Term
| Type I (immediate hypersensitivity) Allergic Rxn |
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Definition
| interaction of allergen with IgE-sensitized mast cells results in release of histamine & other mediators; may be localized to site of allergen exposure or it may be generalized anaphylactic response --> life-threatening, severe angioedema, bronchospasm, urticaria, hypotension, capillary leakage, & shock |
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Term
| Type II (cytotoxic or autoimmune) Rxn |
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Definition
| attachment of IgG or IgM Abs to target cells followed by complement activation & cell lysis; leads to: hemolytic anemia, agranulocytosis, or neutropenia |
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Term
| Type III (immune complex) Rxn |
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Definition
| circulating Ag & IgG complexes that localize near vascular wall & activate complement; leads to mast cell degranulation & an inflammatory response that manifests as "serum sickness" & a defuse vasculitis |
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Term
| Type IV (cellular immune response) Rxn |
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Definition
| Ag stimulation of sensitized T-cells; involved in delayed hypersensitivity conditions like allergic contact dermatitis & hypersensitivity pneumonitis |
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Term
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Definition
| group of disorders characterized by intermittent reversible obstruction of airways; hallmark feature: hypersensitivity of airway to agents that are capable of causing bronchoconstriction (ACh, histamine); results from immunologically-mediated damage to bronchial epithelium |
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Term
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Definition
| precipitation of symptoms related to exposure to specific environmental allergens |
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Term
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Definition
| precipitation of symptoms provoked by a variety of stimuli: cold, exertion, infection, stress, etc. |
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Term
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Definition
| bronchospasm, wheezing, cough, increased mucus production, & increased vascular permeability, congestion, pulmonary edema, airway inflammation, & WBC infiltration |
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Term
| Inhibits release of histamine (degranulation) |
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Definition
| cromolyn sodium [Intal]; agents that increase cAMP & stabilize mast cells (methylxanthines, beta-agonists); corticosteroids |
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Term
| inhibit formation of generated autocoids (i.e. kinins, leukotrienes, superoxides, platelet activating factor, & arachidonic acid products) |
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Definition
| zileuton [Zyflo] --> inhibits lipooxygenase enzyme, decreasing leukotriene formation; zafirlukast [Accolate] & monteleukast [Singulair] --> leukotriene receptor blockers |
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Term
| block receptors for autocoids or bronchoconstrictors |
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Definition
| H1-antihistamines; anticholinergic meds (ipratropium, tiotropium) |
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Term
| bronchodilation by "physiologic antagonists" |
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Definition
| beta-adrenergic agonists (epinephrine, isoproterenol, terbutaline, salmeterol); methylxanthines (theophylline, aminophylline) |
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Term
| prevent inflammation & cell-mediated immunologic reactions |
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Definition
| corticosteroids; immunosuppressives [methotrexate, cyclosporine] |
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Term
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Definition
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Term
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Definition
| inhibits release of histamine & other autocoids; used mainly for prophylactic treatment of bronchial asthma (inhalation) - NOT EFFECTIVE in acute attacks); ADRs are infrequent (bronchospasm, laryngeal edema, HA, rash, nausea); PRIMARY DRUGS for treatment of asthma in CONJUNCTION with other agents (bronchodilators and immunosuppressives); MOST USEFUL in treatment of EXTRINSIC asthma |
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Term
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Definition
| useful in treating allergic rhinitis & allergic dermatitis; NOT EFFECTIVE in treating bronchospastic conditions; SEs: dries secretions |
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Term
| anticholinergic agents (ipratropium [Atrovent], tiotropium [Spiriva]) |
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Definition
| prevents bronchospasm indcued by ACh - limited effectiveness; ADRs: dries secretions; produces few systemic effects due to quaternary nature; used in combination with albuterol [Combivent] |
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Term
| Beta-Adrenergic Agonists (epinephrine, metaproterenol, isoproterenol, albuterol, levalbuterol, salmeterol, terbutaline, pirbuterol) |
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Definition
| act as bronchodilators & inhibit release of autocoids from mast cells; act quickly & are fairly effective in treating acute asthma attack; ADRs: CNS stimulation (anxiety, tremors, restlessness, irritability); development of tolerance & rebound bronchoconstriction are major problems |
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Term
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Definition
| drug of choice in treating life-threatening anaphylactic rxns |
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Term
| methylxanthines [theophylline, aminophylline] |
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Definition
| cause bronchodilation & may inhibit release of mediators from mast cells; inhibits phosphodiesterase leading to increased cAMP in smooth muscle & mast cells; interacts with adenosine receptors; have NARROW THERAPEUTIC WINDOWS --> monitor blood levels; Toxic Effects: mild - nausea, vomiting, HA, insomnia, & nervousness; severe - cardiac arrhythmias, seizures |
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Term
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Definition
| methylxanthine taken orally in conjunction with other agents in more severe forms of asthma; available in time-release preparations |
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Term
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Definition
| more water soluble methylxanthine; given IV for treatment of severe asthma attacks |
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Term
| corticosteroids (glucocorticoids: cortisone, prednisone) |
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Definition
| have anti-inflammatory activity, inhibit recruitment of leukocytes into inflammatory response; inhibit synthesis or release of autocoids including prostaglandins, thromboxanes, leukotrienes, platelet activating factor, etc.; VERY BENEFICIAL in reducing severity of cell-mediated immunological damage to bronchial epithelium; very effective PROPHYLACTICALLY, not in acute attacks; |
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Term
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Definition
| development of cataracts (inhaled); Cushing syndrome; suppression of immune system; osteoporosis; peptic ulceration; suppression of growth in children; suppression of HPA axis; menstrual & reproductive problems |
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Term
| zafirleukast [Accolate] & monteleukast [Singulair] |
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Definition
| cysteinyl leukotriene receptor antagonists; oral - chronic use to reduce frequency & severity of asthma attacks; less effective than corticosteroids; approved for treatment of seasonal allergies |
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Term
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Definition
| 5-lipoxygenase inhibitor; oral - reduces frequency & severity of asthma attacks; potential elevation of liver enzymes & hepatotoxicity; take 4x per day |
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Term
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Definition
| prevention of bronchospams; stabilization of patients |
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Term
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Definition
| use only a simple bronchodilator therapy (albuterol, levalbuterol, etc) |
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Term
| More severe asthma therapy |
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Definition
| requires long-term treatment with a combo of drugs: bronchodilator --> acute attacks; stabilizing agent (cromolyn) + antiinflammatory steroid or leukotriene modulator |
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Term
| Drugs for treatment of Anaphylaxis |
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Definition
| epinephrine, theophylline & isoproterenol, dopamine, corticosteroids, H1-antihistamines |
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Term
| treatment of Mild Allergies |
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Definition
| H1-antihistamines are ideal drugs of choice; mast cell stabilizers or corticosteroids used in more severe allergies; monteleukast (Singulair) for seasonal allergies; systemic corticosteroids for most severe allergies |
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