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	<title>Pharmacology Corner &#187; Allergy &amp; Immunology</title>
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		<title>Animation on histamine release and antihistamines mechanism of action</title>
		<link>http://pharmacologycorner.com/animation-on-histamine-release-and-antihistamines-mechanism-of-action/</link>
		<comments>http://pharmacologycorner.com/animation-on-histamine-release-and-antihistamines-mechanism-of-action/#comments</comments>
		<pubDate>Wed, 04 Feb 2009 23:04:00 +0000</pubDate>
		<dc:creator>Flavio Guzmán, MD</dc:creator>
				<category><![CDATA[Allergy & Immunology]]></category>
		<category><![CDATA[Pharmacology animations]]></category>
		<category><![CDATA[antihistamines]]></category>
		<category><![CDATA[H-1 antagonists]]></category>
		<category><![CDATA[H-1 blockers]]></category>
		<category><![CDATA[mast cells]]></category>
		<category><![CDATA[mechanism of action]]></category>
		<category><![CDATA[pharmacodynamics]]></category>
		<category><![CDATA[video animation]]></category>

		<guid isPermaLink="false">http://pharmacologycorner.com/?p=1070</guid>
		<description><![CDATA[In this 3-D animation, oriented to the general public, we can see the process of histamine release by mast cell starting from the exposure to the allergen: This image shows the same process: H1 blockers are a class of widely prescribed drugs, here an excerpt of its pharmacodynamics (Source: Katzung&#8217;s Basic and Clinical Pharmacology) A. [...]]]></description>
			<content:encoded><![CDATA[<p>In this 3-D animation, oriented to the general public, we can see the process of histamine release by mast cell starting from the exposure to the allergen:<br />
<object classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="425" height="344" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0"><param name="Movie" value="http://www.youtube.com/v/ywdk3BTjK2s&amp;hl=es&amp;fs=1" /><param name="Src" value="http://www.youtube.com/v/ywdk3BTjK2s&amp;hl=es&amp;fs=1" /><param name="WMode" value="Window" /><param name="Play" value="0" /><param name="Loop" value="-1" /><param name="Quality" value="High" /><param name="SAlign" value="LT" /><param name="Menu" value="-1" /><param name="AllowScriptAccess" value="always" /><param name="Scale" value="NoScale" /><param name="DeviceFont" value="0" /><param name="EmbedMovie" value="0" /><param name="SeamlessTabbing" value="1" /><param name="Profile" value="0" /><param name="ProfilePort" value="0" /><param name="AllowNetworking" value="all" /><param name="AllowFullScreen" value="true" /><param name="src" value="http://www.youtube.com/v/ywdk3BTjK2s&amp;hl=es&amp;fs=1" /><param name="allowfullscreen" value="true" /><param name="wmode" value="Window" /><param name="quality" value="High" /><embed type="application/x-shockwave-flash" width="425" height="344" src="http://www.youtube.com/v/ywdk3BTjK2s&amp;hl=es&amp;fs=1" allowfullscreen="true" allownetworking="all" profileport="0" profile="0" seamlesstabbing="1" embedmovie="0" devicefont="0" scale="NoScale" allowscriptaccess="always" menu="-1" salign="LT" quality="High" loop="-1" play="0" wmode="Window" movie="http://www.youtube.com/v/ywdk3BTjK2s&amp;hl=es&amp;fs=1"></embed></object></p>
<p>This image shows the same process:</p>
<p><a href="http://cdn.pharmacologycorner.com/wp-content/uploads/2009/02/histamine-release.jpg"><img class="alignnone size-full wp-image-1075" title="histamine-release" src="http://cdn.pharmacologycorner.com/wp-content/uploads/2009/02/histamine-release.jpg" alt="" width="499" height="272" /></a></p>
<p>H1 blockers are a class of widely prescribed drugs, here an excerpt of its pharmacodynamics (Source: <a href="http%3A%2F%2Fwww.amazon.com%2Fexec%2Fobidos%2Fredirect%3Ftag%3Dzoundry0b-20%26path%3Dhttp%3A%2F%2Fwww.amazon.com%2Fgp%2Fproduct%2F0071451536%3Fie%3DUTF8%26tag%3Dfarmaymedic-20%26linkCode%3Das2%26camp%3D1789%26creative%3D390957%26creativeASIN%3D0071451536">Katzung&#8217;s Basic and Clinical Pharmacology</a>)</p>
<blockquote><p><span style="text-decoration: underline;"><strong>A. HISTAMINE-RECEPTOR BLOCKADE</strong></span><br />
H<sub>1</sub>-receptor antagonists block the actions of histamine by reversible competitive antagonism at the H<sub>1</sub> receptor. They have negligible potency at the H<sub>2</sub> receptor and little at the H<sub>3</sub> receptor. For example, histamine-induced contraction of bronchiolar or gastrointestinal smooth muscle can be completely blocked by these agents, but the effects on gastric acid secretion and the heart are unmodified.</p>
<p><span style="text-decoration: underline;"><strong>B. ACTIONS NOT CAUSED BY HISTAMINE RECEPTOR BLOCKADE</strong></span><br />
The first-generation H<sub>1</sub>-receptor antagonists have many actions not ascribable to blockade of the actions of histamine. The large number of these actions probably results from the similarity of the general structure (<span class="tdsLink" style="WHITE-SPACE: nowrap">Figure 16-1</span>) to the structure of drugs that have effects at muscarinic cholinoceptor, <span style="FONT-FAMILY: Symbol">a</span> adrenoceptor, serotonin, and local anesthetic receptor sites. Some of these actions are of therapeutic value and some are undesirable.<br />
<span style="COLOR: #000000"><strong><span>1. Sedation</span></strong></span> A common effect of first-generation H<sub>1</sub> antagonists is sedation, but the intensity of this effect varies among chemical subgroups (<span class="tdsLink" style="WHITE-SPACE: nowrap">Table 16-2</span>) and among patients as well. The effect is sufficiently prominent with some agents to make them useful as &#8220;sleep aids&#8221; (see <span class="tdsLink">Chapter 64</span>) and unsuitable for daytime use. The effect resembles that of some antimuscarinic drugs and is considered very unlike the disinhibited sedation produced by sedative-hypnotic drugs. Compulsive use has not been reported. At ordinary dosages, children occasionally (and adults rarely) manifest excitation rather than sedation. At very high toxic dose levels, marked stimulation, agitation, and even convulsions may precede coma. Second-generation H<sub>1</sub> antagonists have little or no sedative or stimulant actions. These drugs (or their active metabolites) also have far fewer autonomic effects than the first-generation antihistamines.<br />
<span style="COLOR: #000000"><strong><span>2. Antinausea and antiemetic actions</span></strong></span> Several first-generation H<sub>1</sub> antagonists have significant activity in preventing motion sickness (<span class="tdsLink" style="WHITE-SPACE: nowrap">Table 16-2</span>). They are less effective against an episode of motion sickness already present. Certain H<sub>1</sub> antagonists, notably doxylamine (in Bendectin), were used widely in the past in the treatment of nausea and vomiting of pregnancy (see below).</p>
<p><span style="COLOR: #000000"><strong><span>3. Antiparkinsonism effects</span></strong></span> Some of the H<sub>1</sub> antagonists, especially diphenhydramine, have significant acute suppressant effects on the extrapyramidal symptoms associated with certain antipsychotic drugs. This drug is given parenterally for acute dystonic reactions to antipsychotics.</p>
<p><span style="COLOR: #000000"><strong><span>4. Anticholinoceptor actions</span></strong></span> Many of the first-generation agents, especially those of the ethanolamine and ethylenediamine subgroups, have significant atropine-like effects on peripheral muscarinic receptors. This action may be responsible for some of the (uncertain) benefits reported for nonallergic rhinorrhea but may also cause urinary retention and blurred vision.</p>
<p><span style="COLOR: #000000"><strong><span>5. Adrenoceptor-blocking actions</span></strong></span> <a href="http://pharmacologycorner.com/alpha-1-adrenergic-receptors-antagonists-blockers-mechanism-of-action-animation/">Alpha-receptor-blocking</a> effects can be demonstrated for many H<sub>1</sub> antagonists, especially those in the phenothiazine subgroup, eg, promethazine. This action may cause orthostatic hypotension in susceptible individuals. Beta-receptor blockade is not observed.</p>
<p><span style="COLOR: #000000"><strong><span>6. Serotonin-blocking action</span></strong></span> Strong blocking effects at serotonin receptors have been demonstrated for some first-generation H<sub>1</sub> antagonists, notably cyproheptadine. This drug is promoted as an antiserotonin agent and is discussed with that drug group. Nevertheless, its structure resembles that of the phenothiazine antihistamines, and it is a potent H<sub>1</sub>-blocking agent.</p>
<p><strong><span style="COLOR: #0000ff"><span style="COLOR: #000000">7. Local anesthesia</span></span></strong> Several first-generation H<sub>1</sub> antagonists are potent local anesthetics. They block sodium channels in excitable membranes in the same fashion as procaine and lidocaine. Diphenhydramine and promethazine are actually more potent than procaine as local anesthetics. They are occasionally used to produce local anesthesia in patients allergic to conventional local anesthetic drugs. A small number of these agents also block potassium channels; this action is discussed below.</p>
<p><span style="COLOR: #000000"><strong><span>8. Other actions</span></strong></span> Certain H<sub>1</sub> antagonists, eg, cetirizine, inhibit mast cell release of histamine and some other mediators of inflammation. This action is not due to H<sub>1</sub>-receptor blockade. The mechanism is not understood but could play a role in the beneficial effects of these drugs in the treatment of allergies such as rhinitis. A few H<sub>1</sub> antagonists (eg, terfenadine, acrivastine) have been shown to inhibit the <a href="http://pharmacologycorner.com/mechanism-of-chemotherapy-resistance-animation-of-the-role-of-p-glycoprotein/">P-glycoprotein</a> transporter found in cancer cells, the epithelium of the gut, and the capillaries of the brain. The significance of this effect is not known.</p></blockquote>
<p class="zoundry_raven_tags"><!-- Tag links generated by Zoundry Raven. Do not manually edit. http://www.zoundryraven.com --> <span class="ztags"><span class="ztagspace">There is also a related post on <a href="http://pharmacologycorner.com/histamine-physiologic-effects/">histamine physiologic effects.</a></span><a class="ztag" rel="tag" href="http://www.technorati.com/tag/video+animation"></a></span></p>
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