antihis/ leuko/gout
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- Name 3 2nd generation antihistamines.
-
1- Cetirizine
2-loratadine
3-fexofenadine - Name 2 ocular antihistamines.
-
1-Olopatadine
2- levocabastine - H1 receptors effect what molecule pathway?
- IP3
- H2 receptors effect what molecular pathway?
- adenylyl cyclase and increases cAMP
- When I say H2, you say _____(body part).
- stomach
- What are 5 side effects of H1 antagonists.
-
1- sedation
2- blurred vision
3- nervousness
4- dryness
5- urinary retention - Do 2nd generation antihistamines have a long/ or short duration of action?
- LOng (12-24 hours) this is good
- Name 5 things that can activate mast cells.
-
1- IgE
2- C5a, C3a
3- opiates
4- heat/cold trauma
5- chronic urticaria - The bind of Histamine to H1 causes _____, ___, and ___?
- iching, vasodilation and gastric acid production
- Histamine will ____ PR.
- Lower
- What effect does histamine and H1 have on the bronchial smooth muscle?
- bronchoconstriction
- Dont give antihistamines to ____ patients.
- asthmatic
- What drug is the "yin to the yang" of histamine. it has opposite effects.
- epinephrine
- Chromalins are a family of ________ and are given to patients with ____.
- mass cell stabilizers, asthma
- Leukotriene C4 is a _______ that causes ___ and _____.
- Bronchocontrictor, spasms and mucosal edema
- Could you use an antileukotriene for asthmatic patients.
- of course, this causes broncodilation
- What enzyme is resposible for the conversion of arachidonic acid into leukotrienes?
- 5-lipoxogenase
- What drug inhibits the SYNTHESIS of 5-lipoxogenase?
- Zileuton (inhibits synthesis)
- What 3 drugs competitively bind to the receptor of leukotrienes?
-
1- Montelukast
2- pranlukast
3- zafirlukast - Describe the onset of LTC4.
- late onset of about 3-4 hours
- Can you use Zafirlukast on patients with liver abnormalites?
- NO! (this is a competitive inhibitor of the receptor)
- What 3 drugs are used to treat gout?
-
1- NSAIDS
2- Colchincine
3- Uricosurics - Describe the metabolism of acetaminophen.
- metabolized in the liver through glucuronidation
- What are 2 molecules that you use up when overdosing on tylenol?
-
glucuronic acid
and glutathione - What does gout present as?
- recurrent episodes of acute arthritis
- What substance is laid down int the synovial fluid and tissues in gout?
- monosodium crystals
- In gout you will see ___ levels of blood and urinary uric acid levels.
- increased
- Gout occurs mostly in ___.
- men
- Uric acid is the end product of ___ metabolism.
- purine
- Can renal dysfunction cause gout?
- yes, we excrete uric acid, if this process is reduced we get a build up of the uric acid.
- Is uric acid filtered through the glomerulus?
- no, it is called tubular secretion--presented directly from the blood
- In what part of the nephron is the pump that pumps uric acid from the blood into the tubule?
- DCT
- What are 4 ways to acquire hyperuricemia?
-
1- eat too much
2- hematologic (break down too many cells
3- drugs
4- disease like obesity...... - What are some drugs that decrease the renal excretiong of urate?
-
1- cyclosporine
2- thiazides
3-loops
4- aspirin
5-levodopa
6-nicotinic acid - What is the best drug (2)to use to treat acute gout?
-
NSAIDS- Indomethacin (for pain)
Colchicines - What is the anti-inflammatory drug used in treating gout?
- Cholchicines
- Does Cholchicine relieve pain?
- No
- When exactly shoudl you take chochicine?
- at the first sign of attackq
- What is a drug you can use to treat long-term gout? Describe this drug.
- uricosuric, it increases renal excretion and thus uric acid excretion
- What drug competes with the reabsorption of uric acid and thus more uric acid is excreted?
- probenecid
- ______ blocks uricosuric effects.
- salicylates
- _____ is an uricosuric drug.
- probenecid
- What drug inhibits xanthine oxidase?
- allopurinol
- _______ is the enxzyme that forms uric acid.
- xanthine oxidase