This document provides an overview of drugs used for bronchial asthma. It discusses the history and pathophysiology of asthma, as well as the various drug classes used in treatment including bronchodilators, corticosteroids, leukotriene antagonists, mast cell stabilizers, and novel drug classes. The main routes of drug delivery and goals of pharmacological management are also summarized.
Bronchial asthma is a chronic inflammatory disease of the airways characterized by airflow obstruction, bronchial hyperactivity, and mucus production. It affects 334 million people worldwide and causes 250,000 deaths per year. The disease has genetic and environmental causes and can be triggered by factors like dust, pollen, smoke, and exercise. It is diagnosed based on symptoms, medical history, and pulmonary function tests. Treatment involves bronchodilators, corticosteroids, and other drugs to relieve symptoms and reduce inflammation. Lifestyle changes and avoidance of triggers can also help manage the condition.
Bronchial asthma is a chronic inflammatory disease of the airways characterized by airway hyperresponsiveness and reversible airway obstruction. It is caused by a complex interaction between genetic and environmental factors that lead to airway inflammation and constriction. The document discusses the definition, pathogenesis, triggers, diagnosis and management of asthma with both short-acting bronchodilators and long-term control medications to reduce inflammation and prevent symptoms.
Bronchodilators like short-acting beta-agonists treat acute asthma attacks by relaxing airway smooth muscle. Anti-inflammatory drugs like inhaled corticosteroids and leukotriene receptor antagonists are used for prophylaxis to reduce inflammation and prevent attacks. Inhaled corticosteroids are the most effective anti-inflammatory for long-term asthma control while mast cell stabilizers and leukotriene antagonists are alternatives. Drugs for chronic obstructive pulmonary disease similarly include bronchodilators and may add inhaled corticosteroids.
This document provides information about asthma, including its definition, prevalence, pathophysiology, clinical manifestations, diagnostic studies, management, and nursing considerations. Asthma is a chronic inflammatory disease of the airways characterized by variable and recurring symptoms of wheezing, breathlessness, chest tightness, and cough. It affects over 300 million people globally. Management involves both long-term control medications and quick-relief medications. The goals of nursing management are to stabilize respiratory status, relieve symptoms, reduce anxiety, promote health, prevent complications, and prevent further asthma episodes.
Bronchial asthma is a chronic inflammatory disease characterized by airway hyperresponsiveness and reversible airflow obstruction. The cardinal symptoms are cough, dyspnea, and wheezing. Triggers include pollens, pets, pollution, pharmacological agents, and repeated respiratory tract infections. Treatment includes bronchodilators like beta-2 agonists for quick symptom relief and corticosteroids as long-term controllers to reduce inflammation and prevent exacerbations. Other treatments target specific mediators like leukotriene antagonists or mast cell stabilizers. Severe refractory asthma may be treated with monoclonal antibody therapy against IgE.
Asthma is a chronic inflammatory disease of the airways characterized by recurrent episodes of symptoms like coughing, wheezing, chest tightness and shortness of breath. It affects nearly 17 million Americans and causes over 5,000 deaths annually. The inflammation and narrowing of the airways are typically reversible either spontaneously or with treatment. Management involves both long-term control medications like inhaled corticosteroids to reduce inflammation and quick-relief medications like bronchodilators for acute exacerbations. Patient education focuses on trigger avoidance, proper use of inhalers and monitoring peak flow.
drugs used in bronchial asthma & COPD.pptDrxKhan16
This document discusses the pharmacology of drugs used to treat bronchial asthma and chronic obstructive pulmonary disease (COPD). It describes the pathophysiology and symptoms of these conditions. The main classes of drugs discussed are bronchodilators and anti-inflammatory agents. Bronchodilators like short-acting beta-2 agonists are used to relieve acute asthma attacks, while long-acting beta-2 agonists and antimuscarinics are used for COPD. Anti-inflammatory drugs like inhaled corticosteroids are used to prevent asthma attacks.
Bronchial asthma is a chronic inflammatory disease of the airways characterized by airflow obstruction, bronchial hyperactivity, and mucus production. It affects 334 million people worldwide and causes 250,000 deaths per year. The disease has genetic and environmental causes and can be triggered by factors like dust, pollen, smoke, and exercise. It is diagnosed based on symptoms, medical history, and pulmonary function tests. Treatment involves bronchodilators, corticosteroids, and other drugs to relieve symptoms and reduce inflammation. Lifestyle changes and avoidance of triggers can also help manage the condition.
Bronchial asthma is a chronic inflammatory disease of the airways characterized by airway hyperresponsiveness and reversible airway obstruction. It is caused by a complex interaction between genetic and environmental factors that lead to airway inflammation and constriction. The document discusses the definition, pathogenesis, triggers, diagnosis and management of asthma with both short-acting bronchodilators and long-term control medications to reduce inflammation and prevent symptoms.
Bronchodilators like short-acting beta-agonists treat acute asthma attacks by relaxing airway smooth muscle. Anti-inflammatory drugs like inhaled corticosteroids and leukotriene receptor antagonists are used for prophylaxis to reduce inflammation and prevent attacks. Inhaled corticosteroids are the most effective anti-inflammatory for long-term asthma control while mast cell stabilizers and leukotriene antagonists are alternatives. Drugs for chronic obstructive pulmonary disease similarly include bronchodilators and may add inhaled corticosteroids.
This document provides information about asthma, including its definition, prevalence, pathophysiology, clinical manifestations, diagnostic studies, management, and nursing considerations. Asthma is a chronic inflammatory disease of the airways characterized by variable and recurring symptoms of wheezing, breathlessness, chest tightness, and cough. It affects over 300 million people globally. Management involves both long-term control medications and quick-relief medications. The goals of nursing management are to stabilize respiratory status, relieve symptoms, reduce anxiety, promote health, prevent complications, and prevent further asthma episodes.
Bronchial asthma is a chronic inflammatory disease characterized by airway hyperresponsiveness and reversible airflow obstruction. The cardinal symptoms are cough, dyspnea, and wheezing. Triggers include pollens, pets, pollution, pharmacological agents, and repeated respiratory tract infections. Treatment includes bronchodilators like beta-2 agonists for quick symptom relief and corticosteroids as long-term controllers to reduce inflammation and prevent exacerbations. Other treatments target specific mediators like leukotriene antagonists or mast cell stabilizers. Severe refractory asthma may be treated with monoclonal antibody therapy against IgE.
Asthma is a chronic inflammatory disease of the airways characterized by recurrent episodes of symptoms like coughing, wheezing, chest tightness and shortness of breath. It affects nearly 17 million Americans and causes over 5,000 deaths annually. The inflammation and narrowing of the airways are typically reversible either spontaneously or with treatment. Management involves both long-term control medications like inhaled corticosteroids to reduce inflammation and quick-relief medications like bronchodilators for acute exacerbations. Patient education focuses on trigger avoidance, proper use of inhalers and monitoring peak flow.
drugs used in bronchial asthma & COPD.pptDrxKhan16
This document discusses the pharmacology of drugs used to treat bronchial asthma and chronic obstructive pulmonary disease (COPD). It describes the pathophysiology and symptoms of these conditions. The main classes of drugs discussed are bronchodilators and anti-inflammatory agents. Bronchodilators like short-acting beta-2 agonists are used to relieve acute asthma attacks, while long-acting beta-2 agonists and antimuscarinics are used for COPD. Anti-inflammatory drugs like inhaled corticosteroids are used to prevent asthma attacks.
This document discusses drugs that act on the respiratory system. It describes different types of respiratory diseases including restrictive and obstructive diseases. It then focuses on defining asthma, describing the different types of asthma, and explaining the hypersensitivity process. It also discusses COPD and its classification. The document outlines several classes of drugs used to treat respiratory diseases, including sympathomimetics like salbutamol, methylxanthines like theophylline, anticholinergics like ipratropium bromide, and mast cell stabilizers like sodium cromoglycate. It provides details on the mechanisms of action, pharmacokinetics, uses and side effects of these drug classes and examples within each class.
This document summarizes the pharmacology of drugs used to treat bronchial asthma. It outlines the main disorders of the respiratory system including asthma, cough, allergic rhinitis, and chronic obstructive pulmonary disease. It describes the characteristics of asthmatic airways such as airway hyperreactivity, inflammation, swelling, thick mucus, and bronchospasm. It discusses the aims, types (bronchodilators and anti-inflammatory), examples (corticosteroids, leukotriene antagonists), and administration routes (inhalation, oral, injection) of anti-asthmatic drugs. It also covers the actions, onset, and uses of glucocorticoids as an anti-inflammatory
Asthma is a disease characterized by inflammation of the airways resulting in narrowing. It involves clinical symptoms like coughing, wheezing and shortness of breath. The main drugs used to treat asthma are bronchodilators like salbutamol, corticosteroids, leukotriene antagonists, and mast cell stabilizers. Salbutamol is a selective beta-2 agonist that works quickly to relax airways but has side effects like tremors. Corticosteroids reduce inflammation through various mechanisms but can cause fluid retention and weight gain. The document provides details on the mechanisms and use of these and other drugs in classifying and treating different types and severities of asthma.
This document provides an overview of asthma, including its epidemiology, pathogenesis, pathophysiology, clinical presentation, levels of control, treatment goals, and common treatment options. Key points include:
- Asthma is a common chronic inflammatory airway disease characterized by airflow limitation, airway hyperresponsiveness, and bronchoconstriction.
- Treatment involves reducing impairment through symptom control and lung function maintenance, as well as reducing risk of exacerbations.
- Main treatment options include inhaled beta-2 agonists for relief of symptoms, inhaled corticosteroids to control inflammation, and leukotriene modifiers as additional controllers.
This document discusses bronchial asthma, including its definition, clinical features, pathological findings, precipitating factors, goals of treatment, and various treatment options. Bronchial asthma is an inflammatory disorder characterized by bronchoconstriction and wheezing. The underlying cause is inflammation of the airways. Symptoms are triggered by factors like allergens, infections, and irritants. Treatment focuses on bronchodilation to relieve symptoms and suppressing inflammation. Common medications include bronchodilators, corticosteroids, leukotriene antagonists, and mast cell stabilizers.
Bronchial asthma for pharnacy student.pptxmekulecture
Under normal conditions, only approximately 1 mL of the 125 mL of glomerular filtrate that is formed each minute is excreted in the urine.
The other 124 mL is reabsorbed in the tubules.
This means that the average output of urine is approximately 60 mL/hour… approximately 1.5L urine per day.
Asthma & COPD.pptx by Dr.Malik, DNB anesthesiaMalik Mohammad
This document provides an overview of asthma and chronic obstructive pulmonary disease (COPD). It discusses the pathophysiology, diagnosis, and treatment of asthma including medications, management of acute exacerbations, and considerations for anesthesia. For COPD, it defines the condition, describes emphysema and chronic bronchitis, guidelines for diagnosis, and treatment including smoking cessation and medications. It also outlines preoperative, intraoperative, and postoperative management strategies for patients with COPD undergoing anesthesia and surgery.
Bronchial Asthma & COPD Pharmacotherapy
- Bronchial asthma is a chronic inflammatory disease of the airways that affects hundreds of millions worldwide. Common symptoms include wheezing, coughing, shortness of breath, and chest tightness.
- The main drug classes for treatment are bronchodilators, corticosteroids, mast cell stabilizers, anti-leukotrienes, and monoclonal antibodies. Drugs are primarily delivered via inhalation for direct action in the lungs with fewer systemic side effects.
- Short-acting beta-2 agonists are used for acute attacks while long-acting ones provide prolonged bronchodilation. Inhaled corticosteroids are first-
This document provides information on bronchial asthma including its definition, classification, pathophysiology, and treatment approaches. It discusses the different types of asthma such as atopic, non-atopic, and drug-induced asthma. It describes the cells and mediators involved in asthma inflammation. It covers the mechanisms and classes of drugs used to treat asthma, including bronchodilators, leukotriene antagonists, mast cell stabilizers, corticosteroids, and anti-IgE antibody. It provides details on the mechanisms of action and side effects of various bronchodilators and corticosteroids. It also discusses inhalational drug delivery systems and the treatment of acute asthma attacks.
Bronchial asthma is a chronic inflammatory disorder of the airways characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night or early morning. It is caused by a combination of airway inflammation, constriction of the bronchial muscles, and excess mucus production, leading to bronchial obstruction. Asthma is classified as extrinsic (allergic) or intrinsic (non-allergic) and can be triggered by allergens, viruses, drugs, exercise, food, pollutants, and other factors. Diagnosis involves pulmonary function tests showing reduced airflow and bronchodilator responsiveness. Treatment depends on symptom frequency and severity but generally involves bronchodilators
This document discusses the treatment of cough. It begins by classifying cough based on duration as acute (less than 3 weeks), subacute (3-8 weeks), or chronic (more than 3 weeks). For acute cough, the most common causes are viral infections, sinusitis, pertussis, COPD exacerbations, and allergies. Post-infectious cough can last 1-2 weeks. Chronic cough is often caused by postnasal drip, asthma, gastroesophageal reflux, or smoking-related chronic bronchitis. The document provides guidance on evaluating and treating cough based on duration and suspected etiology. Emphasis is placed on treating the underlying cause rather than just suppressing cough symptoms.
Anesthesia in. Obstructive pulmonary diseaseTenzin yoezer
The document discusses obstructive pulmonary diseases and their influence on anesthetic management. It covers upper respiratory infections, asthma, chronic bronchitis, cystic fibrosis, bronchiectasis, and bronchiolitis. For each condition, it describes characteristics, pathophysiology, preoperative evaluation and management, intraoperative considerations, and complications. It provides treatment guidelines to minimize risks during anesthesia for patients with obstructive lung diseases.
This document provides an overview of bronchial asthma, including its definition, pathophysiology, types, triggers, symptoms, diagnosis, management, and differences from COPD. Key points include:
- Asthma is a disease characterized by reversible airway obstruction and inflammation in response to various stimuli. It is an IgE-mediated hypersensitivity reaction.
- Common symptoms include wheezing, chest tightness, cough and breathlessness. Diagnosis is based on clinical history and pulmonary function tests showing improved airflow with bronchodilators.
- Management involves avoidance of triggers, bronchodilators, inhaled corticosteroids, and a stepped treatment plan escalating medications based on asthma control. Acute
INTRAOPERATIVE BRONCHOSPASM by Dr M.Karthik EmmanuelMKARTHIKEMMANUEL
Funny way to learn
Easy way to understand
Pictorial representation to learn quick
Smart way of creating complicated things into normal and simple and crazy way to learn
This document provides information on bronchial asthma, including its definition, epidemiology, etiology, provoking factors, pathology, symptoms, physical exam findings, laboratory/diagnostic findings, classification by severity, and treatment approaches. Bronchial asthma is a chronic inflammatory airway disease characterized by reversible airway obstruction and bronchial hyperresponsiveness. It has a prevalence of 5-15% worldwide and is caused by genetic and environmental factors like allergens. Symptoms include wheezing, chest tightness, cough, and dyspnea. Treatment involves controllers like inhaled corticosteroids and relievers like short-acting bronchodilators.
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Pharmacotherapy of asthma and copd 1.pptxAbhinav Singh
This document discusses asthma and COPD medications. It describes several classes of drugs used to treat asthma, including bronchodilators like beta-2 agonists that work quickly to relieve symptoms, and anti-inflammatory drugs like corticosteroids that are used long-term to prevent symptoms. Beta-2 agonists work by binding to beta-2 receptors and relaxing airway smooth muscle. Corticosteroids reduce inflammation through various mechanisms. Other discussed drug classes include muscarinic antagonists, methylxanthines, mast cell stabilizers, and leukotriene receptor antagonists.
Pharmacotherapy of Cough & Bronchial asthmaDr.Arka Mondal
This document discusses the pharmacotherapy of cough and bronchial asthma. It begins by describing the etiology and types of cough, as well as the cough reflex process. It then covers the types of drugs used to treat cough, including expectorants, mucolytics, antitussives, and pharyngeal demulcents. The mechanisms and examples of each drug type are provided. The document also discusses the pathophysiology and classification of drugs used to treat bronchial asthma, including bronchodilators, leukotriene receptor antagonists, glucocorticoids, and monoclonal antibodies. The mechanisms and examples of the major drug classes used for asthma treatment are summarized.
Chronic Obstructive Pulmonary Disease (COPD) is a preventable lung disease characterized by airflow limitation caused by chronic inflammation. It includes chronic bronchitis and emphysema. Key risk factors include cigarette smoking and air pollution. Diagnosis involves assessing symptoms, lung function tests showing airflow limitation, and ruling out other conditions. Management focuses on smoking cessation, vaccinations, bronchodilators, corticosteroids, pulmonary rehabilitation, and oxygen therapy for severe disease.
The document provides an overview of the lymphatic system, including its historical perspectives, embryological development, functions, anatomy, and clinical applications. It describes the key components and their roles, such as lymph, lymphatic vessels, lymph nodes, and lymphatic organs. The summary focuses on lymphatic drainage patterns in the head and neck region, noting that lymph drains from tissues and lymph nodes into the right lymphatic duct or thoracic duct. It also discusses the functions of lymph nodes in filtering pathogens and alerting the immune system.
This document discusses various animal models used to test potential antidepressant drugs. It describes models that induce depressive-like behaviors in rats, such as chronic social defeat stress and learned helplessness. Behavioral tests are then used to assess antidepressant effects, including the forced swim test and tail suspension test where antidepressants decrease immobility time. Other models test for antidepressant reversal of behaviors induced by reserpine, amphetamine potentiation, and apomorphine antagonism. The document emphasizes the need for valid animal models that accurately mimic human depressive illness.
This document discusses drugs that act on the respiratory system. It describes different types of respiratory diseases including restrictive and obstructive diseases. It then focuses on defining asthma, describing the different types of asthma, and explaining the hypersensitivity process. It also discusses COPD and its classification. The document outlines several classes of drugs used to treat respiratory diseases, including sympathomimetics like salbutamol, methylxanthines like theophylline, anticholinergics like ipratropium bromide, and mast cell stabilizers like sodium cromoglycate. It provides details on the mechanisms of action, pharmacokinetics, uses and side effects of these drug classes and examples within each class.
This document summarizes the pharmacology of drugs used to treat bronchial asthma. It outlines the main disorders of the respiratory system including asthma, cough, allergic rhinitis, and chronic obstructive pulmonary disease. It describes the characteristics of asthmatic airways such as airway hyperreactivity, inflammation, swelling, thick mucus, and bronchospasm. It discusses the aims, types (bronchodilators and anti-inflammatory), examples (corticosteroids, leukotriene antagonists), and administration routes (inhalation, oral, injection) of anti-asthmatic drugs. It also covers the actions, onset, and uses of glucocorticoids as an anti-inflammatory
Asthma is a disease characterized by inflammation of the airways resulting in narrowing. It involves clinical symptoms like coughing, wheezing and shortness of breath. The main drugs used to treat asthma are bronchodilators like salbutamol, corticosteroids, leukotriene antagonists, and mast cell stabilizers. Salbutamol is a selective beta-2 agonist that works quickly to relax airways but has side effects like tremors. Corticosteroids reduce inflammation through various mechanisms but can cause fluid retention and weight gain. The document provides details on the mechanisms and use of these and other drugs in classifying and treating different types and severities of asthma.
This document provides an overview of asthma, including its epidemiology, pathogenesis, pathophysiology, clinical presentation, levels of control, treatment goals, and common treatment options. Key points include:
- Asthma is a common chronic inflammatory airway disease characterized by airflow limitation, airway hyperresponsiveness, and bronchoconstriction.
- Treatment involves reducing impairment through symptom control and lung function maintenance, as well as reducing risk of exacerbations.
- Main treatment options include inhaled beta-2 agonists for relief of symptoms, inhaled corticosteroids to control inflammation, and leukotriene modifiers as additional controllers.
This document discusses bronchial asthma, including its definition, clinical features, pathological findings, precipitating factors, goals of treatment, and various treatment options. Bronchial asthma is an inflammatory disorder characterized by bronchoconstriction and wheezing. The underlying cause is inflammation of the airways. Symptoms are triggered by factors like allergens, infections, and irritants. Treatment focuses on bronchodilation to relieve symptoms and suppressing inflammation. Common medications include bronchodilators, corticosteroids, leukotriene antagonists, and mast cell stabilizers.
Bronchial asthma for pharnacy student.pptxmekulecture
Under normal conditions, only approximately 1 mL of the 125 mL of glomerular filtrate that is formed each minute is excreted in the urine.
The other 124 mL is reabsorbed in the tubules.
This means that the average output of urine is approximately 60 mL/hour… approximately 1.5L urine per day.
Asthma & COPD.pptx by Dr.Malik, DNB anesthesiaMalik Mohammad
This document provides an overview of asthma and chronic obstructive pulmonary disease (COPD). It discusses the pathophysiology, diagnosis, and treatment of asthma including medications, management of acute exacerbations, and considerations for anesthesia. For COPD, it defines the condition, describes emphysema and chronic bronchitis, guidelines for diagnosis, and treatment including smoking cessation and medications. It also outlines preoperative, intraoperative, and postoperative management strategies for patients with COPD undergoing anesthesia and surgery.
Bronchial Asthma & COPD Pharmacotherapy
- Bronchial asthma is a chronic inflammatory disease of the airways that affects hundreds of millions worldwide. Common symptoms include wheezing, coughing, shortness of breath, and chest tightness.
- The main drug classes for treatment are bronchodilators, corticosteroids, mast cell stabilizers, anti-leukotrienes, and monoclonal antibodies. Drugs are primarily delivered via inhalation for direct action in the lungs with fewer systemic side effects.
- Short-acting beta-2 agonists are used for acute attacks while long-acting ones provide prolonged bronchodilation. Inhaled corticosteroids are first-
This document provides information on bronchial asthma including its definition, classification, pathophysiology, and treatment approaches. It discusses the different types of asthma such as atopic, non-atopic, and drug-induced asthma. It describes the cells and mediators involved in asthma inflammation. It covers the mechanisms and classes of drugs used to treat asthma, including bronchodilators, leukotriene antagonists, mast cell stabilizers, corticosteroids, and anti-IgE antibody. It provides details on the mechanisms of action and side effects of various bronchodilators and corticosteroids. It also discusses inhalational drug delivery systems and the treatment of acute asthma attacks.
Bronchial asthma is a chronic inflammatory disorder of the airways characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night or early morning. It is caused by a combination of airway inflammation, constriction of the bronchial muscles, and excess mucus production, leading to bronchial obstruction. Asthma is classified as extrinsic (allergic) or intrinsic (non-allergic) and can be triggered by allergens, viruses, drugs, exercise, food, pollutants, and other factors. Diagnosis involves pulmonary function tests showing reduced airflow and bronchodilator responsiveness. Treatment depends on symptom frequency and severity but generally involves bronchodilators
This document discusses the treatment of cough. It begins by classifying cough based on duration as acute (less than 3 weeks), subacute (3-8 weeks), or chronic (more than 3 weeks). For acute cough, the most common causes are viral infections, sinusitis, pertussis, COPD exacerbations, and allergies. Post-infectious cough can last 1-2 weeks. Chronic cough is often caused by postnasal drip, asthma, gastroesophageal reflux, or smoking-related chronic bronchitis. The document provides guidance on evaluating and treating cough based on duration and suspected etiology. Emphasis is placed on treating the underlying cause rather than just suppressing cough symptoms.
Anesthesia in. Obstructive pulmonary diseaseTenzin yoezer
The document discusses obstructive pulmonary diseases and their influence on anesthetic management. It covers upper respiratory infections, asthma, chronic bronchitis, cystic fibrosis, bronchiectasis, and bronchiolitis. For each condition, it describes characteristics, pathophysiology, preoperative evaluation and management, intraoperative considerations, and complications. It provides treatment guidelines to minimize risks during anesthesia for patients with obstructive lung diseases.
This document provides an overview of bronchial asthma, including its definition, pathophysiology, types, triggers, symptoms, diagnosis, management, and differences from COPD. Key points include:
- Asthma is a disease characterized by reversible airway obstruction and inflammation in response to various stimuli. It is an IgE-mediated hypersensitivity reaction.
- Common symptoms include wheezing, chest tightness, cough and breathlessness. Diagnosis is based on clinical history and pulmonary function tests showing improved airflow with bronchodilators.
- Management involves avoidance of triggers, bronchodilators, inhaled corticosteroids, and a stepped treatment plan escalating medications based on asthma control. Acute
INTRAOPERATIVE BRONCHOSPASM by Dr M.Karthik EmmanuelMKARTHIKEMMANUEL
Funny way to learn
Easy way to understand
Pictorial representation to learn quick
Smart way of creating complicated things into normal and simple and crazy way to learn
This document provides information on bronchial asthma, including its definition, epidemiology, etiology, provoking factors, pathology, symptoms, physical exam findings, laboratory/diagnostic findings, classification by severity, and treatment approaches. Bronchial asthma is a chronic inflammatory airway disease characterized by reversible airway obstruction and bronchial hyperresponsiveness. It has a prevalence of 5-15% worldwide and is caused by genetic and environmental factors like allergens. Symptoms include wheezing, chest tightness, cough, and dyspnea. Treatment involves controllers like inhaled corticosteroids and relievers like short-acting bronchodilators.
asthma,asthma attack,asthma symptoms,asthma treatment,asthma nursing,symptoms of asthma,asthma (disease or medical condition),severe asthma,what is asthma,asthma pathophysiology,types of asthma,causes of asthma,asthma medicine,#asthma,asthma uk,asthma nursing lecture,asthma kids,asthma diet,exercise induced asthma,asthma cough,asthma nclex,asthma attak,asthma foods,pathophysiology of asthma,asthma series,kid has asthma,asthma control
Pharmacotherapy of asthma and copd 1.pptxAbhinav Singh
This document discusses asthma and COPD medications. It describes several classes of drugs used to treat asthma, including bronchodilators like beta-2 agonists that work quickly to relieve symptoms, and anti-inflammatory drugs like corticosteroids that are used long-term to prevent symptoms. Beta-2 agonists work by binding to beta-2 receptors and relaxing airway smooth muscle. Corticosteroids reduce inflammation through various mechanisms. Other discussed drug classes include muscarinic antagonists, methylxanthines, mast cell stabilizers, and leukotriene receptor antagonists.
Pharmacotherapy of Cough & Bronchial asthmaDr.Arka Mondal
This document discusses the pharmacotherapy of cough and bronchial asthma. It begins by describing the etiology and types of cough, as well as the cough reflex process. It then covers the types of drugs used to treat cough, including expectorants, mucolytics, antitussives, and pharyngeal demulcents. The mechanisms and examples of each drug type are provided. The document also discusses the pathophysiology and classification of drugs used to treat bronchial asthma, including bronchodilators, leukotriene receptor antagonists, glucocorticoids, and monoclonal antibodies. The mechanisms and examples of the major drug classes used for asthma treatment are summarized.
Chronic Obstructive Pulmonary Disease (COPD) is a preventable lung disease characterized by airflow limitation caused by chronic inflammation. It includes chronic bronchitis and emphysema. Key risk factors include cigarette smoking and air pollution. Diagnosis involves assessing symptoms, lung function tests showing airflow limitation, and ruling out other conditions. Management focuses on smoking cessation, vaccinations, bronchodilators, corticosteroids, pulmonary rehabilitation, and oxygen therapy for severe disease.
The document provides an overview of the lymphatic system, including its historical perspectives, embryological development, functions, anatomy, and clinical applications. It describes the key components and their roles, such as lymph, lymphatic vessels, lymph nodes, and lymphatic organs. The summary focuses on lymphatic drainage patterns in the head and neck region, noting that lymph drains from tissues and lymph nodes into the right lymphatic duct or thoracic duct. It also discusses the functions of lymph nodes in filtering pathogens and alerting the immune system.
This document discusses various animal models used to test potential antidepressant drugs. It describes models that induce depressive-like behaviors in rats, such as chronic social defeat stress and learned helplessness. Behavioral tests are then used to assess antidepressant effects, including the forced swim test and tail suspension test where antidepressants decrease immobility time. Other models test for antidepressant reversal of behaviors induced by reserpine, amphetamine potentiation, and apomorphine antagonism. The document emphasizes the need for valid animal models that accurately mimic human depressive illness.
This document discusses drugs used to treat constipation. It begins by defining constipation and describing its common causes and symptoms. It then classifies laxatives and describes the mechanisms of different laxative types, including bulk-forming agents, stool softeners, osmotic purgatives, and stimulant purgatives. The document provides examples of specific drugs for each laxative class and their dosages. It concludes by discussing the appropriate choice and use of laxatives as well as the risks of laxative abuse.
This document provides information on drugs used to treat Parkinson's disease. It begins with a brief history of Parkinson's disease and then discusses the pathophysiology involving the loss of dopamine-producing neurons in the substantia nigra. The main classes of antiparkinsonian drugs described are those affecting the brain's dopaminergic and cholinergic systems. Key drugs discussed in depth include levodopa, peripheral decarboxylase inhibitors like carbidopa, dopamine agonists like pramipexole and ropinirole, MAO-B inhibitors like selegiline and rasagiline, and COMT inhibitors like entacapone and tolcapone. Adverse effects and considerations for each drug class are
This document provides an overview of antimicrobial resistance. It begins by defining drug resistance as the unresponsiveness of microorganisms to antimicrobial agents. It then discusses the history of resistance, noting that Fleming warned of this danger in 1945. The document outlines the different types of resistance, including natural/primary resistance that microbes innately possess and acquired resistance that develops from use of antimicrobials over time. Microbes can develop resistance through mutation of genetic material or acquisition of new genes. The mechanisms of resistance include drug tolerance, drug destruction, changes to target sites, and altered membrane permeability. Cross-resistance between related drugs is also explained. The document concludes by discussing ways to prevent resistance, including prudent antimicrobial use and
This document provides an overview of coagulation and anticoagulation. It describes the coagulation cascade and how anticoagulants work, including indirect thrombin inhibitors like heparin and low molecular weight heparins. It discusses the pharmacology, indications, and adverse effects of various anticoagulants such as heparin, fondaparinux, argatroban, and bivalirudin. Common uses of anticoagulants include treating deep vein thrombosis, pulmonary embolism, myocardial infarction, and cerebrovascular disease.
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2. OBJECTIVES
INTRODUCTION
HISTORY OF ASTHMA
RISK FACTORS/TRIGGERS
PATHOPHYSIOLOGY
ROUTES AND DELIVERY DEVICES
PHARMACOLOGICAL GOALS AND MANAGEMENT
RECENT ADVANCES
3. HISTORY
• The earliest recorded reference to respiratory
distress – a disorder characterized by “noisy
breathing” (wheezing?) is found in China in 2600
BC
• Hippocrates (~400 BC)
first to use the term “Asthma” (Greek for “wind” or
“to blow”) for panting and respiratory distress.
4. Roman doctors described asthma as:-
gasping and the inability to breathe without making noise. They noted “if from running or any other work, the
breath becomes difficult, it is called asthma.
Pliny the elder( 50 AD) :-
• Pollen : as a source of respiratory difficulty
• Recommended the use of ephedra in red wine
Suggested drinking the blood of wild horses & eating 21 millipedes soaked in honey
Maimonides(1135-1204 AD) :-
“Treatise on Asthma”
Rest, good personal hygiene, avoidance of opium, small quantity of wine and special diet.
5. • Rene Laennec, using the stethoscope he invented
• For the 1st time asthma wheezes could be heard
Asthma cigarettes
Herbal preparation containing Atropine like
alkaloids
6. 1905:-
Epinephrine referred for treatment
1950-1960:-
Oral corticosteroids, inhaled corticosteroids &
selective β2 agonist
1969:-
“Allergy & Asthma Medical Group & Research
Centre” leading to therapeutic advancements
7. INTRODUCTION
Asthma is a chronic inflammatory disorder of the airway,
characterised:-
Clinically by :
Recurrent episodes of wheezing
Breathlessness
Chest tightness
Coughing(particularly at night/early
morning)
Physiologically by :
Widespread, reversible narrowing
of the bronchial airways
Marked increase in bronchial
responsiveness
8. Wheezing
Whistling or rattling sound
- result of airway
obstruction
Chest tightness
Dyspnoea
coughing
Early warning Signs:-
• Frequent cough, especially at night
• Shortness of breath
• Feeling very tired or weak while
exercising.
• Wheezing or coughing after exercise
• Feeling tired easily upset, grouchy or
moody.
• Signs of cold or allergies(sneezing,
runny nose, cough, nasal congestion,
sore throat and headache.
• Trouble sleeping.
CLINICAL
MANIFESTATIONS
11. CLASSIFICATION
ACCORDING TO ETIOLOGY:-
1. Allergic or extrinsic asthma
2. Non-allergic or intrinsic asthma
ACCORDING TO DEGREE OF SEVERITY:-
1. Intermittent
2. persistent, mild
3. persistent, moderate
4. Persistent, severe
12. CHARACTERSTICS EXTRINSIC ASTHMA INTRINSIC ASTHMA
DEFINITION
Linked with exposure of specific
allergens. Eg., pollen, house dust
Linked with some nonspecific
stimulants. Eg.,chemical irritants
NATURE
Atopy (Type 1 hypersensitivity reaction)
due to exposure of exogenous non-
bacterial antigens.
IgE mediated.
Non immune mediated, due to increased
airway reactivity to vagal stimulation
AGE GROUP AFFECTED Children Adults
FAMILY HISTORY Usually present Usually absent
TRIGGERED Environment Infection
17. AIRWAY
AIRWAY HYPERRESPONSIVENESS
MUCOUS HYPERSECRETION
AIRWAY NARROWING/BRONCHOSPASM
SYMPTOMS(WHEEZING,SHORTNESS OF BREATH)
MECHANISM OF AIRWAY NARROWING
Airway smooth muscle
(response to bronchoconstrictor)
Airway edema-inflammatory mediators
Airway thickening remodelling
Cholinergic nerves- activated by reflex triggers
Bronchoconstriction
TRIGGERS
Inflammatory mediators
Stimulation of : interleukins, IGE, Interferons
Activation of : Mast cells, Eosinophils
Histamines/Prostaglandins/Leukotrienes
INFLAMMATION
18. CHRONIC OBSTRUCTIVE PULMONARY DISEASE
• Common, preventable & treatable disease,
characterized by persistent airflow limitation that
is usually aggressive & associated with an
enhanced chronic inflammatory response in the
airway & the lung to noxious particles or gases
• Characterized by:
progressive emphysema (alveolar destruction)
bronchial fibrosis
19.
20. LABORATORY DIAGNOSIS
Pulmonary function tests:-
Using Spirometry
Estimating degree of obstruction:-
o Decreased FEV1
o Normal / decreased FVC
o Increased RV & TLC
Chest X-ray:-
normal appearance to hyperinflammation
Flattening of the diaphragm
Arterial blood gas (ABG)
21. ROUTES OF DRUG DELIVERY TO THE
LUNGS
1. INHALED ROUTE:-
• Administration of the drug directly into the lung by aerosol inhalation.
• Particle size:-
› Size of the particle determines the site of deposition in the respiratory tract.
› Optimum size for the particles to settle in the airways :- 2-5 MMAD
› Large particles:- settle in the upper airways
› Smaller particles:- remain suspended & are exhaled
23. Of the total drug delivered - 10-20% enters the lower airways with conventional pMDI
Drugs with higher molecular weights – retain to a greater extent in the airways.
More extensive pulmonary distribution of a drug with a smaller MMAD –
• Increases alveolar deposition
• Likely to increase absorption from the lungs into the general circulation.
24. 2. ORAL ROUTE:-
• Reserved for the few patients unable to use inhalers (e.g., small children, patients with physical problems such
as severe arthritis of the hands).
• Theophylline:- ineffective by the inhaled route and therefore must be given systemically
• Corticosteroids may have to be given orally for parenchymal lung disease
3. PARENTERAL ROUTE:-
• Reserved for delivery of drugs in the severely ill patient who is unable to absorb drugs from the GI tract.
25.
26. APPROACHES TO TREATMENT
Prevention of AG:AB reaction
Neutralization of IgE
Suppression of inflammation & bronchial hyper reactivity
Prevention of release of mediators
Antagonism of released mediators
Blockade of constrictor neurotransmitter
Mimicking dilator neurotransmitter
Directly acting bronchodilators
27. CONTROLLER MEDICATIONS RELIEVER MEDICATIONS
Control/treat chronic inflammation & bring about
an improvement of overall asthma control
Immediate reversal of bronchospasm but no effect on
underlying inflammation
Taken regularly on a long term basis Used at the time of acute attacks
Inhaled glucocorticosteroids
Leukotriene modifiers
Long acting β2 agonists
Low dose sustained release theophylline
Short acting β2 agonists
Anticholinergics
Theophylline immediate release
29. SYMPATHOMIMETICS
β2 Agoinst:-
• Potent bronchodilator
• Usually given by inhalation route
• Effects:-
Relaxation of airway smooth muscle
Inhibition of mast cell mediator release
Reduction in plasma exudate
Increased mucociliary transport
Inhibition of sensory nerve activation
• No effect on airway inflammation
30. SHORT ACTING β2 AGONIST (SABA)
Salbutamol, Terbutaline
• Inhaled SABAs :- most widely used and effective bronchodilators due to their functional
antagonism of bronchoconstriction.
• They are convenient, easy to use, rapid in onset, and without significant systemic side effects.
• Effective in protecting against various asthma triggers : exercise, cold air, and allergens.
• Bronchodilators of choice in treating acute severe asthma.
Nebulized route
31. LONG ACTING β2 AGONIST (LABA)
Salmeterol, Formoterol, Arformoterol, Indacaterol, Vilanterol
12 hours 24 hours
• Improve asthma control (when given twice daily) compared with regular treatment with SABAs
(four to six times daily)
• Formoterol :- more rapid onset of action , almost full agonist
• Salmeterol :- partial agoinst, slower onset of action
In COPD: Alone or in combination with anticholinergics or ICSs. LABAs improve symptoms
& exercise tolerance by reducing both air trapping & exacerbations.
In asthma: Combination with an ICS in a fixed-dose combination inhaler
32. SIDE EFFECTS OF β2 AGOINSTS :-
• Muscle tremor (direct effect on skeletal muscle β2 receptors)
• Tachycardia (direct effect on atrial β2 receptors, reflex effect from increased
peripheral vasodilation via β2 receptors)
• Hypokalemia (direct β2 effect on skeletal muscle uptake of K+)
• Restlessness
• Hypoxemia (↑ V/Q mismatch due to reversal of hypoxic pulmonary vasoconstriction)
• Metabolic effects (↑ FFA, glucose, lactate, pyruvate, insulin)
33. METHYLXANTHINES
Restricted to COPD & selected cases of asthma
as Adjuvant Medication
• Mechanism of action:-
1) Antagonism of adenosine receptors on the cell
membrane.
2) Inhibition of phosphodiesterases that
inactivate cAMP; and
3) Enhancement of deacetylation of histones
involved in the transcription of inflammatory
genes. Theophylline (oral), aminophylline (i.v.)
34.
35. Absorption: well absorbed orally;
erratic rectal absorption
Distribution: all tissues; cross
BBM; 50% pp bound
Metabolism: by CYP1A2 by
demethylation & oxidation
Excretion: only 10 % excreted
unchanged in urine
1.Theophylline : narrow margin of
safety
2. Headache, nausea are early
symptoms
3. Gastric pain ( with oral ), rectal
inflammation (with suppositories)
& pain at the site of i.m injection
4. Rapid i.v injection:- precordial
pain, syncope & even sudden death
1.Bronchial asthma & COPD
2. Apnoea in premature infants
PHARMACOKINETICS ADVERSE EFFECTS USES
36. ANTICHOLINERGICS
Blockade of M3 mediated cholinergic constrictor tone
Acting primarily on Larger Airways
Inhaled Ipratropium bromide:-
• Effective in asthmatic bronchitis & COPD
• Given by aerosol: No decrease in respiratory secretion
& impairment in mucociliary clearance
Tiotropium bromide:-
• Longer acting
• Good for once daily maintenance therapy
37. NOVEL CLASSES OF BRONCHODILATORS
MAGNESIUM SULFATE:-
• Reduces cystolic calcium in airway smooth muscle Bronchodilatation
Additional bronchodilator in children and adults with acute severe asthma
Benefits in serious severe exacerbations( FEV1˂ 30%)
Cheap and well tolerated treatment
• Side effects: flushing, nausea
38. POTASSIUM CHANNEL OPENERS:-
( cromakalim, levcromakalim )
• Open ATP dependent K channels in smooth muscles
Membrane hyperpolarization & relaxation of airway smooth muscle
Maxi-K channel openers inhibits mucus secretion & cough
:- may be particular value in the treatment of COPD
39. VASOACTIVE INTESTINAL POLYPEPTIDE ANALOGUES:-
• VIP binds to VPAC1 ( smooth muscles of blood vessels) & VPAC2 (airway
smooth muscle) couple to Gs adenylyl cyclase
stimulated smooth muscle relaxation
Potent bronchodilator in vitro studies
Produces rapid bronchodilator effect but is not prolonged
40. BITTER TASTE RECEPTOR AGONISTS:-
(Denatonium, chloroquine)
• TAS2R agoinst
• Bronchodilation via G protein phosphatidylinositol pathway
activation of Ca dependent K channel & subsequent hyperpolarization of SM
• Bronchodilation in response to agonists such as quinine & chloroquine.
41. LEUKOTRIENE ANTAGONISTS
Montelukast, Zafirlukast, Zileuton
• Competitive antagonism of cysLT1 receptor mediated bronchoconstriction, airway mucus
secretion, increased vascular permeability & recruitment of eosinophils.
• Episodes of asthma exacerbations are reduced
Indicated for:- prophylactic therapy of mild-to-moderate asthma as alternatives to inhaled
glucocorticoids
Effective in aspirin induced asthma & exercise induced asthma
• Fewer side effects: abdominal pain, headache & rashes
42. Monitoring of liver associated
enzymes required
(zileuton, montelukast &
zafirlukast associated with rare
cases of hepatic dysfunction)
Major Advantage: effectiveness
in tablet form
Effective as once daily
preparation
43. MAST CELL STABILIZERS
Inhibits degranulation of mast cell by
trigger stimuli
Release of mediators like histamine,
LT, PAF, IL is Inhibited
Bronchial hyperreactivity is reduced
Bronchospasm due to various stimuli
( allergens, irritants, cold air &
exercise) is prevented.
Sodium cromoglycate, Ketotifen, Nedocromil
44. Sodium cromoglycate
• Synthetic chromone derivative
• Inhibits : degranulation of mast cells by trigger stimuli
• Restricts the release mediators of asthma- may involve a delayed Cl
channel in the membrane of these cells inhibiting activation.
• It is not a histamine antagonist/bronchodilator:- Ineffective in asthma
attack.
Administered as an aerosol through metered dose inhaler.
Minimal systemic toxicity.
A/E :- Bronchospasm, throat irritation & cough
Uses:-
1. Bronchial asthma:
prophylactic in mild to
moderate asthma
2. Allergic rhinitis: as a
nasal spray
3. Allergic conjunctivitis:
as eye drops
46. MECHANISM OF ACTION:-
• Binding to cytoplasmic receptor
(GR), this complex moves to
nucleus
• Increased transcription of anti-
inflammatory genes
• Supression of transcription of
proinflammatory genes
47. SYSTEMIC CORTICOSTEROID THERAPY
• Systemic steroid therapy is applied in the following cases:-
Severe chronic asthma Status asthmaticus
• Not controlled by bronchodilators & ICS
• Frequent recurrences of increasing severity
Prednisolone 20-60mg daily
dose reduction after 1-2 weeks
shifting patient to ICS
• Asthma attack not responding to intensive
bronchodilator therapy
High dose of rapidly acting i.v. glucocorticoid
which generally acts in 6-24 hrs
Shift to oral therapy for 5-7 days & the taper
rapidly
48. INHALED CORTICOSTEROID
Beclomethasone dipropionate, Budesonide, Fluticasone, Ciclesonide
• Inhaled corticosteroids are recommended as first-line therapy for patients with persistent asthma
• Prevent the episodes of acute asthma
Supress bronchial inflammation
Increase peak expiratory flow rate
Reduce need for rescue beta 2 agonist inhalation
• Peak effect seen after 4-7 days of instituting ICS & benefit persists for a few weeks after
discontinuation
49. ICS
• Currently the most effective long term preventive medications
• Early diagnosis & treatment with ICS: important for prevention of airway remodelling
• Initial treatment: dosing guided by asthma severity
• Long term treatment: titration of the lowest effective dose
• COPD:- High dose ICS in advanced COPD with frequent exacerbations
50. ADVERSE EFFECTS
LOCAL SIDE EFFECTS SYSTEMIC SIDE EFFECTS
Hoarseness of voice
Dysphonia
Sore throat
Oropharyngeal candidiasis
(Clinically relevant only at doses ˃ 600 µg/day)
Adrenal suppression
Growth suppression
Osteoporosis
Cataracts
Glaucoma
Hyperglycaemia
52. ANTI IgE RECEPTOR THERAPY
• Omalizumab : humanized monoclonal antibody
• Blocks the binding of :
IgE to high-affinity IgE receptors (FcεR1) on
mast cells
IgE to low-affinity IgE receptors (FcεRII, CD23)
on T & B lymphocytes, macrophages &
eosinophils
53. • Administered by: s.c. injection every 2-4 weeks
• Reduces :
levels of circulating IgE
Requirement for oral & ICSs
Asthma exacerbations
• HIGH COST!
• A/E : anaphylactic response (˂0.1%)
54.
55. New Drugs in Development for Airway Disease
• CRTh2 ANTAGONISTS
• The chemotactic factor for Th2 cells :- Prostaglandin D2, (DP2 receptor)
• Several DP2/CRTh2 antagonists are now in development for asthma
• Promising initial results in patients with Eosinophilic Inflammation
• ANTIOXIDANTS
• Oxidative stress : contribute to corticosteroid resistance.
Vitamins C and E and N-acetyl-cysteine.
56. • CYTOKINE MODIFIERS
• Interleukin 5:- pivotal role in eosinophilic inflammation
• Anti–IL-5 & anti–IL-5 receptor (IL-5Rα) antibodies : inhibit eosinophilic
inflammation & airway hyperresponsiveness (mild asthma).
• In severe asthma and persistent eosinophilia despite high doses of corticosteroids :
significant reduction in exacerbations and sparing of oral steroids with an anti–IL-5
antibody, Mepolizumab.
57. • CHEMOKINE RECEPTOR ANTAGONIST
• Key role in recruitment of inflammatory cells (eosinophils, neutrophils, macrophages,
and lymphocytes) into the lungs.
• CCR3 antagonists (block eosinophil recruitment) - most favored target
58. • PHOSPHODIESTERASE INHIBITORS
(Roflumilast, cilomilast)
• PDE4 inhibition elevate levels of intracellular cAMP
Supresses inflammatory cell function
Inhibition of mucin production
Alterations in airway smooth muscle tone
59. REFERENCES
1. Goodman L, Gilman A. The pharmacological basis of therapeutics. 13th ed. New York : McGraw-Hill;
2011. Chapter 40, pulmonary pharmacology; p.727-46
2. Tripathi KD. Essentials of medical pharmacology. 8th edition, New Delhi : Jaypee Brothers Medical
publications (P) Ltd; 2019. Chapter 16, Drugs for cough and bronchial asthma; p.237-53
3. Katzung G. basic and clinical pharmacology. 13th edition, Chennai : McGraw-Hill; 2018. Chapter 20, drugs
used in asthma; p. 346-361
4. Whalen K. Lippincott Illustrated reviews of pharmacology. South asian edition,. Wolters Kluwer India Pvt.
Ltd; 2019. Chapter 41, Drugs for disorders of the respiratory system; p.719-28
5. Papi, A., Blasi, F., Canonica, G.W. et al. Treatment strategies for asthma: reshaping the concept of asthma
management. Allergy Asthma Clin Immunol 16, 75 (2020). https://doi.org/10.1186/s13223-020-00472-8
6. Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma (GINA), 2020.
Available from www.ginasthma.org