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Drugs for Inflammation, Allergies, and Immune Disorders

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Defense mechanism designed to contain injury or destroy foreign agent ... primarily in epidermis, vessels, and bronchi, and H2 receptors in stomach ... – PowerPoint PPT presentation

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Title: Drugs for Inflammation, Allergies, and Immune Disorders


1
Drugs for Inflammation, Allergies, and Immune
Disorders
  • Chapter 21

2
Inflammation
  • Defense mechanism designed to contain injury or
    destroy foreign agent
  • Possible triggers injury, heat, invading
    microorganisms, death of cells
  • Signs Redness, swelling, pain, warmth
  • May be acute (resolves in 8-10 days), chronic
    (can persist for years), or seasonal (such as
    with spring hay fever)

3
Histamine
  • Stored and released by mast cells
  • Initiates inflammatory response in seconds
  • Leads to
  • Dilation of blood vessels, allowing immune system
    components to leak out
  • Leakage can lead to swelling
  • Itching
  • Smooth muscle constriction
  • Interacts with H1 receptors primarily in
    epidermis, vessels, and bronchi, and H2 receptors
    in stomach

4
Allergic Rhinitis (Hay fever)
  • Allergy- exaggerated response of immune system,
    results in release of histamine which causes
    inflammation
  • Allergic Rhinitis causes inflammation of mucous
    membranes in nose, throat, eyes, and airways
  • Sx tearing, sneezing, nasal congestion, itching
    throat
  • Numerous possible causes (pollen, mold, dust
    mites, animal dander, other)

5
Allergic Rhinitis Treatment
  • Preventers- used for prophylaxis
  • Antihistamines
  • Glucocorticoids
  • Mast cell stabilizers
  • Relievers- provide immediate, temporary relief
  • decongestants

6
Histamine1 Receptor Antagonists(Antihistamines)
  • Sedating or non-sedating types
  • Best used prophylactically for allergies
  • Other uses vertigo, motion sickness

7
1st Generation Antihistamines (diphenhydramine)
  • Treats allergy and common cold sx by histamine 1
    receptor blockage
  • SE drowsiness, dry mouth, increased heart rate,
    constipation

8
2nd Generation Antihistamines (fexofenadine)
  • Same MOA as diphenhydramine (blocks H1 receptors)
  • SE same, except less drowsiness

9
Intranasal Glucocorticoids (fluticasone)
  • Glucocorticoids- hormones secreted by adrenal
    gland which have strong antiinflammatory effects
  • Fluticasone and others are synthetic versions
  • SE nasal irritation, bleeding

10
Decongestants (oxymetazoline and pseudoephedrine)
  • Mimic fight or flight response (these are
    sympathomimetics)
  • Intranasal or oral
  • Intranasal (oxymetazoline)- produce very rapid,
    local effect
  • Rebound congestion- excessive secretionof mucus
    once drug wears off, common with prolonged use
  • Oral (pseudoephedrine)- slower onset, less
    effective, more systemic SE
  • No rebound congestion

11
Drugs for Systemic Inflammation and Arthritis
  • Nonsteroidal Anti-Inflammatory Drugs
  • Systemic Glucocorticoids
  • Immunosuppressants

12
Nonsteroidal Antiinflammatory Drugs (naproxen)
  • Inhibit prostaglandin synthesis
  • Prostaglandin release leads to pain, fever, and
    inflammation
  • Uses arthritis, gout, menstrual cramps
  • SE GI upset, prolonged bleeding

13
Systemic Glucocorticoids (prednisone)
  • Suppress histamine and prostaglandins
  • Suppress immune system
  • Potent antiinflammatory activity
  • Uses arthritis, bronchospasm of asthma, allergic
    reactions
  • SE ? blood sugar, cataracts, osteoporosis,
    infection, stunted growth, other
  • Guidelines limit to short term use if possible
    if not, try alternate day therapy

14
Immunosuppressants (cyclosporine)
  • Suppresses immune system to prevent transplant
    rejection
  • Also useful for other diseases of severe
    inflammation such as rheumatoid arthritis
  • SE infection, cancer

15
Vaccines
  • Suspension of one of the following
  • Killed microbes
  • Attenuated (weakend) microbes
  • Toxoids (bacterial toxins) that have been made
    safe
  • Result in immune response
  • Immune system remembers the exposure and can
    produce large amounts of antibodies to fight
    infection if re-exposure occurs
  • SE fever, inflammation at injection site
  • Generally not given during an acute illness
  • Vaccines are safe for pregnant women (except MMR
    and varicella, which are attenuated)
  • When in doubt, re-immunize
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