Antitussives and Expectorants - Module 4 Flashcards
antitussives suppress coughing
by working on the cough center in the brain stem or by anesthetizing the stretch rc in the respiratory tract
Codeine/morphine and hydrocodone
Narcotic cough suppressant are the best antittussive drugs. Any opioid will also be used…heroin…
OTC cough and cold medicine
Dextromethorphan (DM or DXM) is more widely used today. NOT AN OPIOID
Codeine
for many years was the drug most often given to suppress a cough.
Expectorants
reduce the thickness of sputum of sputum so that pt can more easily cough it up
Guaifenesin
is the only expectorant we will study
- derived from the guaiac tree, the resin of which has been used for centuries in cough and cold remedies - must take with water
- pupular OTC cough and cold - Robitussin
vertigo
is a disorder with equilibrium, caused a problem in the inner ear. often it is just a temporary viral infection that cases it. sometimes it can be a sign of more serious inner ear disease
Cerumenex
hydrogen peroxide -H2O2
ear drops to soften ear wax impaction
Drug to treat motion sickness and vertigo
Dramamine - antihistamine
Drug to prevent motion sickness
Scopolamine (Transderm Scop) - a belladonna anticholinergic drug,
Pulmonary diseases
Asthma
COPD = emphyseam - Chronic obstructive pulmonary disease
10 people die every day in US due to these disease
drugs use to relax bronchial smooth muscle to treat asthma, emphyseam (COPD) and EIA (exercise induced asthma)
Bronchodilators can be given by mouth or injection or nebulized as liquid or powder
Bronchodialators - sympathetic
Front door
stimulation dilates the bronchioles and relieves asthma
** catecholamines (adrenergic drugs - are “front door” bronchodialators
Bronchodialators - parasympathetic
Back door
stimulation causes bronchoconstriction
** anticholinergics produce effects complimentary to the sympathetic agonists - “back door”
Bronchodialators - Side door
Methylxanthines, through a different mechanism
All the sympathomimetics
stimulate the beta2 adrenergic rc - B2 agonists cause bronchial smooth muscles to relax
Beta1 Rc agonists
cause the heart rate to speed up
Alpha agonist
cause most blood vessels to constrict
“Front-door” sympathomimetic bronchodialators drugs
epinephrine - mixed Beta1, Beta2 and Alpha rc adrenergic agonist. this drug used to treat asthma in 1910.
Ephedrine, amphetamine, cocaine - non-selective sympathetic nervous system “stimulants”
Better bronchodilators drug for everyday use than epinephrine
Albuterol (Proventil, Ventolin) - is the prototypical fast onset, short acting beta2 selective. open the airways w/o stimulating the heart
albuterol
is quick acting and lasts about 4-6 hours used as a “rescue inhaler”
Two of the best long acting beta 2 agonist (LABA)
salmeterol and formoterol - with extended duration of action up to 12 hrs
“Back door” Bronchodilators
Anticholinergics are atropine - like drugs
sympathomimetics
positive simulator of the sympathetic - agonist
sympatholytics
Negative stimulator of sympathetic antagonist
parasympathomimetics
positive simulator of the parasympathetic - agonist
parasympatholytics
Negative stimulator of parasympathetic antagonist
ipratropium
is the prototype parasympatholytic - results in bronchodialation in a manner opposite “back door” of the adrenergic agonists
methylxanthines
found in black tea
are toxic to some animals - ingredient in unsweetened dark chocolate.
Xanthine
are a group of alkaloids commonly used for mild stimulants and as bronchodialtors, notably in treating the symptoms of asthma (not a drug choice). Side-door non-sympathetic bronchodilators
Advair Diskus
Sympathomimetic Bronchodilators
salmeterol + fluticasone - Powder
popular combination of beta 2 agonist combined with potent corticosteroid.
LTA
Leukotrience rc antagonists
Leukotrience
are inflammatory mediators involved in asthma and allergies
Singulair (montelukast) by Merck- LTA
have been approved for treatment of asthma and serve hay fever not responsive to antihistamine therapy.
Accolate (zafirlukast) by Zeneca - LTA
Leukotrience Rc antagonists
Mast Cell Stabilizers
Cromolyn sodium (NasalCrome) Drug that coat mast cells and prevent the release of their allergy causing granules.
Cromolyn sodium was first developed for use in the lungs as the drug Intal
Mast cell
release histamine causing bronchoconstriction in an asthmatic or an allergy reaction in a person with hay fever.
corticosteroids /mast cell stabilizers
are only used prophylactic ally because they do NOT promote immediate bronchodialation - they can only prevent the bronchconstrictions form occuring