surface-bound IgE-Ab complex; mast cells; basophils
Allergic reactions in the nose are mediated by the cross-linking of _______
which activates nasal _____ & ________.
arachidonic acid
IgE-induced mast cell degranulation causes the rapid release of preformed mediators from the _________ cascade.
kinins, PGD2, leukotrienes C4/D4, histamine
Nasal obstruction is caused by which inflammatory mediators? (5)
cytokines; recruitment
The late-phase reaction is caused by _______ & involves the _______ of inflammatory cells.
b
Hyperresponsive nasal pathways occur in
a) Immediate phase
b) Late-phase
reduce inflammation- reduce mediator release & suppress neutrophil chemotaxis; reduce edema & cause mild vasoconstriction; inhibit mast-cell mediated late phase reactions
Nasal steroids MOA? (3)
onset within few days; peak response in 2-3 weeks
When do we see the effects of Nasal steroids?
autacoid; short duration & local activity
What is the class of histamine?
pain & itching in sensory afferent neurons, arousal/waking, suppression of eating
How does Histamine affect the nervous system? (3)
vasodilation-releases NO, increased leaky vessels, recruits leukocytes
How does Histamine affect the CV system? (3)
smooth muscle, endothelium, brain (nerve endings)
Where are H1 receptors found?
muscarinic
H1 receptors are similar to ________ receptors
-zine & -amine suffix
What are the 1st Gen Anti-histamines?
-adine suffix
What are the 2nd Gen Anti-Histamines?
b
Which has NO CNS access?
a) 1st Gen
b) 2nd Gen
a
Which has significant anticholinergic effects?
a) 1st Gen
b) 2nd Gen
b
Which is usually longer acting?
a) 1st Gen
b) 2nd Gen
cetirizine, azelastine; 2nd
Which anti-histamines DON'T fall under the suffix rule?
Which generation are they?
a
Which are lipid-soluble?
a) 1st Gen
b) 2nd Gen
b
Which are P-gp substrates in the BBB?
a) 1st Gen
b) 2nd Gen
meclizine
Which 1st gen anti-histamine has a 12-24 hr half-life?
b
Which can prevent histamine release?
a) 1st Gen
b) 2nd Gen
muscarinic, a-adrenoceptor, serotonin
Which receptors do 1st gen act on besides H1? (3)
before allergen exposure
When are anti-histamines most effective?
a,d
Which is an active metabolite of Hydroxyzine?
a) cetirizine
b) fexofenadine
c) loratadine
d) levocetirizine
e) diphenhydramine
f) desloratadine
e
Which is most prone to causing sedation?
a) cetirizine
b) fexofenadine
c) loratadine
d) levocetirizine
e) diphenhydramine
f) desloratadine
f; acute type
H1 blockers are most useful in treating late-phase allergic reactions. T/F?
d
Which is a single enantiomer of Zyretc?
a) cetirizine
b) fexofenadine
c) loratadine
d) levocetirizine
e) diphenhydramine
f) desloratadine
b
Which is the active metabolite of Terfenadine?
a) cetirizine
b) fexofenadine
c) loratadine
d) levocetirizine
e) diphenhydramine
f) desloratadine
f
Which is the active metabolite of Claritin?
a) cetirizine
b) fexofenadine
c) loratadine
d) levocetirizine
e) diphenhydramine
f) desloratadine