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Updated: Jan 10 2018

Arachidonic Acid Products

  • Overview
  • Snapshot
    • A 30-year-old woman presents to an asthma specialist for management of her moderate-to-severe asthma. She is currently using fluticasone and salmeterol inhalers. She continues to experience 2-3 episodes of asthma exacerbations a week with night-time awakenings and several trips to the emergency room in the past month. Her physician considers adding a targeted therapy that inhibits leukotrienes to her regimen.
  • Introduction
    • Arachidonic acid pathway transforms arachidonic acid into a variety of inflammatory mediators, including leukotrienes, prostacyclin, and prostaglandins
    • Many anti-inflammatory agents, including asthma medications, target downstream molecules in this pathway
    • Lipoxygenase pathway products
      • LTB4
        • ↑ neutrophil chemotaxis
      • LTC4, LTD4, and LTE4
        • ↑ bronchial tone
        • montelukast and zafirlukast inhibit these products
    • Prostacyclin
      • PGI2
        • ↓ platelet aggregation
        • vasodilation
        • epoprostenol is a PGI2 analogue
    • Prostaglandins
      • PGE1
        • vasodilation
        • also known as alprostadil
        • used to maintain a patent ductus arteriosus in newborns with ductal-dependent congenital heart disease
      • PGE2
        • ↑ uterine tone
        • dinoprostone is a PGE2 analogue
      • PGF2α
        • ↑ uterine tone
        • carboprost is a PGF2α analogue
    • Thromboxane
      • TXA2
        • ↑ platelet aggregation
        • ↑ vasoconstriction
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