inflammatoy drugs and steroids

lewi triple reaction

redness → flare → swelling

recruitment of IMS cells

1. rolling → expression of selectins slowing down IMC

2. activation via chemokine and inflammatory mediators

3. tight adhesion via integrins (ICAM, VCAM)

4. transmigration using PECAMS

1st gen antihistamines

chlorphenamine, diphenhydramine

1. crosses BBB acting on H3 causing sedation

2nd gen antihistamine

loratadine, fexophenadine, cetirizine

H2 antihistamine

cimetidine, ranitidine

1. treats GI ulcers

H3 antihistamines

pitolisant, thioperamide

1. treats excess sleep

B2 receptor agonist

kallikrein, bradykinin

B2 antagonist

icatibant → treats hereditary angiodema

prostaglandin agonist

EP1: misoprostol → induce labor

EP2: butaprost

FP3: latanoprost, bimatoprost

IP: iloprost→ pulmonary arterial hypertension, scleroderma, reynauds

leukotriene drugs

1. zileuton → inhibits 5-lipoxygenase to treat asthma

2. monteleukast → inhibits cys-LT1

name the 5 steroids

1. cortisol

2. prednisolone: used during pregnancy as it is sensitive to 11BHSD

3. prednisone: prednisolone pro-drug

4. dexamethasone: not used in pregnancy as it is insensitive to 11BHSD → crosses B-placenta-B

   1. longest duration and high GC receptor affinity

   2. minimal Na+ retention

5. betamethasone

what are the side effects of steroids (4)

1. cushing’s syndrome: skin thinning, central adiposity, poor wound healing, metabollic and psychological effects

2. GI ulcers due to suppression of prostaglandins

3. osteoporosis

   1. glaucoma

what are steroid withdrawal symptoms

1. long-term HPA suppression

2. relapse of underlying disease

3. psychological dependence

4. adrenal crisis: dangerously low BP, hyperkalaemia and calcaemia, hypoglycaemia and natraemia