Histamine

Front 1

An endogenous substance synthesized, released and stored from mast cells, basophils, and neurons.

Back 1

Histamine

Front 2

These cells are found in skin, GI tract, and the respiratory tract.

Back 2

Mast cells

Front 3

These cells are found in the blood.

Back 3

Basophils

Front 4

These are found in the peripheral and central NS and release histamine.

Back 4

Neurons.

Front 5

___is synthesized from histidine (an amino acid) by the inducible enzyme l-histidine decarboxylase.

Back 5

Histamine

Front 6

Histmaine is metabolized via 2 pathways: name both.

Back 6

1. Methylation to N-methyl histamine and then to N-methyl imidazole acetic acid (MAO) prior to urinary excretion.
2. Oxidative deamination to imidazole acetic acid (DAO) and them to imidazole acetic acid ribose prior to urinary exrcretion.

Front 7

What drug will cause higher levels of histamine?

Back 7

MAO-inhibitors b/c they inhibit MAO, part of the metabolic process of histamine.

Front 8

Allergens rec. by ___cells and produces____towards that allergen.

Back 8

plasma; antibodies.

Front 9

Antibodies then attach to ___cells and cause release of ____.

Back 9

Mast cells; histamine. Histamine then binds to histamine receptor.

Front 10

Histamine receptors are are members of what receptor family?

Back 10

G-protein coupled receptors.

Front 11

What forms of histamine are r/t to ACUTE allergic reactions.

Back 11

H1

Front 12

This Histamine receptor is located bronchial smooth muscle, intestinal smooth muscle, cardiac endothelium, cardiac tissue and CNS.

Back 12

H1

Front 13

Allergens rec. by ___cells and produces____towards that allergen.

Back 13

plasma; antibodies.

Front 14

This type of histamine receptor is found in vascular SM, cardiac tissue, basophils, and parietal cells

Back 14

H2

Front 15

These histamine receptors are found t/o the CNS

Back 15

H3

Front 16

These histamine receptors are found in bone marrow and WBC

Back 16

H4

Front 17

This histamine receptor has a role in secretion of gastric acid

Back 17

H2

Front 18

This histamine receptor is important for modulating neurotransmission.

Back 18

H3

Front 19

These histamine receptors are important in regulating the immune response

Back 19

H4

Front 20

Mild cutaneous response to histamine

Back 20

erythema, urticaria, and/or itching.

Front 21

Mild to moderate histamine reactions

Back 21

skin reactions, tachycardia, dysrhythmia, hypotension, mild resp. distress.

Front 22

Severe anaphylactic symptoms include:

Back 22

hypotension, ventricular fibrillation, cardiac arrest, bronchospasm, respiratory arrest.

Front 23

What histamine receptors cause vasodilation of small blood vessels?

Back 23

H1 and H2

Front 24

This histamine receptor causes an increase in post-capillary venules.

Back 24

H1

Front 25

What is the are the "steps" in the triple response?

Back 25

Localized red spot (w/n sec), Flare (due to reflexive vasodilation), wheal (as a result of inc. capillary permeability)

Front 26

The binding of what 2 histamine receptors cause increase in inotropy (force)

Back 26

H1 and H2

Front 27

What receptor causes an increase of chronotropy?

Back 27

H2

Front 28

What receptor causes decreased AV conduction?

Back 28

H1

Front 29

What histamine receptor causes direct bronchoconstriction, and increased mucus viscosity?

Back 29

H1

Front 30

What histamine receptor causes SLIGHT bronchoDILATION, and increase mucous SECRETION?

Back 30

H2

Front 31

What histamine receptor causes a cough?

Back 31

H1

Front 32

What histamine receptor causes increased acid secrtion in the GI tract (parietal cells?/HCL)

Back 32

H2

Front 33

What two receptors cause cutaneous itching and PAIN.

Back 33

H1 and H2

Front 34

This histamine receptor causes presynaptic inhibition of histamine synthesis and release.

Back 34

H3

Front 35

This histamine causes regulation of DA, GABA, Ach, 5-HT, and NE.

Back 35

H3

Front 36

Food examples of direct histamine releasers:

Back 36

peanuts, strawberries, eggs, milks...

Front 37

Drug examples...

Back 37

PCN, sulfonamides.

Front 38

Fire ants, snake, bee

Back 38

examples of venom that cause histamine release

Front 39

examples of foreign proteins that cause histamine release:

Back 39

non-human insulin/serum proteins.

Front 40

What generation of H1 receptor antagonists is sedating?

Back 40

1st generation is very sedating. 2nd generation non-sedating.

Front 41

These drugs inhibit degranulation of mast cells and thereby prevent histamine release.

Back 41

Mast cell stabilizers.

Front 42

What is the #1 problem with H1 receptor antagonists?

Back 42

Very Sedating.

Front 43

What generation of H1 receptor antagonists is sedating?

Back 43

1st generation is very sedating. 2nd generation non-sedating.

Front 44

Diphenydramine

Back 44

1st generation H1 antagonist

Front 45

Hydroxyzine

Back 45

1st generation H1 rec. antagonist.

Front 46

Chlorpheniramine

Back 46

1st generation H1 receptor antagonist.

Front 47

Cyclizine

Back 47

1st generation H1 recp. antagonist. Tx: motion sickness

Front 48

Dimenhydrenate

Back 48

1st genertion H1 recp. antagonist. Tx: motion sickness

Front 49

Meclizine

Back 49

1st generation H1 receptor blockers. Tx: motion sickness.

Front 50

Promethazine

Back 50

1st generation H1 recp. blocker. Tx: nausea.

Front 51

1st generationg H1 recp. antagonists are ___/___antagonists.

Back 51

reversible/competitive

Front 52

1st gen. H1 Recp. Blockers also have mild___effects=anti-___

Back 52

anticholinergic; anti-slude

Front 53

1st generation H1 receptor blockers cross the___ and ____.

Back 53

BBB and placenta. Careful in pregnant women.

Front 54

Adjuvant to epi c/ anaphylactic, relief of allergy sx, sedation/sleep aid, prevention of motion sickness, vertigo, N/V, local anesthetic and anitussive.

Back 54

Uses for 1st generation H1 blockers.

Front 55

Sedation (c/ paradoxical effects in children; excitation), dizzy, fatigue, tacycardia, dysrhythmias, allergic rx w/ topical use, peripheral anti-msucarinic effects.

Back 55

Adverse effects of H1 receptor blockers (antagonist).

Front 56

Avoid what types of dugs with 1st generation oH1 receptor antagonist.

Back 56

MAO-Inhibitors.

Front 57

1st generation H1 blockers will cause synergystic AE when gvien with ___&___.

Back 57

antimuscarinics and CNS depressants.

Front 58

Acrivistine

Back 58

2nd generation H1 blocker

Front 59

Fexofenadine (allegra)

Back 59

2nd generation H1 blocker

Front 60

Loratidine (claritin)

Back 60

2nd generation H1 blocker

Front 61

Cetirizine (zyrtec)

Back 61

2nd generation H1 blocker

Front 62

Desloratadine

Back 62

2nd generation H1 receptor blocker.

Front 63

What 2nd generation H1 blocker has more of a CNS effect and therefore not recommended in pilots?

Back 63

Cetrizine

Front 64

What three 2nd generation H1 blockers are secreted in an unmetabolized form?

Back 64

Cetrizine/Loratadine/Fexofenadine.

Front 65

___/___are secreted in the urine.

Back 65

Cetrizine and Loratadine

Front 66

___is excreted in the feces.

Back 66

Fexofenadine.

Front 67

Cimetidine

Back 67

H2 receptor antagonist

Front 68

Nizatadine

Back 68

H2 receptor antagonist

Front 69

Famotiadine (pepcid)

Back 69

H2 receptor antagonist.

Front 70

Ranitidine (zantac)

Back 70

H2 receptor blocker

Front 71

H2 recptor blockers are used for what?

Back 71

reduce gastric acid (HCL) production by parietal cells of GI tract. Tx: GERD.

Front 72

Cromolyn Sodium and Nedocromil are examples of what?

Back 72

Mast cell stabilizers.

Front 73

Adveres effects of Mast cell stabilizers are?

Back 73

cough and bitter taste, which decrease pt. compliance.

Front 74

Use for mast cell stabilizers?

Back 74

Prophylactic treatment of asthma and allergic rhinitis.