Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
54 Cards in this Set
- Front
- Back
|
Explain an autocoid? |
1.Occur naturally in the body 2.produced by many tissues 3.are formed by the tissues in which they act |
|
|
Give examples of an autocoid |
1. Histamine 2. Prostaglandin 3. Thromboxane 4. Leukotrienes 5. Kinins 6. Substance P
|
|
|
What is histamine? |
a ubiquitous biogenic amine |
|
|
What happens when an allergic reaction occurs? |
mast cells degranulate and histamine is released |
|
|
H-1 agonist effects |
Vasodilation Increased capillary permeability Bronchoconstriction Pain or itching on cutaneous nerve endings |
|
|
H-2 Agonist effects |
Increased gastric secretion |
|
|
Adverse reactions of Histamines |
Allergic reaction Anaphylaxis bronchoconstriction
|
|
|
What is the drug of choice for anaphylaxis? |
parenteral epinephrine |
|
|
What are H-1 receptor antagonists? |
antihistamines |
|
|
Why are H-1 receptor antagonists important to us? |
Seasonal allergies Mild allergic reaction Xerostomia (side effect) additive CNS depressants |
|
|
H-1 blockers |
antihistaminic anticholinergic Antiserotonergic Sedative effects
|
|
|
antihistamine H-1 blocking effects |
Capillary permeability Vascular smooth muscle non-vascular smooth muscle nerve endings
|
|
|
Other antihistamine effects |
CNS depression Anticholinergic Antiemetic Local anesthesia
|
|
|
Adverse reactions of antihistamines |
CNS depression (wanted or unwanted) Anorexia, nausea, vomiting Xerostomia |
|
|
Toxicity of antihistamines |
death results from coma with cardiovascular and respiratory collapse |
|
|
Uses of antihistamines |
Allergic rhinitis Acute uticarial attacks Topical anesthesia Local anesthesia Nausea and vomiting preoperative sedation OTC sleep aids |
|
|
Peripheral (non sedating) H-1 receptor antagonists |
no common denominator Do not cross blood brain barrier will eventually replace older H-1 use |
|
|
Older H-1 drugs |
will have a place in dentistry for their side effects |
|
|
Fexofenadine (Allegra) |
Onset of action 1 hour Peak serum 2.6 hours Half life 14.4 20% metabolized in liver and excreted in urine. 80% excreted in feces |
|
|
Loratidine (claritin) |
Onset of action 1-3 hours Peak serum 8.4-28 hours Half life 12-15 hours Metabolized to an active metabolite
|
|
|
Loratidine (Claritin) adverse reaction |
headache somnolence fatigue xerostomia
|
|
|
Desloratadine (Clarinex) |
Once daily fatigue xerostomia headache GI disturbance |
|
|
Cetirizine (Zyrtec) |
Onset of action < 1/2 hour Peak serum 1 hour Half life 8 hours NON SEDATING |
|
|
How many stages of periodontal disease involve prostaglandins? |
1. Inflammation 2. Resorption of alveolar bone |
|
|
Prostaglandin antagonists |
NSAIDS-inhibit PG synthesis Aspirin- Inhibit platelet aggregation Indomethacin- blocks effect of PG on ductus arteriosus Clove oil |
|
|
Leukotrienes |
Powerful bronchoconstrictor more potent than histamines
|
|
|
Kinins |
polypeptides Kallidin and bradykinin (plasma) may play a role in dental disease |
|
|
WHat inhibit kinin evoked response? |
Salicilates (aspirin) glucocorticoids (steroids) |
|
|
Substance P |
Neurotransmitter in CNS Local hormone in GI tract |
|
|
What does Substance P do? |
vasodilator (hypotension) Increases action of intestinal and bronchial SM Cause salivary gland secretion Increase in water and salt excretion from kidney |
|
|
What does the term adrenocorticosteroids refer to? |
Group of agents secreted by the adrenal cortex |
|
|
Why would long term therapy of steroids be indicated? |
Chronic systemic disease asthma arthritis |
|
|
What can happen with long term use of exogenous steroids? |
The adrenal gland atrophies |
|
|
Cortisol |
without stress: 20 mg/day with stress: 200 mg/day maximal secretion between 4-8 AM
|
|
|
Hydrocortisone |
inhibits release of CRH (hypothalamus->pituitary) ACTH (pituitary -> adrenal cortex) |
|
|
Exogenous corticosteroids |
Acts the same way as hydrocortisone |
|
|
Addison's disease |
deficiency of adrenocorticosteroids |
|
|
Cushing's syndrome |
excess of adrenocorticosteroids |
|
|
Glucocorticoids/corticosteroids (exogenous adrenocorticosteroids) may be given |
topically orally intramuscularly Intravenously |
|
|
Glucocorticoids/corticosteroids |
Used as an antiinflammatory agent Increases concentration of neutrophils Decreases lymphocytes, monocytes, eosinophils and basophils Pharmacological and adverse reactions ARE CLOSELY RELATED |
|
|
Glucocorticoids/corticosteroids adverse reactions |
proportional to dose moon face buffalo hump truncal obesity weight gain muscle wasting Hyperglycemia Infections CNS effects Peptic ulcer Ophthalmic Electrolyte and fluid balance Adrenal crisis Dental effects impaired wound healing osteoporosis Periodontal disease |
|
|
Glucocorticoids/corticosteroids adverse reactions Infections |
decrease resistance to infection |
|
|
Glucocorticoids/corticosteroids adverse reactions CNS |
behavior and personality changes agitation psychoses depression |
|
|
Glucocorticoids/corticosteroids adverse reactions Peptic Ulcer |
Increase in production of stomach acid and pepsin |
|
|
Glucocorticoids/corticosteroids adverse reactions osteoporosis |
may result in tooth loss |
|
|
Glucocorticoids/corticosteroids adverse reactions Ophthalmic |
increase intraocular pressure (glaucoma) Cataracts |
|
|
Glucocorticoids/corticosteroids adverse reactions Electrolyte and Fluid |
Hypertension CHF |
|
|
Glucocorticoids/corticosteroids adverse reactions adrenal crisis |
weakness syncope cardiovascular collapse death |
|
|
Glucocorticoids/corticosteroids adverse reactions Dental |
mucosal surfaces more friable heals slowly oral candidiasis with inhalers |
|
|
Glucocorticoids/corticosteroids Uses |
Replacement Emergencies (shock, adrenal crisis) Inflammation/allergies (most extensive) Dental
|
|
|
What is the most commonly used oral corticosteroid? |
Prednisone |
|
|
Adrenocorticosteroids Uses Inflammation |
rheumatoid arthritis rheumatic fever Systemic lupus erythematosus Scleroderma Inflammation in joints and soft tissue Acute bronchial asthma acute allergic reactions
|
|
|
Adrenocorticosteroids Uses Dental |
Oral lesions erythema multiforme lichen planus pemphigus desquamative gingivitis benign mucous membrane pemphygoid apthous stomatitis TMD ORAL Surgery |
|
|
Adrenocorticosteroids Uses Dental surgery |
reduces postoperative edema, trismus and pain |
