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Autacoids, Antihistamines, Corticosteroids

rename
olola's version from 2016-11-07 13:24

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Question Answer
H1 receptor anatagonist, clinically used in nasal decongestant/cold preps, has sedative propertieschlorpheramine
H1 receptor anatagonist, in which Nitrogen atom exists in an aliphatic side chainDiphenhydramine (Benadryl)
H1 receptor anatagonist, in which Nitrogen atom exists in a ring structuremeclizine
antihistamines with LA effectsDiphenhydramine (Benadryl), Promethazine
antihistamine used to cause sedation in OTC prep, or to decrease sedation in general anesthesiaPromethazine, Hydroxyzine
antihistamine used to treat nausea, vomiting, motion sicknesspromethazine
second gen antihistaminesFexofenadine (Allegra), Loratadine (Claritin), Levocabastine (Livastin) - drugs with NO significant CNS effects b/c can't pass BBB
H2 receptor antagonistCimetidine (Tagamet)
generally well-tolerated, but adverse effects are- CNS effects, liver problems, endocrine effects, blood dyscrasia, bone marrow depression, MANY drug interactionsCimetidine (Tagamet)
rightward shift in dose response curve for acid productionCimetidine (Tagamet)
relative potency of adrenal corticosteroidsHydrocortisone < Prednisone / Prednisolone (4x) < Triamcirolone (5x) < Dexamethasone or Betamethasone (25x)
Short-acting adrenal corticosteroids (8-12 hrs)Cortisone, Hydrocortisone
Intermediate-acting adrenal corticosteroids (18-36 hrs)Methylprednisolone, Prednisolone, Prednisone, Triamcinolone
Long-acting adrenal corticosteroids (36-72 hrs)Betamethasone, Dexamethasone, Paramethasone
Dexamethasone is ___ more portent than hydrocortisone25x
Betamethasone is ___ more potent than hydrocortisone25x
Triamcirolone is ___ more potent than hydrocortisone5x
Prednisone and Prednisolone is _________ more potent than hydrocortisone4x
corticosteroids are classified byDuration of action (t1/2)- Short-acting (<12 hr), Intermediate-acting (12-36 hr), Long-acting (>36 hr)
used to alleviate migrainesserotonin (by stimulating release of autocoids)
used to induce laborprostaglandins (by stimulating release of autocoids)
used to treat peptic ulcers by stimulating release of autocoidsprostaglandins
serotonin has what effect on vascular smooth muscle, and nonvascular smooth muscle?vasoconstriction on vascular smooth muscle, contraction of GI and other nonvascular smooth muscle. Also stimulates platelet aggregation and acts as a CNS neurotransmitter
antihistamines that are also antipsychotic agentsPhenothiazine, Chlorpromazine
T/F? Second gen antihistamines are used often in dentistry.FALSE! 2nd gen don't have systemic effects so not used often in dentistry. 1st Gen is used more often!
common side effect of these antihistamines is CNS depression at high dosesEthanolamines, Phenothiazines
this antihistamine has potential teratogenicityDoxylamine
all H2 antagonists are rapidly and completely absorbed after oral administration EXCEPT _______famotidine
H2 antagaonists have a slow or rapid onset?SLOW onset b/c there are many steps that it must block, takes 3 hrs or more
there are many drug interactions with Cimetidine/Tagamet, b/cCimetidine is a H2 anatagonist that INHIBIT p450 enzymes and reduces hepatic blood flow > increasing blood concentration of other drugs > thus patients should be given less dose of them
main steroid structure isPregnane (21 C)
Natural or Synthetic corticoids are more potent and more specific to glucocorticoidsSynthetic are more potent and longer-acting
composition of Aldosteronemainly a Mineralcorticoid (30,000x more than a glucocorticoid), so mainly used for sodium retention
composition of Hydrocortisone1:1 Glucocorticoid to Mineralcorticoid, so used for both Liver glycogen deposition & Sodium retention
composition of Dexamethasonemainly a Glucocorticoid (25x more than a mineralcorticoid), so mainly used to Liver Glycogen deposition
_____ levels influence aldosterone secretionAngiotensin II (followed by renin release), NOT BY CORTISOL LEVELS. Hyponatremia and Hyperkalemia promote aldosterone secretion!
corticosteroids are contraindicated in pts with ______Infections, e.g. Herpes, b/c glucocorticoids can increase chance of infections; and contraindicated in pts with Diabetes b/c glucocorticoids can cause hyperglycemia and glucosuria
examples of synthetic glucocorticoidsPrednisone, Dexamethasone, Triamcinolone
some tissues contain more histamine than others (>6 ug/g)lung, nasal mucosa, stomach, duodenum, facial skin
"classic antihistamines"H1 antagonists
Misoprostola prostaglandin analogue, that binds to both epithelial and parietal cells, to increase mucus + bicarb secretion in epithelial cells, and acid secretion in parietal cells
T/F? Corticosteroids are stored in the bodyFalse! They are continuously synthesized and secreted, in a diurnal variation (plasma conc is highest at 8am)
Hyponatremia and Hyperkalemia stimulate the release ofAldosterone
____% of corticoids are bound to plasma proteins, primarily ____90%, to alpha globulin (transcortin)
which glucocorticoids have longer half-livessynthetic ones (Prednisolone, Dexamethasone, Triamcinolone)
T/F? Corticoids have potential to cause greater harm than goodtrue
which classifications of glucocorticoids are preferred for long-term use in the treatment of chronic inflammatory disordersIntermediate-acting (12-36hr) and Long-acting (>36 hr), b/c they have greater ratio of glucocorticoid activity
Biologic half-life of corticosteroid is defined asthe period of suppression of the hypothalamo-pituitary-adrenal axis
T/F? Corticosteroids are contraindicated in diabeticsTrue!
T/F? Corticosteroids are contraindicated in pts with Infections?True!
Lipocortinanti-inflammatory corticosteroid that affects phospholipase A2 and arachidonic acid breakdown, results in inhibition of COX
all corticosteroids are absorbed in GIT except ____________Desocycorticosterone
these drugs are used in dentistry for Oral ulcers, Pulpal hypersensitivity, TMD, postop sequelae, Anaphylaxis and other allergic rxsCorticosteroids
administration of angiotensin results inincreased blood pressure
which of the following pharmacologic actions is NOT produced by prostaglandins?increased gastric acid secretion (prostaglandins DECREASE gastric acid secretion)
All of the following statements with regard to the autacoid prostaglandin are correct EXCEPTderived from essential amino acids (they're derived from essential fatty acids)
In man, which of the following responses is NOT caused by histamine?bronchodilation
Epi antagonizes the effects of histamine byproducing physiologic actions opposition to that of histamine
The mechanism of action of H1 antihistamines iscompetitive antagonism
Gastric acid secretion has been shown to be most effectively reduced with the use ofH2 histamine receptor antagonists
Cimetidine is administered toinhibit gastric secretion
Which of the following antihistamines is most commonly used as preoperative medications?promethazine
Which of the following drugs is useful in treating dermatologic manifestations of an allergic response?Chlorpheniramine (1st gen H1 antagonist)
Which of the following is a frequent side effect of antihistamine therapy?drowsiness
Which of the following is not a property of diphenhydramineblocks the depressor effect of isoproterenol- (But Diphenhydramine/Benadryl DOES relieve bronchospasm induced by histamine, inhibits wheal formation after intracutaneous histamine, inhibits contractiosn of isolated intestine caused by histamine, reduces anaphylaxis induced by horse serum in sensitized guinea pigs)
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