This document provides information on drugs used for upper and lower respiratory infections. It discusses the anatomy of the respiratory tract and the process of respiration. For upper respiratory infections, it describes antihistamines, decongestants, intranasal glucocorticoids, antitussives, and expectorants. For lower respiratory disorders like asthma, it discusses beta-2 adrenergic agonists, anticholinergics, methylxanthine derivatives, leukotriene modifiers, glucocorticoids, cromolyn, and nedocromil. The document provides details on the mechanisms, uses, and side effects of these various drug classes.
Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to symptoms like wheezing, coughing, shortness of breath, and chest tightness. It can be triggered by various factors including allergens, respiratory infections, exercise, smoke, and pollutants. Management involves medication, identifying triggers, creating an action plan, monitoring symptoms, staying active, maintaining a healthy lifestyle, getting vaccinated, and regular check-ups with healthcare providers. Effective management aims to control symptoms, prevent flare-ups, and improve overall quality of life.
Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to symptoms like wheezing, coughing, shortness of breath, and chest tightness. It can be triggered by various factors including allergens, respiratory infections, exercise, smoke, and pollutants. Management involves medication, identifying triggers, creating an action plan, monitoring symptoms, staying active, maintaining a healthy lifestyle, getting vaccinated, and regular check-ups with healthcare providers. Effective management aims to control symptoms, prevent flare-ups, and improve overall quality of life.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. Respiratory Tract
• Upper respiratory tract
includes: nares, nasal
cavity, pharynx, and
larynx.
• Lower respiratory tract
includes: trachea,
bronchi, bronchioles,
alveoli, and alveolar-
capillary membrane
• Air enters the upper
resp. tract & travels to
the lower tract where
gas exchange takes
place
3. Respiratory Tract
• Respiration = the process whereby gas exchange occurs at
the alveolar-capillary membrane. 3 phases:
1. Ventilation - movement of air from the atmosphere
through the upper & lower airways to the alveoli
2. Perfusion - blood from the pulmonary circulation is
adequate at the alveolar-capillary bed
3. Diffusion - molecules move from area of higher
concentration to lower concentration of gases - O2 passes
into the capillary bed to be circulated & CO2 leaves the
capillary bed & diffuses into the alveoli for vent. excretion
4. Respiratory Tract
• Perfusion - influenced by alveolar pressure. For gas
exchange, the perfusion of each alveoli must be matched
by adequate ventilation. Mucosal edema, secretions, &
bronchospasms increase the resistance to airflow & dec.
ventilation & diffusion of gases
• Bronchial Smooth Muscle - In the tracheobronchial tube is
smooth muscle whose fibers spiral around the tube
contraction constriction of airway
- Parasympathetic Nervous system releases acetylcholine
bronchoconstriction
- Sympathetic Nervous system releases epinephrine
stimulates beta-2 receptors in bronchial smooth muscle
bronchodilation
5. Drugs for Upper respiratory
Infections
• Upper Respiratory Infections (URI’s) = common cold,
acute rhinitis, sinusitis, acute tonsillitis, acute laryngitis
- The common cold = most expensive > $500 million
spent on OTC preparations
• Common Cold & Acute Rhinitis -
- Common cold caused by the rhinovirus & affects
primarily the nasopharyngeal tract.
- Acute rhinitis (inflammation of mucus membranes of
nose) usually accompanies the common cold
- Allergic rhinitis - caused by pollen or a foreign substance
6. Drugs for Upper Respiratory
Infections
• Incubation period of a cold = 1 to 4 days before
onset of symptoms & first 3 days of the cold
- Home remedies = rest, chicken soup, hot toddies,
Vitamins
- 4 groups of drugs used to manage symptoms =
antihistamins (H-1 blocker), decongestants
(sympathomimetic amines), antitussives,
expectorants
7. Drugs for Upper Respiratory
Infections - Antihistamines
• Antihistamines or H-1 blockers - compete w/ histamine for
receptor sites prevents a histamine response.
2 types of histamine receptors - H-1 & H-2
H-1 stimulation = extravascular smooth muscles
(including those lining nasal cavity) are constricted
H-2 stimulation = an inc. in gastric secretions = peptic
ulcer disease
Do not confuse the 2 receptors - antihistamines decrease
nasopharyngeal secretions by blocking the H-1 receptor
8. Drugs for Upper Respiratory
Infections - antihistamines
• Histamines - A compound derived from an amino acid
histadine. Released in response to an allergic rxn (antigen-
antibody rxn) - such as inhaled pollen
- When released it reacts w/ H-1 receptors = arterioles &
capillaries dialate = inc. in bld flow to the area =
capillaries become more permeable = outward passage of
fluids into extracellular spaces= edema (congestion) =
release of secretions (runny nose & watery eyes)
- Large amts. of released histamine in an allergic rxn =
extensive arteriolar dilation = dec. BP, skin flushed &
edematous = itching, constriction & spasm of bronchioles
= SOB & lg. amts. of pulmonary & gastric secretions
9. Drugs for Upper Respiratory
Infections - Antihistamines
• Astemizole (Hismanal), Cetirizine (Zertec), Loratadine
(Claritin), Chlorpheniramine (Chlortrimeton),
Diphenhydramine (Benadryl)
• Actions = competitive antagonist at the histamine
receptor; some also have anticholinergic properties
• Uses = Treat colds; perennial/seasonal allergic rhinitis
(sneezing, runny nose); allergic activity (drying &
sedation); some are also antiemetic
• SE = Drowsiness, dizziness, sedation, drying effects
• CI = glaucoma, acute asthma
10. Drugs for Upper Respiratory
Infections - Decongestants
• Nasal congestion results from dilation of nasal bld.
vessels d/t infection, inflammation, or allergy.
With dilation there’s transudation of fluid into
tissue spaces swelling of the nasal cavity
• Decongestants (sympathomimetic amines)
- stimulate alpha-adrenergic receptor
vasoconstriction of capillaries w/in nasal mucosa
shrinking of the nasal mucus membranes &
reduction in fluid secretion (runny nose)
11. Drugs for Upper Respiratory
Infections - Decongestants
• Naphazoline HCL (Allerest), Pseudoephedrine
(Actifed, Sudafed), Oxymetolazone (Afrin),
Phenylpropanolamine HCL (Allerest, Dimetapp)
• Use - Congestion d/t common cold, hayfever, upper resp.
allergies, sinusitis
• SE = Jittery,nervous,restless, Inc BP, inc. bld. sugar
• CI = Hypertension, cardiac disease, diabetes
• Preparations = nasal spray, tablets, capsules, or liquid
• Frequent use, esp. nasal spray, can result in tolerance &
rebound nasal congestion - d/t irritation of nasal mucosa
12. Drugs for Upper Respiratory Infections -
Intranasal Glucocorticoids
• Beclomethasone (Beconase, Vancenase, Vanceril),
Budesonide (Rhinocort), Dexamethasone
(Decadron)fluticasone (Flonase)
- Action - steroids used to dec. inflammation locally in the
nose
- Use - Perennial/seasonal allergic rhinitis (sneezing, runny
nose) - May be used alone or w/ antihistamines
- SE - rare, but w/ continuous use dryness of the nasal
mucosa may occur
13. Drugs for Upper Respiratory
Infections - Antitussives
• Action - Acts on the cough control center in the medulla to
suppress the cough reflex
• Use - Cough suppression for non-productive irritating
coughs
* Codeine - Narcotic analgesic to control a cough d/t the
common cold or bronchitis
* Dextromethorphan - nonnarcotic antitussive that
suppresses the cough center in the medulla, widely used
- syrup, liquid, chewable & lozenges
- SE = drowsiness, sedation
14. Drugs for Upper Respiratory
infections - Expectorants
• Action - Loosens bronchial secretions so they can
be eliminated w/ coughing
* A nonproductive cough becomes more productive
and less frequent
• Uses - Nonproductive coughs
• Guaifenesin (Robitussin) = Most common
* Use alone or in combo w/ other resp. drugs
• Hydration is the best expectorant
16. Drugs for Lower Respiratory
Disorders
• Lung Compliance - Lung volume based on the unit of
pressure in the alveoli
* Determines the lung’s ability to stretch (tissue elasticity)
* Determined by: connective tissue; surface tension in the
alveoli controlled by surfactant
- surfactant lowers surface tension in alveoli & prevents
interstitial fluid from entering
* Inc. (high) lung compliance in COPD
* Dec. (low) lung compliance in restrictive pulmonary
disease = lungs become “stiff” & need more pressure
17. Drugs for Lower Respiratory
Disorders
• Chronic obstructed pulmonary disease (COPD) &
restrictive pulmonary disease = 2 major lower resp. tract
diseases
• COPD = airway obstruction w/ inc. airway resistance to
airflow to lung tissues - 4 causes
- Chronic bronchitis - emphysema
- Bronchiectasis - asthma
* Above frequently result in irreversible lung tissue
damage. Asthma reversible unless frequent attacks and
becomes chronic.
18. Drugs for Lower Respiratory
Disorders
• Restrictive lung disease = a dec. in total lung
capacity as a result of fluid accumulation or loss of
elasticity of the lung.
* Causes: Pulmonary edema, pulmonary fibrosis,
pneumonitis, lung tumors, scoliosis
• Bronchial Asthma = 10-12 million people of all
ages affected - a chronic obstructive pulmonary
disease characterized by periods of bronchospasm
resulting in wheezing & difficulty in breathing
19. Drugs for Lower Respiratory
Disorders
• Asthma - Bronchospasm or bronchoconstriction results
when the lung tissue is exposed to extrinsic or intrinsic
factors that stimulate a bronchoconstrictive response
- Causes: humidity, air pressure changes, temp. changes,
smoke, fumes, stress, emotional upset, allergies, dust,
food, some drugs
* Pathophys = Mast cells (found in connective tissue
throughout the body) are directly involved in the asthmatic
response - esp. to extrinsic factors
- allergens attach themselves to mast cells & basophils =
antigen-antibody rxn
20. Drugs for Lower Respiratory
Disorders - Asthma
• Mast cells stimulate release of chemical mediators
(histamines, cytokines, serotonin, ECF-A (eosinophils))
• These chemical mediators stimulate bronchial constriction,
mucous secretions, inflammation, pulmonary congestion
• Cyclic adenosine monophosphate (cAMP) - a cellular
substance responsible for maintaining bronchodilation -
When inhibited by histamines & ECF-A bronchoconst.
• Sympathomimetic (adrenergic) bronchodilators inc. amt.
of cAMP & promote dilation first line drugs used
21. Drugs for Lower Respiratory
Disorders
• Sympathomimetics: Alpha & Beta-2 Adrenergic
Agonists
• Increase cAMP dilation of bronchioles in acute
bronchospasm caused by anaphylaxis from allergic rxn
give nonselective epinephrine (Adrenalin) - SQ in an
emergency to promote bronchodilation & inc. BP
SE = tremors, dizziness, HTN, tachycardia, heart
palpitations, angina
• For bronchospasm d/t COPD - selective beta-2 adrenergic
agonists are given via aerosol or tablet
22. Drugs for Lower Respiratory
Disorders
• Metaproterenol (Alupent, Metaprel) - some beta-1, but
primarily used as a beta-2 agent - PO or inhaler/nebulizer
- For long-term asthma Rx beta-2 adrenergic agonists
frequently given by inhalation
* more drug delivered directly to constricted bronchial
site
* Effective dose less than PO dose & less side effects
- Action = relaxes bronchial smooth muscle - onset = fast
- SE = Nervousness, tremors, restlessness, insomnia & inc.
HR
23. Drugs for Lower Respiratory
Disorders
• Albuterol (Proventil, Ventolin) - More beta-2 selective
- PO or inhaler
- Used for acute/chronic asthma
- Rapid onset of action & longer duration than
Metaproterenol
- Fewer SE because more beta-2 specific, but high doses
can still effect beta-1 receptors & cause nervousness,
tremors & inc. pulse rate
24. Drugs for Lower Respiratory
Disorders - Anticholinergics
• Ipratropium bromide (Atrovent) -
- Action - competitive antagonist (inhibits) of cholinergic
receptors in bronchial smooth muscle = bronchiole
dilation - Inhaler
- Use - In combination w/ beta agonist for asthma & for
bronchospasm associated w/ COPD
- Need to teach clients how to use properly: If using
Atrovent w/ a beta-agonist, use beta-agonist 5 min. before
Atrovent; If using Atrovent w/ an inhaled steroid or
cromolyn, use Atrovent 5 min. before the steroid or
cromolyn - bronchioles dilate & drugs more effective
25. Drugs for Lower Respiratory
Disorders - Methylxanthine derivatives
• Aminophylline, Theophylline (TheoDur), Caffeine –
* PO or IV -
* Use - Treatment of asthma & COPD
* Action - Inc. cAMP bronchodilation; also - diuresis,
cardiac, CNS & gastric acid stimulation
* When given IV a low therapeutic index & range -
Monitor levels frequently
* PO doses can be given in standard dosages
* Avoid smoking, caffeine & inc. fluid intake
26. Methylxanthine derivatives
• Drug Interactions: Inc the risk of dig toxicity, decreases the
effects to lithium,dec theophyllin levels with Dilantin,
theophyllin and beta-adrenergic agonist given together -
synergistic effect can occurcardiac dysrhythmias. Beta
blockers, Tagamet, Inderal and e-mycin decrease the liver
metabolism rate and inc. the half-life and effects of theophyllin
• SE : Anorexia, N&V, nervousness, dizziness, palpitations, GI
upset & bleeding, HA, restlessness, flushing, irritability,
marked hypotension, hyper-reflexia and seizures.
• CI: Severe cardiac dysrhythmias, hyperthyroidism, peptic
ulcer disease (increases gastric secretions)
27. Drugs for Lower Respiratory Disorders -
Leukotrine Receptor Antagonists & Synthesis
Inhibitors
• Leukotriene (LT) a chemical mediator that can cause
inflammatory changes in the lung. The group cysteinyl
leukotrienes promotes and inc in eosinophil migration,
mucus production, and airway wall edema, which result
in broncho-constriction.
• LT receptor antagonists & LT synthesis inhibitors
(Leukotriene modifiers) effective in reducing the
inflammatory symptoms of asthma triggered by allergic
& environmental stimuli - Not for acute asthma
28. Leucotriene receptor antagonist and synthesis
inhibitors
•Zafirlukast (Accolate), Zileuton (Zyflo), Montelukast
sodium (Singulair) – PO
• Action - Decreases the inflammatory process Use -
prophylactic & maintenance drug therapy for asthma
•Accolate – 1st in group, leukotriene receptor antagonist
reduce inflammation & dec bronchoconstriction, PO-
BID-rapidly absorbed
•Singulair –New leukotriene receptor antagonist, short
t1/2 (2.5-5.5) Safe for children under 6yo.
29. Drugs for Lower Respiratory
Disorders - Glucocorticoids (Steroids)
• Glococorticoids have an anti-inflammatory action and are
used if asthma is unresponsive to bronchodilator therapy
• Given: inhaler- beclomethasone (Vanceril, Beclovent);
tablet - triamcinolone (Amcort, Aristocory),
dexamethasone (Decadron), prednisone; injection -
dexamethasone, hydrocortisone
• SE significant w/ long-term oral use - fluid retention,
hyperglycemia, impaired immune response
• Irritating to the gastric mucosa - take w/ food
• When d/c’ing taper the dosage slowly
30. Drugs for Lower Respiratory
Disorders - Cromolyn & Nedocromil
• Cromolyn (Intal) - for prophylactic Rx of bronchial
asthma & must be taken on a daily basis - NOT used for
acute asthma - Inhaler
* Action - inhibits the release of histamine that can cause an
asthma rxn
* SE - mouth irritation, cough & a bad taste in the mouth
** Caution - rebound bronchospasm is a serious side effect
do not d/c the drug abruptly
• Nedocromil sodium - action & uses similar to Intal -
prophylactic usage - inhalation therapy - may be more
effective than Intal
31. Drugs for Lower Respiratory
Disorders - Mucolytics
• Acetylcysteine (Mucomyst) - nebulization
* Action - liquefies & loosens thick mucous secretions so
they can be expectorated
* Use - dissolves thick mucous, acetaminophen overdose
(bonds chemically to reduce liver damage)
* SE - N & V, chest tightness, bronchoconstriction
* Use w/ a bronchodilator
• Dornase alfa (Pulmozyme) - an enzyme that digests the
DNA in thick sputum of cystic fibrosis (CF) clients
32. MATH
NDC 000w-7293-01 VIAL No. 7293
R/X Lilly
ADD-Vantage Vial
NEBCIN
Tobramycin sulfate
injection, usp
60 Mg per 6ml
You need to prepare 30 mg. How
much solution will you need?
30 mg X 6 ml =
60 mg
1 X 6 ml =
2
6 = 3 ml
2