Term
| Large numbers of mast cells are located in the...(3) |
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Definition
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Term
| Histamine is also synthesized in ___ and acts as ___. |
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Definition
Non-mast cells of gastric mucosa and epidermis
Acts as an NT in the CNS |
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Term
| Histamine exerts an ___ in ___. |
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Definition
Anabolic effect
Growth and repair |
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Term
| Inhibition of ___ doesn't affect the degradation of histamine |
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Definition
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Term
| Some ___ contain histamine. |
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Definition
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Term
| Re-exposure to the offending Ag causes ___ on ___, which results in ___ |
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Definition
IgE bridges form
Surface of the mast cell
Increased intracellular Ca and degranulation |
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Term
| Something released from mast cells elicits ___ |
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Definition
| De novo synthesis of bronchoconstrictors PGD2, LTC4, and LTD4 (LTC and LTD are the slow-reacting substances of anaphylaxis) |
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Term
| The majority of the inflammation and tissue damage caused by mast cell degranulation is actually ___, which explains why antihistamines ___ |
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Definition
Mediated by compounds other than histamine
Antihistamines are only partially effective in reversing the inflammatory reactions involved in hypersensitivity |
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Term
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Definition
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Term
| ___ producing ___ of mast cells also causes histamine release. |
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Definition
| Mechanical injury producing destruction of mast cells |
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Term
| Ag-induced histamine release (mast-cell degranulation) is inhibited by (2), MOA |
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Definition
Cromolyn sodium
Olapatadine
Both prevent the increase in intracellular Ca caused by IgE cross-bridging |
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Term
| See the chart on p. 346 for the role of histamine in the secretion of gastric acid. |
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Definition
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Term
| H1R second messenger system effects (5) |
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Definition
IP3
On arteriolar endothelium: synthesizes NO => hypotension and reflexly-mediate tachycardia (fast onset and offset)
Sensory nerve endings: pain, itching
Contraction of:
-Postcapillary venule endothelial cells => extravasation of plasma => local edema
-Bronchial smooth muscle => decreased ventilation, FEV1, PEFR
-GI smooth muscle => enhanced peristalsi => cramping, involuntary defecation |
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Term
| H2R second messenger system, effects (2) |
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Definition
Adenyl cyclase
Arteriolar VD => hypotension (slow onset and offset)
Parietal cell: increased acid secretion |
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Term
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Definition
Flush: histamine => VD => localized red spot at site of injury w/in a few seconds
Flare: histamine => axonal reflexes in sensory nerves => surrounding blood vessel VD => diffuse flush extending 1cm around site of injury, appears more slowly
Wheal: histamine => increased capillary permeability => edema localized at site of injury, several minutes |
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Term
| Stimulate sensory nerve endings to cause sensations of pain, itching, and burning = algesia (3) |
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Definition
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Term
| Immediate hypersensitivity reaction, drugs (2) |
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Definition
Bronchoconstriction => severe dyspnea
DOC bronchoconstriction is subcu EPI
Tx hypotension: H1 + H2 blockers = diphenhydramine + cimetidine |
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Term
| Gastric/duodenal ulcer: pathophysiology |
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Definition
Stimulation of H2R
Increased acid secretion
Promotes/exacerbates ulceration and can cause stress ulcers like in severe trauma (burns) |
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Term
| Cromolyn sodium: indications (3) and method of admin (4) |
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Definition
Asthma: inhaler
Allergy: eyedrops, nasal spray
Food allergy: oral |
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Term
| Olopatadine: indication, method of admin, also blocks... |
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Definition
Allergy: eyedrops
Also blocks H1R |
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Term
| H1R antagonists = antihistamines (13) |
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Definition
brompheniramine
cetirizine
chlorphenirmaine
cyproheptadine
desloratadine
dimenhydrinate
diphenhydramine
fexofenadine
hydroxyzine
loratadine
meclizine
olopatadine
promethazine |
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Term
| Most antihistamines are prego class ___ except HOP (3) |
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Definition
B
C:
-Hydroxyzine
-Olopatadine
-Promethazine |
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Term
| Most antihistamines are sedating except (4?) |
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Definition
Cetirizine
Fexofenadine
Loratadine
?Olapatadine? |
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Term
| If an antihistamine is sedating it's also ___. |
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Definition
|
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Term
| The least sedating/anti-emetic of the sedative antihistamines are (3) |
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Definition
Brompheniramine
Chlorpheniramine
Cyproheptadine |
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Term
| H1R blockade (both sedating and non-sedating antihistamines): effects (3) |
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Definition
Prevents bronchial and GI smooth muscle contraction
Inhibits pain and itching (sensory nerve endings)
Antagonizes the increased capillary permeability |
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Term
| Muscarinic-R blockade (sedating antihistamines only): effects (4) |
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Definition
Depress CNS
Inhibit nasopharyngeal secretion
Prevent motion sickness (vestibular nuclei)
Anti-emetic |
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Term
| Topical diphenhydramine: specific effect, MOA |
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Definition
Local anesthesia
Blocks Na channels in afferent sensory pain fibers |
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Term
| H1R blockers: indications (7) |
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Definition
Seasonal and allergic rhinitis
Acute hypersensitivity adjunct tx
Motion sickness
Pre-op sedation
N/v
Vertigo
Parkinson's
Don't use in serous otitis media! |
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Term
| Motion sickness: drugs (3) |
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Definition
Prophylaxis: dimenhydrinate
Diphenhydramine
Meclizine
Promethazine |
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Term
|
Definition
|
|
Term
| Vertigo (spontaneous bursts of semicircular canal activity): drugs, effects (2) |
|
Definition
Dimenhydrinate
Meclizine
Reduce the nausea, ataxia, nystagmus |
|
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Term
| Parkinson's: drug, effect |
|
Definition
Diphenhydramine
Treat central motor disorder caused by the antipsychotics |
|
|
Term
| Promethazine: method of admin (2), indications (6) |
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Definition
IM (not IV!)
Rectal suppository
Acute hypersensitivity
Allergic dermatoses
Motion sickness
Sedate anxious patients
Prevent post-op n/v
Tx n/v associated with GI infection |
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Term
|
Definition
CNS depression: decreased alertness, slowed reaction times, somnolence (potentiates CNS depression caused by other depressants)
CNS excitation: paradoxical, with overdose
Dizziness, tinnitus
Antimuscarinic (esp. in older patients): dry mouth and respiratory tract, urinary retention if have BPH, exacerbation of glaucoma |
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Term
|
Definition
Cimetidine
Famotidine
Ranitidine |
|
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Term
|
Definition
Inhibit basal and nocturnal acid secretion
Inhibit secretion of gastric acid induced by things like food, coffee, insulin, muscarinic agonists, increased vagal nerve activity, histamine agonists, and gastrin |
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Term
| H2R blockers: indications (5?) |
|
Definition
Gastric/duodenal ulcers
GERD
Prophylaxis for stress ulcers
Anaphylaxis
?Viral warts? |
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Term
|
Definition
|
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Term
|
Definition
Inhibits P450
-Can't breakdown estrogen => anti-androgenic effects
-Increases the t1/2 of things like B-blockers, warfarin, diazepam
CNS effects: mental confusion to over psychosis in older patients/prior hx psych disease/large doses for long period |
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