Where is histamine found?

A

In mast cells

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4
Q

Where are mast cells produced?

A

Bone marrow

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5
Q

What is the IgE receptor on mast cells?

A

FcER1

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6
Q

How does mast cell degranulation occur?

A

Exposure to allergen creates IgE antibodies which bind to mast cells
second exposure to mast cells bind to IgE on mast cell surface and activates mast ecll

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7
Q

What can inhibit histamine release?

A

cAMP

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8
Q

What is the main histamine receptor called?

A

H1

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9
Q

What does the H1 receptor cause?

A

Systemic vasodilation
increased vascular permeability
itching

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10
Q

What are used to treat allergies?

A

H1 receptor antagonists

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11
Q

What are the two types of H1 receptor antagonists?

A

1st gen - shorter generation, cross blood brain barrier

2nd gen - longer, dont cross

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12
Q

What do H2 receptors do?

A

Inhibit gastric acid secretion

treat gastric ulcers

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13
Q

What is used to treat anaphylaxis?

A

Adrenaline

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14
Q

What are eicosanoids generated from and when?

A

Phospholipids, on demand rather than stored

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15
Q

What is the intermediate form of eicosanoids?

A

Arachidonic acid

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16
Q

What is the enzyme which changes phospholipids into arachidonic acid/eicosanoids?

A

Phospholipase A2

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17
Q

What are the 3 eicosanoids?

A

Prostaglandins
Thromboxanes
Leukotrienes

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18
Q

What can stimulate phospholipase A2?

A
Bradykinin
Mast cells
thrombin
complement
cell damage
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19
Q

Which prostaglandins are involved in inflammation?

A

PGE2 and PGI2

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20
Q

What converts arachidonic acid to prostaglandins?

A

Cyclooxygenase

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21
Q

What are the two isoforms of cyclooxygenase?

A

COX1 and COX2

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22
Q

What is the difference between COX1 and COX2?

A

1 is normally expressed in most cells

2 is not normally present, induced by inflammation

23
Q

What is significant about cyclooxygenase?

A

It is the target of corticosteroids and NSAIDS

24
Q

What effect does PGE2 and PGI2 have on vascular smooth muscle?

A

Relaxation

25
Q

What effect does PGE2 have on bronchial muscle?

A

Dilation

26
Q

What other effects do prostaglandins have on the body?

A

Hyperalgesia - increased pain sensitivity

PGE2 also causes fever

27
Q

What actions do thromboxanes cause?

A

Vasoconstriction and bronchoconstriction

Induce platelet aggregation

28
Q

How is thromboxane synthesised?

A

From PGH2

TXA2 synthase activates it

29
Q

Where is TXA2 synthase found?

A

in platelets

30
Q

What enzyme converts arachidonic acid to leukotrienes?

A

Lipoxygenase

31
Q

Where are leukotrienes produced?

A

Leukocytes, mast cells

32
Q

What do leukotrienes do?

A

activates leukocytes and cytokines

cause bronchoconstriction and vasodilation - asthma

33
Q

What are the main sources of prostaglandins?

A

Mast cells, leukocytes

34
Q

Where are glucocorticoids synthesised?

A

Zona fasciculata in the adrenal gland

35
Q

What is the main glucocorticoid in animals?

A

Corticosterone (cortisol)

36
Q

What causes glucocorticoid release?

A

Hypothalamus releases CRF - corticotrophin releasing factor

Anterior pituitary releases ACTH

37
Q

What is the pattern of glucocorticoid release?

A

Pulsetile

38
Q

What do glucocorticoids cause?

A

Increased or decreased gene transcription
Hyperglycaemia
increased protein catabolism - muscle wasting
redistribution of fat
increased Ca2+ excretion - hypocalcaemia

39
Q

What is the condition called from reduced glucocorticoids?

A

Addisons disease

40
Q

What is the condition for excess corticosteroids called?

A

Cushing’s syndrome

41
Q

What are the symptoms of cushing’s disease?

A

Hyperglycaemia
Muscle wasting
Osteoporosis

42
Q

What effects do glucocorticoids have on inflammation?

A

Glucocorticoids decrease the expression of COX2 so cant produce prostaglandins
Inhibits the early inflammatory response - good
inhibits late response - bad

43
Q

What are glucocorticoids used to treat?

A

Asthma, hypersensitivity, inflammatory skin conditions

44
Q

What is bad about glucocorticoids?

A

Inhibits late inflammatory response

Supresses immune response by preventing Th cell proliferation

45
Q

What are chondroprotective drugs?

A

Provide the building blocks to make the cartilage matrix

46
Q

What is cartilage made up of?

A

Collagen
Hyaluronic acid
Glycosaminoglycan
Proteoglycan

47
Q

What do NSAIDs do?

A

Inhibit cyclooxygenase

reduce prostaglandin and thromboxane synthesis

48
Q

What symptoms do NSAIDs treat?

A

Inflammation
fever
pain

49
Q

What is the binding pocket like on COX2?

A

Wider than COX1

50
Q

What are the side effects of NSIADs?

A

Gastric ulceration

51
Q

What do NSAIDs cause gastric ulceration

A

Inhibit PGE2 and PGI2 which usually protect mucosa

also inhibit platelet aggregation

52
Q

Why are NSAIDs particularly dangerous for dogs?

A

Have enterohepatic recycling
from liver out in bile
increases time drug is in GI tract

53
Q

What is a problem with COX2?

A

Increases sodium retention in the kidney

reduce kidney function

54
Q

How are NSAIDs metabolised?

A

Hepatic metabolism

glucouronidation - cats cant