2015留抗过敏.ppt

Histamine and Antihistamines Nasal Steroids vs. Antihistamines * Urticaria:过敏性皮炎 Allergic rhinitis:过敏性鼻炎 Henoch-Schonlein purpura: 过敏性紫癜 Allergic shock:过敏性休克 [Histamine Pharmacology] 1. First autacoid to be discovered. 2. Synthesized in 1907 3. Demonstrated to be a natural constituent of mammalian tissues (1927) 4. Involved in inflammatory and anaphylactic reactions. 5. Local application causes swelling redness, and edema, mimicking a mild inflammatory reaction. 6. Large systemic doses leads to profound vascular changes similar to those seen after shock or anaphylactic origin Storage and release of Histamine: 1. Most histamine:in granules in?mast cells?and in white blood cells called?basophils?and?eosinophils. 2. Mast cells: at sites of potential injury-the nose, mouth, and feet, internal body surfaces, and blood vessels. 3. Non-mast cell histamine is found in several tissues, including the?brain, where it functions as a neurotransmitter. 4. Another important site : stomach. Pharmacological Effects of Histamine 1. Cardiovascular system. (1) reddening at injection site due to vasodilation (2) wheal or disk of edema (3) a bright crimson flare surrounding the wheal (4) i.v. histamine: lowered blood pressure, flushing, rise in skin temperature, intense headache. 2. Smooth muscle of bronchioles: contraction 3. Exocrine glands: enhanced secretion 4. Peripheral Nervous system: itching and pain Pharmacological Effects: Exocrine Glands Gastric glands Salivary glands Sweat glands Pancreas Bronchial glands Lacrimal glands Increased Secretion Pharmacological Effects: Arterioles, Capillaries Venules 1. Vasodilation 2. Increased permeability, (edema) 3. Systemic hypotension Smooth Muscle Contraction 1. Bronchial tree 2. Gastrointestinal tract 3. Uterus General Mechanism of Action of Antihistamines 1. Blocks action of histamine at receptor 2. Competes with histamine for binding 3. Displaces histamine from receptor 4. Most beneficial when given early Thera