This document discusses drugs pharmacology in lung disease. It begins with an introduction about the lungs being a site of drug absorption and their role in removing volatile substances. It then covers practical issues when giving drugs to patients with lung disease like positioning to prevent aspiration. The document outlines uses of drugs in lung disease like vaccines to prevent infections. It details pulmonary adverse effects of various drugs like how passive smoking increases cancer risk and how crack cocaine can cause respiratory symptoms. It closes by noting drugs can complicate interpretation of side effects in patients with lung disease and their selection should consider any preexisting conditions.

2. Drugs Pharmacology in Lung Disease
By
M. H. Farjoo M.D. , Ph.D.
Shahid Beheshti University of Medical Sciences

3. Drugs Pharmacology in Lung Disease
 Introduction
 Practical Issues
 Use of Drugs in Lung disease
 Pulmonary Adverse Effects of Drugs

4. Introduction
 The lungs are among drug absorptive sites.
 The lungs mainly remove volatile substances, (eg:
anesthetic gases & antiasthmatics).
 They have a large surface area for absorption of
drugs.
 Debilitating illnesses such as chronic lung disorders
interfere with appetite and GI function.

5. Practical Issues
 With NG tubes, medications may be aspirated into the
lungs (Disadvantages)
 Patients should be positioned appropriately to prevent
aspiration of oral drugs into the lungs.
 Do not give oral drugs to excessively sedated or
unconscious clients to avoid aspiration.
 Spinal anesthesia is preferred for surgery in elderly
people with chronic lung disease.

6. Use of Drugs in Lung disease
 In chronic lung disease, respiratory infections may be
prevented by measures such as:
 Immunizations with pneumococcal pneumonia
vaccine (a single dose)
 Influenza vaccine (annually)
 Prenatal corticosteroids promote surfactant
production to decrease respiratory distress syndrome
in preterm infants.

7. Pulmonary Adverse Effects of Drugs
 Passive smoking (“second hand” smoke) increases
the risks of cancer & lung disease.
 Inhalation of crack cocaine causes respiratory
symptoms in 25% of users and include:
 Bronchitis & bronchospasm
 Cough & dyspnea
 Pneumonia & pulmonary edema
 Fatal lung hemorrhage.

8. Pulmonary Adverse Effects of Drugs
 Marijuana (hashish) possibly increases the risk of
mouth, throat, and lung cancer
 Some carcinogens are much higher in marijuana
smoke than in tobacco smoke.
 Blockade of β2 receptors in bronchial tree causes
constriction in people with lung diseases.
 In asthmatic children, beclomethasone caused growth
inhibition.

9. Pulmonary Adverse Effects of Drugs
 Digoxin toxicity may result from hypoxia due to lung
disease, which increases myocardial sensitivity to
digoxin
 Amiodarone accumulates in the lung and even in low
doses fatal pulmonary fibrosis occurs in 1% of
patients.

10. Pulmonary Adverse Effects of Drugs
 Concomitant disease can complicate interpretation of
drug adverse effects.
 Dyspnea in a patient with lung disease receiving
amiodarone could be due to the drug or the lung
disease.
 The presence of chronic lung disease and dyspnea,
should be considered in selection of antiarrhythmics.

12. Thank you
Any question?