H1 ve H2 reseptör antagonistlerinin kan gazı üzerine etkisi

Amaç: Histamin organizmada yaygın olarak bulunan bir amindir. Hücrelerin histamine yanıtları sitoplazmada bulunan H1 ve H2 reseptörleri ile sağlanır. Bu çalışmada organizmada yaygın olarak bulunan histamin reseptörlerinin ilaçlarla bloke edilmesinin böbrek akciğer ve hemoglobin aracılığı ile çok dar aralıkta dengede tutulan kan gazı üzerine etkisinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Çalışma 1988-1989 yılları arasında Ankara Numune Hastanesi 1. Dahiliye Kliniği’ne yatarak tedavi gören 25 peptik ülser, 10 alerji, 10 kan gazını etkilemeyen farklı hastalık nedeniyle yatan 25 kadın 20 erkek olgu alındı. Alerji nedeniyle yatan hastalara H1 ve peptik ülser hastalarına H2 reseptör antagonistleri olağan tedavi dozunda intravenöz uygulandı. Uygulamadan önce ve uygulamadan 1 saat sonra kan gazı örnekleri alınarak değerlendirme yapıldı. Kontrol grubuna ilaç verilmeksizin 1 saat ara ile kan gazı değerlendirmesi yapıldı.Bulgular: H1 reseptör antagonistlerinin pH, pO2, HCO3, BEB, BEcf değişimi istatistiksel olarak anlamsız bulunurken (p>0.05), pCO2 değerinde ise istatisksel olarak anlamlı düşme (ilaç öncesi 36,01+4,023; ilaç sonrası ortalama pCO2 34,42+3,72 p<0.05) saptandı. H2 reseptör antagonisti uygulamasında ise pCO2 ve pO2 değişiminde istatistiksel olarak anlamlı değişiklik bulunmazken, pH (<0.05), HCO3 (p<0.001), BEB (p<0.01) ve BEecf (p<0.01) değerlerinde istatistiksel olarak anlamlı artma bulundu Sonuç: Histamin reseptör antagonisti ilaçlar kan gazı parametrelerinde antagonize ettikleri reseptörlere bağlı olarak patolojik sınırlarda olmayan değişimlere neden olabilirler. Ancak kan gazında değişime neden olan klinik durumlarda ciddi problem yaratıp yaratmayacakları hakkında yorum yapabilmek için daha kapsamlı çalışmalara gereksinim vardır.

Anahtar Kelimeler:

H1 ve H2 reseptör antagonisti, kan gazı, etki

Effect of H1 and H2 receptor antagonists on blood gas

Aim: Histamine is a common anhydrous substance in the organism. Histamine responses of the cells were found in the cytoplasm of H1 and it is provided by H2 receptors. In the IBU study, it was aimed to investigate the effect of drug-blocking of histamine receptors commonly found in organism on blood gas, which is maintained in a very narrow range with kidney lung and hemoglobin.Material and Method: Between 1988-1989, 25 female and 20 male patients who were hospitalized in Ankara Numune Hospital 1st Internal Medicine Clinic were included in this study. H1 and peptic ulcer patients received H2 receptor antagonists intravenously at the usual treatment dose and blood gas samples were taken before and 1 hour after administration. Blood gas evaluation was performed in the control group at 1 hour interval without drug administration.Result: The change of pH, pO2, HCO3, BEB, BEcf of H1 receptor antagonists was statistically insignificant (p>0.05) while pCO2 value was statistically significant (36.01+4.023 before treatment, 34.42+3.72 p<0.05 after treatment). H2 receptor antagonist administration showed statistically insignificant change in pCO2 and pO2 levels but statistically significant increase in pH (<0.05), HCO3 (p<0.001), BEB (p<0.01) and BEcf (p<0.01).Conclusion: Histamine receptor antagonist drugs may cause changes to the blood gas parameters that are not pathological depending on the receptors to which they are antagonized. However, there is a need for more extensive work to comment on whether or not they will cause serious problems in clinical situations that cause change in blood gas.

Keywords:

H1 and H2 receptor antagonist, blood gas, effect,

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1. Flynn SB, Gristwood RW, Owen DAA. Differantion of the roles of Histamine H1 and H2 receptors in the mediation of the effects Histamine in the isolated working heart of the qunea pig. Br.J. Pharmacol 1977; 65; 127-37.
2. Ash AS, Schild HO. Receptors mediating some actions of histamine. Br J Pharmacol Chemother 1966: 27: 427-39
3. Carpenter DO, Gaubatz GL. H1 and H2 histamine receptors on aplasia neurons. Nature 1973: 254: 343.
4. Borchard D, Hafner D. Electrophysiological charactersation of histamine receptors subtypes in mammalian heart preparation. Naunyn-Schmiedberg’s Arch Pharmacol 1986: 334; 294-302.
5. Black JW, Duncan WAM, Durant CJ, Ganellin CR, Parsons ME. Definition and antagonism of histamine H1 receptors. Nature1972: 236: 385-90.
6. El-Acked TM, Brody MJ. Evidence for mast cell histamine in the vascular wall. Blood Vessels 1975: 12: 181.
7. Anton AH, Sayre DF. A modified fluorimetric procedure for tissue Histadine and its distrubition in various animals. J Pharmacol Exp Ther 1969: 166: 285.
8. Reinhardt D, Borchard UH. H1 receptor antogonists: comperative pharmacology and clinical use. Clin Wochenschr 1982: 60: 983-90.
9. Levi R, Capurro N, Lee CH. Pharmacological caracterization of cardiac histamin receptors: sensitivity to H1 and H2 receptors agonists antagonists. Eur J Pharmacol 1975; 30: 328-35.
10. Corbic M, Munoz C, Dumont M, Erlinger S. Effect of systemic pH, pCO and bikarbonate concentration biliary bicarbonate on secretion in the rat. Hepatology 1985; 5: 594-9.
11. Dale HH. Conditions which are conducive to the production of shock by histamine. British J Experimental Pathol 1920; 1: 103-14.
12. Wallace GB, Pellini EJ. Proc Sot Exp Biol Med; 1920- 21; xviii: 115.
13. Underhill FP, Ringer MJ. Biol Chem 1921; xlviii, 533.
14. Hiller A. The effect of histamine on the asid-base balance. J Biol Chem 1927: 3: 833-46.
15. Best CH, Dale HH, Dudley HW, Thprpe WV. The nature of the vaso-dilator constituents of certain tissues. J Physiol 1927; 62: 397.
16. Chand N. Distrubution and classification of airway histamine receptors: the physsiological significance of histamine H1 receptörs. Adv Pharmacol Chemother 1980: 17: 103.
17. Lindgren BR, Grunström N, Anderssson RGG. Compration of the effects of clonidine and quanfacine on the histamine liberation from human mast cells and basophils and on th human bronchial smooth muscle activity. Arzneim Forsch Drug Resp 1987: 37: 551-3.