Respiratoy drugs

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Respiratoy drugs

  1. 1. Pharmacology Drugs used to treat: Asthma Rhinitis & Cough
  2. 2. Topics• Bronchodilators • Decongestants• Methylxanthines • Antihistamines• Anticholinergics • Antitussives• Anti-inflammatory • Expectorants & Agents mucolytics• Leukotriene Antagonists• Mast cell stabilizers
  3. 3. Asthma• Inflammatory response to allergen• Antibody binds with & ruptures mast cells – Releases histamine, prostaglandins, leukotrienes• Two primary issues – Bronchoconstriction – Inflammation (mucous production)
  4. 4. Approaches to Treatment• Relax bronchial smooth muscle – ß2 agonists – methylxanthines – anticholinergics• Inhibit release of mediators – Glucocorticoids – Mast cell stabilizers• Block affects of mediators – Leukotriene antagonists
  5. 5. Bronchodilatorsß2 agonists albuterol (Proventil®), metaproterenol (Alupent®) terbutaline (Breathair®)Nonselective epinephrine (Adrenalin®)Methylxanthines theophylline (TheoDur®) aminophyllin, (Aminophylline®)Anticholinergics ipratropium bromide (Atrovent®)
  6. 6. Antiinflammatory AgentsGlucocorticoids inhaled beclomethasone (Beclovent®) flucticasone (Flovent®) oral prednisolone (Deltasone®) injected methylprednisolone (Solu-Medrol®) dexamethasone (Decadron®)Mast cell Stabilizer cromolyn (Nasalcrom®, Intal®)Leukotriene Antagonists zafirlukast (Accolate®) zileuton (Zyflo®)
  7. 7. Colds and Allergies• Nasal Inflammation – Vasodilation & engorgement• Itching, redness, rhinorrhea – Mast/basophil degranulation
  8. 8. Nasal Decongestants∀ ⇓ congestion via • phenylephrine (Neo- vasodilation Synephrine®)• Alpha1 stimulation • pseudoephedrine – Topical administration (Sudafed®, Actifed®) • A moment of silence for: – phenylpropanolamine (AlkaSeltzer Cold®, Contact®, Allerest®)
  9. 9. Antihistamines• H1 receptors • Other histamine – Vasodilation receptors – Increased capillary – Sedation permeability – Bronchoconstriction• H2 receptors – Increase gastric acid secretion (Zantac®), etc)
  10. 10. Antihistamine Agents• First generation • Second generation – Sedation – No sedation• chlorpheniramine – blood-brain barrier (Chlor-Trimeton®) • Sniff, sniff:• diphenhydramine – terfenadine (Seldane®) (Benadry®) • fexofenadine• clemastine (Tavist®) (Allegra®)• promethazine • cetirizine (Zyrtec®) (Phergan®) • loratadine (Claritin®)
  11. 11. Cough Suppressants• Antitussives • Expectorants – Decrease cough reflex – guaifenesin may work – Opioids – others are doubtful • codeine & hydrocodone • Mucolytics – Non-opioids – Decreases viscocity • dextromethorphan – acetlycysteine • benzonatate (Tessalon®) (Mucomyst®) – hypertonic saline

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