Hosam Mohamed-
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
