Anti Asthmatic Drugs: These are those drugs which are used in the treatment of Asthma

1. ASTHMATIC
ANTI
PREPARED BY : ABDUSSAMI MOULVI

2. DEFINATION
• ASTHMA IS CHARACTERIZED INCREASED
RESPONSIVENESS BY OF TRACHEA AND
BRONCHI TO VARIOUS STIMULI AND BY
NARROWING OF THE AIRWAYS.
• ANTIASTHMATIC ARE DRUGS USED TO TREAT
ASTHMATIC CONDITIONS.

3. • Bronchodilators
CLASSIFICATION
• These are the drugs
used in bronchial
asthma and relax the
spasm of bronchi by
sympathetic nervous
system stimulation.
• Leukotriene antagonists
• Leukotrienes are
inflammatory
chemicals the body
releases after coming in
contact with an
allergen or allergy
trigger.
• Mast cell stabilizers
• Mast cell stabilizers are
used to prevent disorders.
or control allergic
• They block a calcium
channel essential for mast
cell degranulation, stabilizing
the cell.
• Anti-IgE antibody
• Anti-inflammatory agents
Anti-IgE is a form of
treatment for allergic
conditions that has been
approved for the treatment
of moderate to severe
persistent asthma and
chronic idiopathic urticaria
A drug or substance that
reduces inflammation
(redness, swelling, and pain)
in the body

4. BRONCHODILATOR
• Classified as -
• Beta 2 sympathomimetics
• Methylxanthines
• Anticholinergics

5. BETA 2
SYMAPATHOMIMETICS
• The Symapathomimetic drugs, whose mimic that of sympathetic
stimulation.
• The Symapathomimetic agents or beta adrenergic receptor agonists
are widely used for treatment of asthma.
• There are two type of receptors- beta 1 and beta 2.
• The beta 1 adrenergic receptors are present in the heart and beta 2 receptors are
present in lungs.
• By stimulation of beta 2 adrenergic receptors these agents ;
relax bronchial muscles, inhibit the release of mediators from
mast cells, enhance mucociliary activity and effect
composition of mucus.
So when receptor beta- adrenergic agonists are administered,
adverse effects are caused by stimulation of beta-1 receptors in
heart, which cause cardiac stimulation.
• Thus, now drugs having greater affinity to beta 2 adrenergic
receptors has been developed.
• Adenergic that effect the primarily beta 2 adrenergic receptors
are called selective beta 2 adrenergic agonists.
• But selectivity is lost at sufficiently high concentration of these
drugs.

6. BETA 2 SYMPATHOMIMETICS
DRUGS
• Terbutaline
• Salbutamol
• salmetrol

7. • 1.catecholamines
Beta 2 sympathomimetic agents are
classified under 2 broad categories.
• 2. noncatecholamines
• For the purpose of simplify the understanding, the important beta 2
sympathomimetic discussed under drugs are
• 1.selective beta 2 receptor agonist and
• 2.non-selective beta 2 receptor agonist categories.

8. • It is a short acting
beta 2 adrenergic
receptor agonist used
for the relief of
bronchospasm in
conditions such as
asthma and COPD.
01
• SALBUTAMOL
(ALBUTEROL):
02 03
• Airway smooth muscle
has little sympathetic
nervous supply but
contain lots of beta 2
adrenoreceptors that
respond to circulating
adrenaline.
SALBUTAMOL
MOA
• The stimulation of
beta 2 receptors leads
to rise in intracellular
cyclic adenine
monophosphate (cAMP)
levels and the
subsequent bronchial
smooth muscle
relaxation.
• Oral (children)
• 2-6 years: 0.1-0.2
mg/kg/dose three times
/ day, maximum does
not exceed 12 mg/day
(divided doses)
DOSE
• 1.SELECTIVE BETA 2 RECEPTOR AGONIST

9. • 6-12 years : 2mg/dose 3-4
times/day; maximum does not
exceed 24 mg/day (divided
doses)
• Extended release: 4 mg every 12
hours; maximum dose not to
exceed 24 mg/day ( divided
doses).
04
2-4 mg 3-4 times /day,
not to exceed 32 mg/day
• Extended release: 8 mg
every 12 hours, not to
exceed 32 mg/day
• Elderly: 2 mg 3-4
times/day, maximum 8
mg 4 times/day.
DOSE
ABOVE 12 YEARS
AND ADULTS
• Children: > 2-12 years:
0.63-1.25 mg every 4-6
hours.
• Children 4 years :
• - quick relief: 0.63-2.5 mg
every 4- 6 hours.
• Exacerbation of asthma :
0.15 mg/kg every 20 min for 3
doses.
Children 5-11 years
• Quick relief: 1.25-5mg
every 4-8 hours
• Exacerbation of
asthma : 0.15mg/kg
every 20 min 3 times.
• 1.SELECTIVE BETA 2 RECEPTOR AGONIST
05
NEBULIZATION

10. Above 12 years and adults
• Quick relief: 1.25-5mg every 20
min for 3 doses
• Continuous infusion :
• Adults: severe bronchospasm
and status asthmaticus.
• Asthma
• COPD
• Exercise induced
bronchospasm
• 1.SELECTIVE BETA 2 RECEPTOR AGONIST
06
INDICATIONS

11. • 2.NON-SELECTIVE BETA 2 RECEPTOR
AGONIST CATEGORIES.
Ephedrine (ΕΡΗ) is a sympathomimetic amine used as a
stimulant, decongestant, treating allergic asthma and
bronchodilator.
Ephedrine releases tissue stores of norepinephrine
and there by produces an alpha and beta adrenergic
stimulation longer acting and less potent than
epinephrine.
• EPHEDRINE
• EPHEDRINE MOA
• Children: oral, 3mg/kg/day
• IM, slow IV push: 0.2-0.3 mg/kg
• Adults: oral: 25-50 mg every 3-4 hours
• Sc:25-50 mg
• IV: 5-25mg/dose slow IV push
DOSE INDUCATION
Treatment of bronchial asthma and broncospasm

12. METHYLXANTHINES
THEOPHYLLINE
• Theophylline known as
dimethylxanthine drug used for
COPD or asthma.
• THEOPHYLLINE
• AMINOPHYLLINE
• HYDROXYETHYL
THEOPHYLLINE
Theophylline MOA
• It causes bronchodilatation, which increase tissue
concentrations of CAMP, (cyclic adenine
monophosphate (cAMP) which in turn promotes
catecholamine of lipolysis, glycogenolysis and
gluconeogenesis and induces release of
epinephrine from adrenal medulla cells.
Dosage
• Adult minimum / maximum dose :
6.0 mg/kg/24.0 mg/kg
• Paediatric minimum / maximum
dose: 2.0mg/kg/24.0mg/kg

13. ANTICHOLINERGICS (MUSCARINIC ANTAGONIST)
ANTICHOLINERGIC
DRUGS
• Ipratropium
bromide
• Tiotropium
bromide
IPRATROPIUM
BROMIDE
Ipratropium bromide
- Ipratropium bromide
is an anticholinergic
drug,
- chemically related to
atropine.
IPRATROPIUM
BROMIDE MOA
• It blocks muscarinic
cholinergic receptors,
• Resulting in a decrease
in the formation of
cyclic guanosine
monophosphate (cGMP).
• This results in
decreased contractility
of smooth muscle.
An anticholinergic agent substance that blocks is a the
neurotransmitter acetylcholine in the central and the
peripheral nervous system.
Dosage
• 1.Aerosol inhalation
two inhalations four
times daily. Do not
exceed 12 inhalations in
24 hours.
• Spray 0.03 formulation
:2 sprays per nostril 3 or
4 times daily.
DOSAGE
DOSAGE

14. LEUKOTRIENE ANTAGONISTS
• Leukotrienes are
inflammatory
chemicals the body
releases after
coming in contact
with an allergen or
allergy trigger.
Leukotriene antagonists
• Montelukast
• Zafirlukast
Montelukast
• A leukotriene antagonist is
a drug that inhibits
leukotrienes.
Montelukast MOA
• That inhibits the cysteinyl
leukotrine receptor.
Dosage
• Oral (children)
• 6-11 months: Asthma: 4mg
once daily
• 6-23 months: allergic
rhinitis : 4mg once daily
• 12-23 months: Asthma: 4
mg once daily.

15. MAST CELL STABILIZER
MAST CELL
• A mast cell is
a type of white
blood cell and
part of immune
and
neuroimmune
system
contains
histamine.
Mast cell stabilizers
• Mast cell stabilizers
are used to prevent
disorders. or control
allergic
• They block a calcium
channel essential for
mast cell
degranulation,
stabilizing the cell.
Mast cell
stabilizers
• Sodium
cromoglyc
ate
• Ketotifen
Sodium
cromoglycate MOA
• It prevents
mediators the
release of that
inflammatory cells
attract
• And because it
stabilizes the
inflammatory cells.

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