Exam 4; Biogenic Amines

Question 1

What is used to convert histamine to histamine

Answer 1

histadine decarboxylase

Question 2

What are four functions of histamine

Answer 2

growth and regeneration
neurotransmission
regulator of microcirculation
defense mechanisms

Question 3

Histamine is released following a tissue injury, and has what four effects

Answer 3

inflammatory response
mechanical, thermal, chemical, or radiant injury
warning system via stimulation of sensory neurons
enhancer of the immune system

Question 4

What is the mechanism of action of histamine

Answer 4

it binds to specific histamine receptor

Question 5

What are four physiologic effects involving histamine and the vascular system

Answer 5

constricts larger vessels
dilate smaller vessels
cause pooling of the blood at the injury site
cause endothelial cell leakage; “wheal”

Question 6

What is the “triple response” to injected histamine

Answer 6

central red spot; due to vasodilation
flare
wheal

Question 7

What are the two neuronal physiologic effects of histamine

Answer 7

stimulation of sensory neuron; itching/pain

CNS effects increasing alertness

Question 8

What are two physiologic effects of histamine regarding the smooth muscle

Answer 8

constricts bronchioles; bronchoconstriction

constricts metastmeal muscle; diarrhea

Question 9

What is the physiologic effect of histamine regarding exocrine secretion

Answer 9

stimulates bronchial, salivary, and digestive secretions

Question 10

What is the mechanism behind anti-histamine actions

Answer 10

blocks the histamine receptor

Question 11

What are the CNS effects of H1 blockers

Answer 11

sedative (can be excitatory in children and the elderly)
anti-emetic
anti-nausea

Question 12

H1 blockers cause the drying of this

Answer 12

mucous membranes

histamine stimulates the secretion

Question 13

How does H1 blockers affect the peripheral nervous system

Answer 13

acts as a local anesthetic

Question 14

Hows does H1 blockers affect the smooth muscle

Answer 14

it is a dilator; bronchial smooth muscle dilator

Question 15

H1 blockers inhibit the secretion of what

Answer 15

interleukins, which are stimulators of the immune system and other inflammatory mediators

Question 16

H2 blockers affect gastric secretion how

Answer 16

histamine is required to stimulate gastric secretion from parietal cells, an H2 blockade leads to a decrease in acid secretion

Question 17

What three things under the category of “dermatoses” are the first generation classes H1 anti-histamines used for

Answer 17

urticarias (itching)
insect stings/bites
allergic rhinitis and allergic conjunctivitis

Question 18

What are H1 antihistamines NOT of value in treating

Answer 18

asthma or the common cold

Question 19

H1 anti-histamines are used for these two things besides dermatoses

Answer 19

motion sickness (anti-emetic, anti-nauseant)
sedative

Question 20

This first generation h1 blocker has sedative effects and is used for motion sickness

Answer 20

diphenyhydramine

Question 21

This first generation h1 blocker is used for motion sickness

Answer 21

clemastine

Question 22

This first generation h1 blocker is not used for motion sickness

Answer 22

chlopheniramine

Question 23

This first generation h1 blocker is used as a sedative and anti-itch

Answer 23

hydroxyzine

Question 24

This first generation h1 blocker was a precursor of the first anti-psychotic drugs and is a strong sedative/anti-emetic

Answer 24

promethazine

Question 25

This first generation h1 blocker is a sedative and has local anesthetic effects

Answer 25

tripelennamine

Question 26

True or False | The first generation h1 blockers can ever the CNS

Answer 26

True; because they are not ionized

Question 27

All of the first generation h1 blockers can act on what

Answer 27

the peripheral and central histamine receptors

Question 28

What are the four second generation h1 blockers

Answer 28

``` the "-ines" lortadine fexofenadine desloratadine cetirizine ```

Question 29

The second generation H1 blockers have less this than compared to the first generation

Answer 29

CNS effects; all are ionized in the blood

Question 30

What are the three toxicities and contraindications for ALL h1 blockers

Answer 30

high therapeutic index first generations can react with other CNS depressants anti-mucarinic effects

Question 31

What are the four H2 blockers

Answer 31

``` (-tidine's) cimetidine rantidine famotidine nazitidine ```

Question 32

What is the side effects of cimetidine

Answer 32

``` H2 blocker anti-androgen effects breast growth in males lactation in women low sperm count ```

Question 33

The -tidine drugs do not cross what

Answer 33

the blood brain barrier | H2 blockers

Question 34

What is serotonin synthesized from

Answer 34

tryptophan

Question 35

What are the four physiologic effects of serotonin

Answer 35

smooth muscle constriction itching and pain central neurotransmission (important neurotransmitter) can cause nausea

Question 36

What is carcinoid syndrome

Answer 36

tumor of enterochromaffin cells (where serotonin is found)

Question 37

What are the five effects of an increase in serotonin

Answer 37

``` diarrhea bronchospasm sin flushing fibrosis of heart valves no CNS effects; produced peripherally ```

Question 38

How is the role of serotonin in migraines inferred

Answer 38

by the effect of certain drugs useful in treating migraines

Question 39

How do the agents that affect migraines alter the serotonin system

Answer 39

agonists or partial agonists of serotonin receptor

Question 40

The serotonin agonists that act on migraines all cause what

Answer 40

vasoconstriction

Question 41

What are the agents that act on serotonin receptors

Answer 41

the "-triptan's" | sumatriptan

Question 42

The triptan drugs should never be given with these drugs, would lead to a synergistic effect

Answer 42

SSRIs or MAO inhibitors

Question 43

What is serotonin syndrome

Answer 43

hyperthermia and muscle twitching

Question 44

What are the two ergot alkaloids

Answer 44

ergotamine | dihydrogotamine

Question 45

How do the ergot alkaloids affect serotonin

Answer 45

partial serotonin agonists; can also affect adrenergic and dopaminergic receptors

Question 46

What are the for side effects of ergot alkaloids

Answer 46

``` ergotism; excess of ergot alkaloids "St. Anthony's fire" hallucinations uterine contractions severe vasospasms; gangrene ```

Question 47

What is the pregnancy category of ergot alkaloids (ergotamine and dihydrogotamine)

Answer 47

X