DRUGS ACTING ON THE RESPIRATORY SYSTEM Flashcards
Impairment of airflow in bronchial asthma is caused by
i. Contraction of airway smooth muscles
ii. Thickening of bronchial mucosa from edema and cellular infiltration
iii. Inspissations in the airway lumen of abnormally thick, viscid plugs of excessive mucus.
How many type of bronchial asthma?
Extrinsic and Intrinsic.
Extrinsic asthma is associated with history of
allergies in childhood, family history of allergies, hay fever, or elevated IgE.
Which asthma type occurs in middle age?
Intrinsic asthma occurs in middle-aged subjects with no family history of allergies, negative skin tests and normal serum IgE.
Define Asthma?
Asthma is a disease mediated by reaginic (IgE) antibodies bound to mast cells in the airway mucosa. But not all features of asthma can be accounted for by antigen-challenge model. Nonantigenic stimuli like viral infections, exercise, and cold air stimulate bronchial spasm.
How many categories of drug group used in bronchia asthma?
Three main categories
1. Bronchodilators
2. Mast cell stabilizers
3. Antiinflammatory agents (corticosteroids)
What are the drugs come under Mast cell stabilizers category?
Cromolyn sodium
Nedocromil
Ketotifen
How many Bronchodilators drug types?
β- Adrenergic agonists
Methylxanthines
Muscuranic receptor antagonists
Name bronchodilators muscarinic receptor antagonists?
Pratropium bromide
Name methylxanthines drugs?
Theophylline derivatives
Bronchodilators β- adrenergic agonists include:
Non selective β-agonists e.g. adrenaline
Selective β-agonists e.g. salbutamol
Salbutamol is
Bronchodilators β- adrenergic agonists
Adrenaline is
Bronchodilators non selective β-agonists
What anti-inflammatory agent used to treat BRONCHIAL ASTHMA
Corticosteroids
β- Adrenergic agonists is also called
SYMPATHOMIMETIC AGENTS
What are the SYMPATHOMIMETIC AGENTS non- selective- β-agonists?
Epinephrine
Ephedrine
Isoprotenerol
What are the SYMPATHOMIMETIC AGENTS selective- β-agonists?
Salbutamol
Terbutaline
Metaproterenol
Salmeterol
Formaterol
What is Mechanism of Action of β-Agonists?
β-Agonists stimulate adenyl cyclase and increase formation of cAMP in the airway tissues.
What is pharmacological actions of β-Agonists?
- Relax smooth muscles
- Inhibit release of inflammatory mediator
- Inhibit microvasculature leakage
- Increase mucociliary transport
What is pharmacological actions of non-selective β- agonists?
Cause more cardiac stimulation
Bronchodilator
What is contra-indication of SYMPATHOMIMETIC AGENTS?
Hypertension
Arrhythmia
Which Non- selective- β-agonists drug is long duration of action?
Ephedrine
Which are the new generation of long acting β2- selective agonists?
Salmeterol
Formeterol
What are the side effects of Selective β2- selective agonists?
Tremors, anxiety, insomnia, tachycardia, headache, hypertension
Sympathomimetics are contraindicated in patients with
known hypersensitivity to the drugs
What precautions should take for Selective β2- selective agonists?
Precautions: They should be used cautiously in patients with hypertension, cardiac dysfunction, hyperthyroidism, glaucoma, diabetes, pregnancy.
What are the METHYLXANTHINES drugs?
Theophylline
Caffeine
Theobromine
What is MUSCRANIC RECEPTOR ANTAGONISTS mechanism of action?
Muscarinic antagonist competitively inhibit effect of acetylcholine at muscarinic receptors – hence block the contraction of air way smooth muscle and the increase in secretion of mucus that occurs in response to vagal activity e.g atropine sulfate
Name few corticosteroids drugs?
Hydrocortisone
Predinisolone
Beclomethasone
Triamcinolone
Why corticosteroids not given via oral route routinely?
Because of severe adverse effects when given chronically, oral and parenteral corticosteroids are reserved for patient who need urgent treatment and those who have not improved with 81
bronchodilator.
What are the Clinical uses of corticosteroids in bronchial asthma?
- Urgent treatment of severe asthma not improved with
bronchodilator - IV, inhalation or oral. - Nocturnal asthma prevention - oral or inhalation
- Chronic asthma - Regular aerosol corticosteroids
What is the drug name used as MAST CELL STABILIZERS?
Cromolyn sodium
What is clinical use for Cromolyn sodium?
Exercise and antigen induced asthma
Occupational asthma
What are the side effects of Cromolyn sodium?
Throat irritation, cough, dryness of mouth, chest tightness
What is Status asthmatics?
Very sever and sustained attack of asthma which fails to respond to treatment with usual measures
What are the management of status asthmatics
- Administration of oxygen
- Frequent or continuous administration of aerosolized ß2 agonists like salbutamol
- Systemic corticosteroid like methyl prednisolone or hydrocortisone IV
- Aminophylline IV infusion
- Iv fluid to avoid dehydration
- Antibiotics in the presence of evidence of infection
How many types of Anti-tussives drugs?
Central antitussives
Peripheral antitussives
What is the peripheral antitussives drugs?
Demulcents (liquorices lozenges, honey)
Name Central antitussives drugs?
o Opoid antitussive e.g. codeine, hydrocodeine, etc
o Non opoid antitussives e.g. dextromethorphan
Central antitussive drugs divided into two groups, which are:
Opoid antitussive
Non opoid antitussives
Name Opoid antitussive drugs?
Codeine, Hydrocodeine,
Codeine drugs is a
narcotic relatively less addicting drug and central antitussive agen and it’s main side effects are dryness of mouth, constipation and dependence.
DEXTROMETROPHAN drugs is
is an opoid synthetic antitussive, essentially free of analgesic and addictive properties and the main side effects are respiratory depression
What is DECONGESTANTS?
Decongestants are the drugs that reduce congestion of nasal passages, which in turn open clogged nasal passages and enhances drainages of the sinuses.
Name few DECONGESTANTS drugs?
Phenylephrine
Oxymetazoline
What is the clinical uses of DECONGESTANTS
Used in congestion associated with rhinitis, hay fever, allergic rhinitis and to a lesser extent common cold.
What is the classifications of DECONGESTANTS?
- Short acting decongestants administered topically
- Long acting decongestants administered orally
- Long acting topical decongestants
What are short acting decongestants?
Phenylepherne
Phenylpropanolamine
What are long acting decongestants?
Ephedrine
Pseudoephedrine
Naphazoline
What are long acting topical decongestants
Xylometazoline
Oxymetazoline
What are the contraindications of decongestants?
Hypertension
Severe coronary artery disease
Short-acting beta-agonists
