Download - Histamine and pharmacological treatment of allergy. Antiemetics. Antiserotonic drugs. Anton Kohút
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Histamine and pharmacological treatment of allergy.
Antiemetics. Antiserotonic drugs.
Anton Kohút
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Acute allergic reaction
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Allergens
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omalizumab
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• Histamine is formed from the amino acid histidine by
histidine decarboxylase.
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Histamine is a basic amine, stored in mast cells and basophils (lung, skin, GIT, CNS).
R e l e a s eHistamine is released during inflammatory and alergic
reactions. Secretory process is initiated by a rise of intracellular calcium.
• Drugs increasing histamine release: morphine tubocurarin substance P
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Actions of histamine
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Antihistaminics (H1)
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Antihistaminics (H2)
CimetidineFamotidineNizatidineRanitidine
Treatment of gastric ulcer
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Serotonin (5-HT)
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Serotonin (5-HT)
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5-HT neurotransmission
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5HT-R Action Agonist Antagonist
1A, B neuronal inhibition, behavioural effects: sleep, feeding, anxiety, thermoregul.
Buspirone, Sertindole
Ergotamine Metiotepine
1D vasoconstriction Sumatriptan Ergotamin Metiotepine
2A neuronal excitation(increase in the number in suicides)
LSD KetanserineCyproheptadineNefazodone
3 neuronal excitation, vomiting, anxiety
-Metyl-5-HT
OndanzetronGranizetronTropizetron
7 not known LSD KetanserineCyproheptadine
5-HT-R classification and function in CNS
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Serotonin has been linked to an exhausting list of conditions:
- depression,- eating disorders, - schizophrenia,- premenstrual syndrome,
anxiety, panic disorder,- seasonal affective disorder, - extreme violence,- hostility and aggression,- suicide, migraine,-- addiction, and more.
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Actions and functions of 5–HT
Actions• increased GIT motiliti,• smooth muscle (bronchi, uterus)-
contraction• mixture of vascular constriction and
dilatation,• increased microvascular
permeability• platelet aggregation, • stimulation of peripheral
nociceptive nerve endings• excitation/inhibition of CNS
neurons,
Pathophysiological role• in periphery: peristalsis, vomiting,
platelet aggregation, inflammatory mediator, sensitisation of nociceptors and microcirculation control.
• in CNS: control of apetite, sleep, mood, hallucinations, pain perception and vomiting.
Clinical conditions:- migraine, - carcinoid syndromeflushing, diarhoe, bronchoconstriction,
hypotension), - mood disorders (depression) and
anxiety, - vomiting
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Drugs influencing serotoninergic function
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Antiemetics
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Receptors involved in vomiting
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Causes of vomiting
I. Drugs• Anticancer drugs,
cardiac glycosides, apomorphine, levodopa, bromocryptine, cholinomimetics, opiates, ergot alkaloids
II. Physiological• Pregnancy, head
motion, weitghlesness
III. Pathophysiological• Uremia,
endocrinopathies, alcoholism, migraine, allergies,
• gastric irritations
IV. Toxic• Food poisons,
industrial poisons, radiations, infections
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Grops of antiemetic drugs
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Recomended antiemetic treatment
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Migraine are recurrent, moderate-to-severe episodes of head
pain that may be induced by a variety of triggers.A migraine headache is a form of vascular headache. Migraine
headache is caused by vasodilatation that causes the release of
chemicals from nerve fibers.
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Pathophysiology and treatment of migraine
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