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66 Cards in this Set
- Front
- Back
Histamine is formed from what
|
histidine
occurs primarily bound to heparin in mast cells and basophils |
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mast cells are important initiators of what
|
allergic reactions
|
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mast cells promote what kind of response and how
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inflammatory response by providing mediators which initiate chemotaxis of leukocytes
|
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where do mast cells highly occur
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lung
GI tract skin |
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basophils are primarily found where
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the blood
|
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what are the factors involved in histamine release
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mast cells respond to injury by increasing blood flow
histamine is release from mast cells by antigen antibody interactions |
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what are the 2 receptors for histamine
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H1
H2 |
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activation of H1 receptors causes what
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vasodialation increased capillary permeability, nerve ending stimulation, and bronchiolar and intestinal constriction
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H2 receptors are most important for what
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gastric acid secretion
they also mediate some cardiac and CNS actions of histamine and contribute to vasodialation |
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the dominant actions of histamine are on ?
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blood vessels
other smooth muscles afferent nerve endings (H1 receptors) secretion of gastric acid and pepsin (H2) |
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what is the triple response
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red spot (vasodialation)
wheal (fluid leakage causing edema) flare (diffuse redness due to nerve stimulation) itching and pain usually accompany this as well |
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what does histamine constrict
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nonvascular smooth muscle including bronchioles, gut, and urinary bladder
|
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the allergic response to the release of histamines ranges from what to what
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hives--> anaphylactic shock
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antihistamines that are H1 receptor antagonists are used to treat primarily
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allergic reactions other than anaphylaxis
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antihistamines come from ___ chemical classes and are (specific/non specific) in structure and (small/large)
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7
non specific large |
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antihistamines antagonize all the components of the ______ ______
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triple response
|
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what is the triple response again
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vasodilation
increased capillary permeability stimulation of nerve endings |
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what are the 6 antihistamine H1 receptor antagonists drugs
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diphenhydramine
promethazine chlorpheniramine loratadine fexofenadine meclizine |
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H2 receptor antagonists are used for what
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ulcer therapy
esophageal reflux hypersecretory states |
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what are the 4 H2 receptor antagonists drugs
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cimetidine
ranitidine famotidine nizatidine |
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what does H1 do
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allergic response
|
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what does H2 do
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gastrointestinal: release of acid and pepsin
|
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what do H1 and H2 have in common
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both cause vasodilation
|
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Promethazine
- what kind of drug - MOA - whats it used for |
- antihistamentic
- H1 receptor antagonist - used as antiemetic to decrease throwing up like to chemo treatment |
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Diphenhydramine
- what kind of drug - MOA - what else is it known as |
- antihistamentic
- H1 receptor antagonist - benadryl |
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Chlorpheniramine
- what kind of drug - MOA |
- antihistamentic
- H1 receptor antagonist |
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which three H1 receptor antagonists (H1 blockers) produce a lot of sedation
|
Diphenhydramine
Promethazine Chlorpheniramine - get into brain - good for allergic responses |
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Loratadine
- kind of drug - MOA - what are they good for |
- antihistamentic
- H1 receptor antagonist - allergic responses |
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Fexofenadine
- Kind of drug - MOA - what are they good for |
- antihistamentic
- H1 receptor antagonist - allergic responses |
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which 2 H1 receptor antagonists can be used by prescription only
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Loratadine
Fexofenadine - don't cross blood brain barrier readily |
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Meclizine
- kind of drug - MOA - what is it good for |
- antihistamentic
- H1 receptor antagonist - motion sickness |
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what are H2 receptor antagonists beneficial for
|
gut
GI tract - decrease secretion of acid and pepsid into tract |
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what do H2 receptor antagonists treat
|
peptic ulcers
reflux disease |
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Cimetidine
- kind of drug - MOA - what does it treat - other info |
- antihistamentic
- H2 receptor antagonist - treats ulcers and reflux - has untoward effects. duration isn't long so have to take more doses |
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Rantidine
- kind of drug - MOA |
- antihistamentic
- H2 receptor antagonist |
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Famotidine
- kind of drug - MOA |
- antihistamentic
- H2 receptor antagonist |
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Nizatidine
- king of drug - MOA |
- antihistamentic
- H2 receptor antagonist |
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whats the principal function of the respiratory system
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exchange oxygen and carbon dioxide
|
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what was the most important respiratory disease at the turn of the century
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tuberculosis
|
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how was tuberculosis reduced
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isoniazid
|
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what was the main respiratory disease in the 1930s and how was it controlled
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pneumococcal pneumonia
- controlled by penicillin |
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what are the top 4 leading causes of death
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heart disease
cancer stroke chronic lower respiratory diseases |
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what is asthma
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inflammatory disease with associated bronchospasm
|
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what are the symptoms of asthma
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wheezing
breathlessness cough mucosal edema production of mucoid sputum |
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what is the main symptom of asthma in children
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persistent cough
|
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asthma exacerbations are characterized by decreases in what
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expiratory airflow
|
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what are the 2 types of drugs for asthma
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quick relief medications
long term controllers |
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what are the 3 types of quick relief medications
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inhaled beta 2 adrenoceptor agonists
anticholinergic systemic corticosteroids |
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inhaled beta-2 adrenoceptor agonists
- what do they do |
- relaxation in airways
- quick relief |
|
Albuterol
- what kind of drug - what does it do - adverse effects (acute/chronic) |
- inhaled beta 2 adrenoceptor agonist
- relief of acute symptoms. preventative treatment prior to exercise induce asthma - acute: tremors or shakes b/c it could make too much ACh - chronic: no impact on chronic airway inflammation |
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cholinergic antagonism
- what do they do |
- second line drug in treating bronchial asthma but first line in treating COPD
|
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Ipratropium
- king of drug - what does it do - mechanism - adverse effects |
- highly charged anticholingergic
- relief of acute bronchospasm. alternative for patients with intolerance to beta 2 agonists - bronchodilation by competitive inhibition of muscarinic cholinergic receptors - dry mouth, increased wheezing first line for COPD |
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systemic corticosteroids
- what form are they in - other |
- pill or shot form
- be in bloodstream for short period of time |
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Prednisone
- kind of drug - what does it do - mechanism - adverse effects |
- systemic corticosteroids
- for short term burst to gain control, speed recovery and prevent recurrence - anti-inflammatory by reduce airways hyperresponsiveness. blocks late reaction to allergens - increased appetite, fluid retention, mood alterations given if attack is really bad change your carb and protein metabolism |
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long term controllers
- what do they treat |
- inflammation of asthma
|
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what are the 6 types long term controller drugs
|
inhaled corticosteroids
histamine release inhibitors leukotriene modifiers oral long acting inhaled beta 2 adrenoceptor agonists systemic corticosteroids methylxanthine (theophylline sustained release) |
|
Beclomethasone
- kind of drug - indication - mechanism - adverse effects |
- inhaled corticosteroids
- long term prevention of symptoms; suppression, control and reversal of inflammation - same as systemic corticosteroids - cough, dysphonia, oral thrush |
|
Fluticasone
- kind of drug - indication - mechanism - adverse effects |
- inhaled corticosteroids
- long term prevention of symptoms; suppression, control and reversal of inflammation - same as systemic corticosteroids - cough, dysphonia, oral thrush (yeast infection of mouth) limited to the lungs |
|
Cromolyn
- kind of drug - indications - mechanism - adverse effects |
- histamine release inhibitor (powder)
- long term prevention of symptoms, preventative treatment prior to exposure to exercise or allergen - stabilize mast cell membranes and inhibit activation and release of mediators from eosinophils and epithelial cells - irritant effect of powder VERY SAFE |
|
Zafirlukast
- kind of drug - indications - mechanism |
- leukotriene modifiers oral
- prevention of mild persistent asthma - leukotriene inhibitor (LT D4 and LT E4) receptor blockers on bronchial smooth muscle |
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Montelukast
- kind of drug - indications - mechanism |
- leukotriene modifiers oral
- prevention of mild persistent asthma - leukotriene inhibitor (LT D4 and LT E4) receptor blockers on bronchial smooth muscle |
|
Zileuton
- kind of drug - indications - mechanism |
- leukotriene modifiers oral
- prevention of mild persistent asthma - enzyme blocker: 5-lipoxygenase inhibitor |
|
Salmeterol (brace yourself)
- kind of drug - indications - mechanism |
- long acting inhaled beta 2 adrenoceptor agonist
- long term prevention of symptoms, especially nocturnal symptoms. prevention of exercise- induced bronchospasm - bronchodilation by stimulating cAMP which causes relaxation |
|
Salmeterol continued
- adverse effects - therapeutic comments |
- skeletal muscle tremor, tachycardia, hypokalemia
- not to be used to treat acute symptoms or exacerbations. to achieve 75% maximal effect takes one hour compare to 5 min for short acting inhaled beta 2 adrenoceptor agonists |
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Prednisone
- kind of drug - indications - mechanism - adverse effects |
- systemic corticosteroid
- long term prevention of symptoms in severe asthma - anti-inflammatory by reduce airway hyperresponsiveness. inhibit cytokine production, adhesion protein activation, and inflammatory cell migration and activation - adrenal axis suppression, growth suppression, moon face, buffalo hump, mood alterations |
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Methylxanthine
- where is it found - indications - mechanism - adverse effects |
- coffee and tea
- prevention of symptoms especially nocturnal symptoms - very good bronchodilator. mainstay in tx of bronchial asthma. serum concentration monitoring is essential due to signif. toxicity, narrow therapeutic range and individual difference in metabolic clearance - too much can cause cardiac arrythmias and seizures so measure blood levels at least once a month increases cyclic AMP |