Page 313 - Basic _ Clinical Pharmacology ( PDFDrive )

CHAPTER 16 Histamine, Serotonin, & the Ergot Alkaloids 299

Mantegani S, Brambilla E, Varasi M: Ergoline derivatives: Receptor affinity and Bray GA: Drug therapy of obesity. www.uptodate.com, 2016.
selectivity. Farmaco 1999;54:288. Flegal KM et al: Trends in obesity among adults in the United States, 2005 to
Porter JK, Thompson FN Jr: Effects of fescue toxicosis on reproduction in 2014. JAMA 2016;315:2284.
livestock. J Anim Sci 1992;70:1594. Heymsfield SB, Wadden TA: Mechanisms, pathophysiology, and management of
obesity. N Engl J Med 2017;376:254.
Obesity Khera R et al: Association of pharmacological treatments for obesity with weight
loss and adverse events. A systematic review and meta-analysis. JAMA
Adan RAH et al: Anti-obesity drugs and neural circuits of feeding. Trends 2016;315:2424.
Pharmacol Sci 2008;29:208.
Apovian CM et al: Pharmacological management of obesity: an Endocrine Society Pi-Sunyer X et al: A randomized, controlled trial of 3.0 mg of liralutide in weight
management. N Engl J Med 2015;373:11.
clinical practice guideline. J Clin Endocrinol Metab 2015;100:342.
Bloom SR et al: The obesity epidemic. Pharmacological challenges. Mol Interv Skinner AC et al: Cardiometabolic risks and severity of obesity in children and
young adults. N Engl J Med 2015;373:1307.
2008;8:82.

C ASE STUD Y ANSWER

These patients demonstrate typical symptoms and signs termed scombroid poisoning (Scombridae family of fish is
caused by histamine. Fortunately, neither patient in this most commonly associated with this toxicity). Treatment
episode of food poisoning had significant laryngeal edema with maximal doses of histamine blockers, especially H
1
or bronchospasm. Certain types of fish, if improperly blockers, is usually sufficient to control the symptoms.
preserved, contain large quantities of histamine, due to Because this is not an allergic reaction, administration of
the conversion—by bacteria contaminating the muscle epinephrine is not necessary unless hypotension or airway
tissue—of histidine to histamine. If consumed in suf- obstruction is severe. (See Edlow JA: The Deadly Dinner
ficient amount, enough histamine can be absorbed to Party: And Other Medical Detective Stories. Yale University
cause the clinical picture described. This syndrome is Press, 2009.)