Updated: 1/10/2018

Arachidonic Acid Products

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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
    • LTC
      4
      , LTD4, and LTE4
      • ↑ bronchial tone
      • montelukast and zafirlukast inhibit these products
  • Prostacyclin
    • PGI2
      • ↓ platelet aggregation
      • vasodilation
      • epoprostenol is a PGIanalogue
  • 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
    • PGF
      • ↑ uterine tone
      • carboprost is a PGF analogue
  • Thromboxane
    • TXA2
      • ↑ platelet aggregation
      • ↑ vasoconstriction
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