Regal- Anti-inflammatory and Immunosuppressive Learning Exercises Flashcards Preview

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Flashcards in Regal- Anti-inflammatory and Immunosuppressive Learning Exercises Deck (29)
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1

What are the symptoms associated with hives?

Wheal and flare
Redness (vasodilation)
Swelling (edema- increased vascular permeability)
Pain

2

What inflammatory mediators are associated w/ Redness?

Histamine (mast cells/basophils)
PGE
PGI
Kinins

3

Which inflammatory mediators are associated with swelling?

Histamine
cytokines
leukotrienes
kinins

4

Which inflammatory mediators are associated w/ pain?

Kinins
PGE2,I2
LTB4

5

What mediator is associated with the intrinsic pathway and what does it do?

Kalikrein- converts:
kininogens-->kinins
FActor XII--> XIIa

6

Histamine stimulates what receptor?

R on smooth muscle cells/basophils/mast cells

H1, H1--are primary targets

7

What receptors do PGE and PGI stimulate?

EP
IP

8

What receptors do kinins stimulate?

Bradykinin
B1 and B2

9

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

10

Describe the pathological process of type I hypersensitivity?

Pollen crosslinks IgE>
Activates MC>
Release of:
Histamine
PGD2
TCR/D4/E4

11

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.

12

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

13

What is amalizumab?

Anti-IgE Ab--> has a broader effect than most drugs without compromising ability to combat infection

14

What drugs affect ACh?

Atropine
Diphenhydramine
Fexofenadine

15

What inflammatory mediators can cause bronchoconstriction?

ACh
Histamine
Bradykinin
Leukotrienes
PGs

16

How do increasing amts of Ach effect bronchoconstriction (dose response curve)?

As ACh increases, bronchoconstriction increases than plateaus

17

What is atropine?

Competitive antagonist

18

What does atropine do the the DRC?

shifts curve right

19

What are the adverse effects of atropine?

Dry mouth

20

What receptor do antihistamines effect?

H1 antagonists

21

What are the two older antihistamines and what do they do?

Diphenhydramine
Chlorepheniramine

Shift curve right but less than atropine

22

What are the adverse effects of older antihistamines?

Drying secretions
sedation
GI upsets

23

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

24

What are the four examples of non-sedating anti-histamines?

Centinizoline
Fexofenadine
loratadine

25

What does fexonfenadine do to the DRC?

Nothing

26

What drugs effect histamine?

Atropine
Diphenhydramine
Fexofenadine
Ibuprofen
prednisone

27

What does atropine do to the DRC?

nothing

28

What is diphenhydramine?

competitive antagonist of H1 receptor

29

What does diphenhydramine do to the DRC?

shifts curve right