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INTRODUCTION
 Naturally occuring substances – termed as local
  harmones which originate from diffuse tissues &
  produce intense pharmacological action near their
  site of formation & release.
 Auto’s=Self ; akos= remedy/ medicinal agent.
CLASSIFICATION
 Based on chemical nature;
 1.BIOGENIC / ENDOGENOUS AMINES: Histamine,
    5-HT.
   2.POLYPEPTIDES:Bradykinin, sub-p.
   3.LIPID SOLUBLE ORGANIC ACIDS/ PHOSPHO
    LIPID DERIVATIVES:
   (A).EICOSINOIDS: PG’S, PC’S, LT’S, TX’S.
   (B).PAF.
HISTAMINE
 Tissue amine.
 Histos- Tissue.
 DISTRIBUTION: Widely distributed in almost all
  mammal tissues & in venom of bees & wasps.
 SYNTHESIS: In mammals formed by Decarboxylation
  of Histidine in prescence of Histidine decarboxylase.
 STORAGE: Present in platelets, leucocytes, basophills
  & mastcells.
 Mainly in mastcells & basophills due to presence of
  his.decarboxylase, specialised storage granules.
MECHANISM OF ACTION
 Acts through 4 receptors viz : H1, H2, H3, H4 – all
  belonging to family GPCR.
 Activation of H1 receptors :
 Activation of H2 receptors:
PHARMACOLOGICAL ACTIONS
 CVS: (A). BLOOD VESSELS: In herbivores – Sys & Pul
    vasoconstriction.
   In humans Pul.vasodilation.
   Acts by 3 ways: (a).Activation of H1 receptors on the
    endothelial cells cause rapid- short lived vasodilation.
   (b).Activation of H2 receptors in the vascular smooth
    muscle causes slower but prolonged vasodilation.
   (c).Relaxation of smooth muscle of capillaries &
    venules leading to their dilation and fall in BP.
PHARMACOLOGICAL ACTIONS
 (B).BP: Therapeutic doses induces hypotension, short
  lived.
 Large doses –prolonged hypotension.
 Hypotension left untreated may cause irreversible
  shock & death.
 Histamine induced hypotension is partially reversed
  by anti-histaminics & completely reversed by
  adrenaline.
PHARMACOLOGICAL ACTIONS
 TRIPLE RESPONSE; When given (20mcg) ID develops
    a triple response :
   (a).FLUSH(RED REACTION): Red line r spot develop
    with in 10sec, due to local dilation of capillaries &
    venules.
   (b).WHEAL: Local swelling due to edema, mottled
    reddening around injury.
   Lasts about 1 1/2min.
   Due to increased permeability of capillaries 7 post
    capillary venules with consequent xtravasation of
    fluid.
PHARMACOLOGICAL ACTIONS
 (c).FLARE: Redness with irregular margins spreads out
    from injury.
   Triple response is part of normal reaction to injury.
   Its prevention is used to evaluate anti-histaminic activity
    of a new drug.
   (C).HEART:Increases sinus rate (+ve chronotropic action)
   Increases the amplitude of ventricular contraction
    (+inotropic effect)
   Decreases AV conduction time & increases coronary blood
    flow, high conc. induce ven.fibrillation.
PHARMACOLOGICAL ACTIONS
 (D)SMOOTH MUSCLE: Stimulates smooth muscles
    of various tissues by direct action(H1).
   Bronchial & Uterine smooth muscle – highly sensitive.
   GIT & Ureteral smooth muscle – respond moderately.
   Thru H1 receptor – gall bladder contraction ,
   H2 receptor – gall bladder relaxation.
   ‘H’ –induced bronchospasm – antagonised by
    adrenaline, isoprenaline & aminophylline but not by
    anti-histaminics r atropine.
PHARMACOLOGICAL ACTIONS
 ENDOCRINE GLANDS: Important physiological
  mediator of gastric acid secretion.
 CNS: Doesn’t cross BBB, ‘H’ constituted in 2types of
  cells – Histaminergic neurones & Mast cells.
 Considered as ‘Waking amine’- increase in sensitivity
  of large cerebral areas to excitatory inputs.
 IMMUNOMODULATION: Increases Humoral &
  Cellular immunity by various receptors , H1- cellular
  immunity , H2- Humoral immunity.
A,D,M,E:
 Stable compound & absorbed from all sites .
 Rapidly under go first pass metabolism in liver.
 Metabolism varies acc.to: animal spcs, sex , organ
  studied.
 Chemically it is B-Imidazolyl etylamine.
 End products of metabolism include N-Methyl
  imidazole aectic acid, N-acetyl histamine.
ADR
 Due to pharmacological actions: hypotension, visual
    disturbances, dyspnea, diarrhoea.
   Man, Gunea pig- extremely sensitive.
   Rats & Mice – highly resistant.
   Large dose causes – severe nausea, gripping, headache
    & sweating.
   USES:Study of gastric acid secretion.
ANTI-HISTAMINICS
 Certain phenolic ether – anti-histaminic properties.
 CLASSIFICATION: By two ways Clinically &
    Chemically.
   (A).CLINICAL CLASSIFICATION:
   1.POTENT & SEDATIVE: Diphenhydramine,
    Promethazine.
   2.POTENT & LESS SEDATIVE: Cyclizine, Meclizine.
   3.LESS POTENT & LESS SEDATIVE: Antazoline,
    Cinnarizine.
   4.NON SEDATIVE: Loratidine, Cetirizine.
CHEMICAL CLASSIFICATION
 General formula:
 Based on configuration of ‘X’ classified as :
 1. ETHANOLAMINES(X=‘O’): Diphenhydramine,
  Doxylamine.
 2.ETHYLENE DIAMINES(X=‘N’): Mepiramine, Antazoline.
  (show negligible anti-cholinergic & anti-emetic efcts)
 3.ALKYL AMINES (X=‘C’): Chloropheneramine,
  Triprolidine.
 4.PIPERAZINES: (X=‘C’ in conjunction with piperazine
  ring): Cinnarizine, Cetirizine.
CHEMICAL CLASSIFICATION
 5.PHENO THIAZINES (X=‘N’ as apart of
  phenothiazine nucleus): Promethazine, Trimeprazine,
  show potent anti-emetic effect.
 6.PIPERIDINES: Loratadine, Fexofenadine.
 7.DIBENZOXYPINES: Doxepine (Tricyclic anti
  depressant) shows potent anti-histaminic properties.
‘H’- ANTAGONISTIC ACTIONS
 1.ANTI-HISTAMINIC ACTIONS: Competatively block
    ‘H’ at various sites.
   Antgonize stimulant action of ‘H’ on: Smooth muscle
    of GIT, bronchi, uterus & bld.ves.
   Reduce ‘H’ induced triple response.
   Anti-allergic & anti-inflammatory actions involve:
    (a). Inhibition of release of mediators from mastcells,
    basophills.
   (b).Down regulation of H1-receptors.
   Don’t antgonize CVS actions of ‘H’.
ANTAGONISTIC ACTIONS
 OTHER ACTIONS: Related to their blocking of 5-HT
  & A1-Adreno receptors.
 1.SEDATION & HYPNOSIS: CNS depression –
  common side effect.
 Induce varying degrees of sedation, drowsiness &
  sleep.
 2.CNS STIMULATION: Stimulation is less ,
  conventional doses of Promethazine cause
  restlessness, tremors & insomnia.
ANTAGONISTIC ACTIONS
 3. ON ANS: First gen. anti-histaminics show
  muscarinic blocking activity, second gen. anti-
  histaminics doesn’t show these actions.
 4.ANTI-EMETIC & ANTI-MOTION SICKNESS:
  Diphenhydramine & Promethazine block
  histaminergic signals from the vestibular nucleus to
  vomiting center.
 5.ANTI-PARKINSONIAN EFFECTS: Central anti-
  muscarinic actions useful in treating parkinsonism.
ANTAGONISTIC ACTIONS
 6.CVS: Rapid IV administration of Diphenhydramine,
    Antazoline may produce dose related prolongation of
    QT interval due to membrane stabilising effect.
   7.LOCAL ANAESTHESIA: Promethazine,
    Diphenhydramine exhibit local anaesthetic activity.
   A,D,M,E: Well absorbed orally & parenterally.
   Anti-histaminic effect starts with in 15-30 min, peaks
    by 1hr & lasts for 3-6hrs.
   Meclizine- action persists for 12-24hrs.
ANTAGONISTIC ACTIONS
 A,DM,E: First gen compounds metabolised by
    CYP3A4 in liver.
   H1-antagonists induce hepatic microsomal enzymes,
    facilitating their own metabolism.
   ADR: Mild,
   1.CNS: Sedation & Hypnosis, Fatigue.
   In children less than 2yrs- Promethazine cause
    Apnoea.
   ANTI-MUSCARINIC EFFECTS: Dry mouth, blurred
    vision, bladder disturbances & rarely impotence.
ADR:
 GIT: Nausea, vomiting, epi-gastric distress.
 MISC: May produce allergic manifestations despite of
 their anti-allergic & anti-inflammatory properties.
THERAPEUTIC USES
Used in treatment of : 1.Allergic disorders,
2.Reagenic allergy,
3. Allergic conjunctivitis ,
4. Mastocytosis,
5.Other uses (a).As hypnotics,
              (b).As anti-emetics,
              (c).In parkinsonism,
              (d).In motion sickness & vertigo,
              (e).Anti-tussives,
              (f).Local anaesthetics.
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Autocoids

  • 1.
  • 2. INTRODUCTION  Naturally occuring substances – termed as local harmones which originate from diffuse tissues & produce intense pharmacological action near their site of formation & release.  Auto’s=Self ; akos= remedy/ medicinal agent.
  • 3. CLASSIFICATION  Based on chemical nature;  1.BIOGENIC / ENDOGENOUS AMINES: Histamine, 5-HT.  2.POLYPEPTIDES:Bradykinin, sub-p.  3.LIPID SOLUBLE ORGANIC ACIDS/ PHOSPHO LIPID DERIVATIVES:  (A).EICOSINOIDS: PG’S, PC’S, LT’S, TX’S.  (B).PAF.
  • 4. HISTAMINE  Tissue amine.  Histos- Tissue.  DISTRIBUTION: Widely distributed in almost all mammal tissues & in venom of bees & wasps.  SYNTHESIS: In mammals formed by Decarboxylation of Histidine in prescence of Histidine decarboxylase.  STORAGE: Present in platelets, leucocytes, basophills & mastcells.  Mainly in mastcells & basophills due to presence of his.decarboxylase, specialised storage granules.
  • 5. MECHANISM OF ACTION  Acts through 4 receptors viz : H1, H2, H3, H4 – all belonging to family GPCR.  Activation of H1 receptors :  Activation of H2 receptors:
  • 6. PHARMACOLOGICAL ACTIONS  CVS: (A). BLOOD VESSELS: In herbivores – Sys & Pul vasoconstriction.  In humans Pul.vasodilation.  Acts by 3 ways: (a).Activation of H1 receptors on the endothelial cells cause rapid- short lived vasodilation.  (b).Activation of H2 receptors in the vascular smooth muscle causes slower but prolonged vasodilation.  (c).Relaxation of smooth muscle of capillaries & venules leading to their dilation and fall in BP.
  • 7. PHARMACOLOGICAL ACTIONS  (B).BP: Therapeutic doses induces hypotension, short lived.  Large doses –prolonged hypotension.  Hypotension left untreated may cause irreversible shock & death.  Histamine induced hypotension is partially reversed by anti-histaminics & completely reversed by adrenaline.
  • 8. PHARMACOLOGICAL ACTIONS  TRIPLE RESPONSE; When given (20mcg) ID develops a triple response :  (a).FLUSH(RED REACTION): Red line r spot develop with in 10sec, due to local dilation of capillaries & venules.  (b).WHEAL: Local swelling due to edema, mottled reddening around injury.  Lasts about 1 1/2min.  Due to increased permeability of capillaries 7 post capillary venules with consequent xtravasation of fluid.
  • 9. PHARMACOLOGICAL ACTIONS  (c).FLARE: Redness with irregular margins spreads out from injury.  Triple response is part of normal reaction to injury.  Its prevention is used to evaluate anti-histaminic activity of a new drug.  (C).HEART:Increases sinus rate (+ve chronotropic action)  Increases the amplitude of ventricular contraction (+inotropic effect)  Decreases AV conduction time & increases coronary blood flow, high conc. induce ven.fibrillation.
  • 10. PHARMACOLOGICAL ACTIONS  (D)SMOOTH MUSCLE: Stimulates smooth muscles of various tissues by direct action(H1).  Bronchial & Uterine smooth muscle – highly sensitive.  GIT & Ureteral smooth muscle – respond moderately.  Thru H1 receptor – gall bladder contraction ,  H2 receptor – gall bladder relaxation.  ‘H’ –induced bronchospasm – antagonised by adrenaline, isoprenaline & aminophylline but not by anti-histaminics r atropine.
  • 11. PHARMACOLOGICAL ACTIONS  ENDOCRINE GLANDS: Important physiological mediator of gastric acid secretion.  CNS: Doesn’t cross BBB, ‘H’ constituted in 2types of cells – Histaminergic neurones & Mast cells.  Considered as ‘Waking amine’- increase in sensitivity of large cerebral areas to excitatory inputs.  IMMUNOMODULATION: Increases Humoral & Cellular immunity by various receptors , H1- cellular immunity , H2- Humoral immunity.
  • 12. A,D,M,E:  Stable compound & absorbed from all sites .  Rapidly under go first pass metabolism in liver.  Metabolism varies acc.to: animal spcs, sex , organ studied.  Chemically it is B-Imidazolyl etylamine.  End products of metabolism include N-Methyl imidazole aectic acid, N-acetyl histamine.
  • 13. ADR  Due to pharmacological actions: hypotension, visual disturbances, dyspnea, diarrhoea.  Man, Gunea pig- extremely sensitive.  Rats & Mice – highly resistant.  Large dose causes – severe nausea, gripping, headache & sweating.  USES:Study of gastric acid secretion.
  • 14. ANTI-HISTAMINICS  Certain phenolic ether – anti-histaminic properties.  CLASSIFICATION: By two ways Clinically & Chemically.  (A).CLINICAL CLASSIFICATION:  1.POTENT & SEDATIVE: Diphenhydramine, Promethazine.  2.POTENT & LESS SEDATIVE: Cyclizine, Meclizine.  3.LESS POTENT & LESS SEDATIVE: Antazoline, Cinnarizine.  4.NON SEDATIVE: Loratidine, Cetirizine.
  • 15. CHEMICAL CLASSIFICATION  General formula:  Based on configuration of ‘X’ classified as :  1. ETHANOLAMINES(X=‘O’): Diphenhydramine, Doxylamine.  2.ETHYLENE DIAMINES(X=‘N’): Mepiramine, Antazoline. (show negligible anti-cholinergic & anti-emetic efcts)  3.ALKYL AMINES (X=‘C’): Chloropheneramine, Triprolidine.  4.PIPERAZINES: (X=‘C’ in conjunction with piperazine ring): Cinnarizine, Cetirizine.
  • 16. CHEMICAL CLASSIFICATION  5.PHENO THIAZINES (X=‘N’ as apart of phenothiazine nucleus): Promethazine, Trimeprazine, show potent anti-emetic effect.  6.PIPERIDINES: Loratadine, Fexofenadine.  7.DIBENZOXYPINES: Doxepine (Tricyclic anti depressant) shows potent anti-histaminic properties.
  • 17. ‘H’- ANTAGONISTIC ACTIONS  1.ANTI-HISTAMINIC ACTIONS: Competatively block ‘H’ at various sites.  Antgonize stimulant action of ‘H’ on: Smooth muscle of GIT, bronchi, uterus & bld.ves.  Reduce ‘H’ induced triple response.  Anti-allergic & anti-inflammatory actions involve: (a). Inhibition of release of mediators from mastcells, basophills.  (b).Down regulation of H1-receptors.  Don’t antgonize CVS actions of ‘H’.
  • 18. ANTAGONISTIC ACTIONS  OTHER ACTIONS: Related to their blocking of 5-HT & A1-Adreno receptors.  1.SEDATION & HYPNOSIS: CNS depression – common side effect.  Induce varying degrees of sedation, drowsiness & sleep.  2.CNS STIMULATION: Stimulation is less , conventional doses of Promethazine cause restlessness, tremors & insomnia.
  • 19. ANTAGONISTIC ACTIONS  3. ON ANS: First gen. anti-histaminics show muscarinic blocking activity, second gen. anti- histaminics doesn’t show these actions.  4.ANTI-EMETIC & ANTI-MOTION SICKNESS: Diphenhydramine & Promethazine block histaminergic signals from the vestibular nucleus to vomiting center.  5.ANTI-PARKINSONIAN EFFECTS: Central anti- muscarinic actions useful in treating parkinsonism.
  • 20. ANTAGONISTIC ACTIONS  6.CVS: Rapid IV administration of Diphenhydramine, Antazoline may produce dose related prolongation of QT interval due to membrane stabilising effect.  7.LOCAL ANAESTHESIA: Promethazine, Diphenhydramine exhibit local anaesthetic activity.  A,D,M,E: Well absorbed orally & parenterally.  Anti-histaminic effect starts with in 15-30 min, peaks by 1hr & lasts for 3-6hrs.  Meclizine- action persists for 12-24hrs.
  • 21. ANTAGONISTIC ACTIONS  A,DM,E: First gen compounds metabolised by CYP3A4 in liver.  H1-antagonists induce hepatic microsomal enzymes, facilitating their own metabolism.  ADR: Mild,  1.CNS: Sedation & Hypnosis, Fatigue.  In children less than 2yrs- Promethazine cause Apnoea.  ANTI-MUSCARINIC EFFECTS: Dry mouth, blurred vision, bladder disturbances & rarely impotence.
  • 22. ADR:  GIT: Nausea, vomiting, epi-gastric distress.  MISC: May produce allergic manifestations despite of their anti-allergic & anti-inflammatory properties.
  • 23. THERAPEUTIC USES Used in treatment of : 1.Allergic disorders, 2.Reagenic allergy, 3. Allergic conjunctivitis , 4. Mastocytosis, 5.Other uses (a).As hypnotics, (b).As anti-emetics, (c).In parkinsonism, (d).In motion sickness & vertigo, (e).Anti-tussives, (f).Local anaesthetics.