Pbt Treatment Of Hypersensitivity

Front 1

what are the alternate names for type I injuries?(2)

Back 1

1. atopy
2. allergy

Front 2

what is the most common immune mediated clinical entity?

Back 2

allergic rhinitis

Front 3

Mr. X comes into the office in June complaining of nasal congestion and repeated sneezing. Physical examine reveals pale nasal mucosa, a transverse crease, and light bruising under the eyes. What does he have?

Back 3

allergic rhinitis

Front 4

what is the most common and accurate method of identifying offending antigens (allergens)?

Back 4

skin test

Front 5

how are mast cells activated in type I hypersensitivity?

Back 5

the have receptor for Fc region on IgE so when IgE binds allergen then mast cell becomes activated

Front 6

what is the name of the chemotactic factor that attracts eosinophils to sites of mast cell activation?

Back 6

ECF

Front 7

what effect does histamine have when it binds to H1 receptors?

Back 7

increases IP3 and DAG formation from PIP

Front 8

the immediate, localized symptoms of an allergy are cause by?

Back 8

histamine release

Front 9

what is responsible for persistent inflammation after histamine wears off?

Back 9

Leukotrienes

Front 10

what are leukotrienes derived from?

Back 10

arachadonic acid

Front 11

in addition to histamine, what anti-clotting agent is released during degranulation of mast cells?

Back 11

heparin

Front 12

why is there usually eosinophilia with nasal discharge?

Back 12

mast cells release ECF which attracts eosinophils to the site of degranulation

Front 13

What is the drug? Treatment of allergic rhinitis.

H1-antagonist of the ethanolamine class

Significant antimuscarinic activity (H1 receptor is related to muscarinic receptor so some crossover happens). Produce marked sedation in most patients.

Back 13

Diphenhydramine (Benadryl)

Front 14

What is the drug? (2)Treatment of allergic rhinitis.

H1-antagonist of the ethanolamine class

It is the active metabolite of another H1-antagonist, terfenadine

Does not cause drowsiness- less crossover to the CNS

At higher doses, it is irreversible

Back 14

Loratadine (Claritin)Fexofenadine (Allegra)

Front 15

what can be used as a long-term prophylaxis for allergic rhinitis?
# Cytotoxic to leukocytes
# Nasal spray

Back 15

Corticosteroids

Front 16

how do corticosteroids cause their anti-inflammatory action?

Back 16

stimulate the synthesis of phospholipase A2 inhibitory proteins called lipocortins which inhibit release of arachadonic acid

Front 17

what are the two corticosteroids availible for treatment of allergic rhinitis?

Back 17

1. Fluticasone Propionate (Flonase) -> alright
2. Cromolyn sodium (NasalCrom) -> best, but take a long time to work

Front 18

what is the only long term choice for dealing with allergies?

Back 18

desensitization by formation of IgG antibodies to allergens which remove them before the can react with IgE

Front 19

what are the 3 major players in bronchoconstriction?

Back 19

1. Histamines
2. Leukotrienes
3. ECF

Front 20

what is responsible for the overproduction of mucous in the lungs of an asthmatic?

Back 20

leukotrienes

Front 21

what is the generic name for Advair?

Back 21

Salmeterol

Front 22

what receptors do albuterol and salmeterol?

Back 22

beta-2 thus cause smooth muscle in bronchioles to relax

Front 23

what is the best inhaled emergency drug for asthma?

Back 23

albuterol

Front 24

what is a good long-term prophylactiv for asthma or obstructive airway disease?

Back 24

salmeterol

Front 25

what does the binding of albuterol and salmeterol to beta2 receptors cause to happen?

Back 25

increase intracellular cAMP

Front 26

what is an inhaled oral xanthine derivative which causes bronchodilation, but should only be used wih physician supervision?

Back 26

theophylline

Front 27

why is supervision of theophylline administration needed?

Back 27

it acts on all cells by inhibiting phosphodiesterase thereby causing an increase in cAMP

Front 28

what are the oral (inhaled) corticosteroids for treating asthma?

Back 28

1. Beclamethasone
2. Prednisone

Front 29

what is a big problem seen with beclamethasone use?

Back 29

hoarsness caused by direct effect on larynx or by thrush. Nystatin is the DOC for treatment of thrush.

Front 30

what is the mechanism of action of betamethasone?

Back 30

1. binds to cytoplasmic receptor
2. receptor complex then inhibits PLA2
3. this inhibits proliferation of B cells

Front 31

If someone presented with a "moon face", peptic ulcers and adrenal suppression you might want to know if they are on what type of drug?

Back 31

oral corticosteroid

Front 32

Drugs for the treatment of asthma by blocking Leukotriene D4 & E4 receptors are? (2)

Back 32

1. Zafirlukast (ACCOLATE)
2. Montelukast (Singulaire)

Front 33

What drug is this?

Inhibits bronchoconstriction caused by sulfur dioxide, cold air

It also attenuates the early- and late-phase reaction in asthmatics caused by inhalation of antigens such as
grass, cat dander, ragweed, and mixed antigens

Back 33

Zafirlukast

Front 34

What drug is this?

Stabilizes mast cell membranes

Thus, it is effective in prophylactic, but not acute, treatment of extrinsic asthma

Back 34

Cromolyn Sodium

Front 35

Reactions which produce the symptoms of anaphylaxis in the absence of an IgE mediated allergic reaction are called?

Back 35

Anaphylactoid reactions

Front 36

what are the two most life-threatening complications of anaphylaxis?

Back 36

1. systemic vasodilation and fluid loss -> hypotension
2. cardiac ischemia

Front 37

what causes the hypotension sometimes seen in anaphylaxis?

Back 37

systemic release of histamine which binds to H2 receptors on smooth muscle leading to vasodilation

Front 38

why do you get contractions of smooth muscle in the gut when you get relaxation of smooth muscle in vasculature with anaphylaxis?

Back 38

the gut has H2 receptors where as the vascular smooth muscle has H1 receptors

Front 39

what are some foods which are most associated with anaphylaxis?

Back 39

1. Shellfish
2. Nuts

Front 40

How can antibiotics become anaphylactic agents?

Back 40

they can become haptens by binding with serum and tissue proteins (EX penicillin
streptomycin, cephalosporin,
amphotericin B)

Front 41

how should you treat the cardiovascular symptoms of anaphylactic shock?

Back 41

aqueous epinephrine

Front 42

how should you treat the Cutaneous & GI reactions
of anaphylactic shock?

Back 42

Antihistamines (EX Diphenhydramine)

Front 43

how should you treat the Bronchiolar Obstruction symptom of anaphylactic shock?

Back 43

Bronchodilator (EX. Albuterol or Epinephrine)

Front 44

how can you treat contact dermitis?

Back 44

cortisone cream