Pulmonary Drugs Flashcards
Asthma, Lower respiratory infections (laryngotracheitis/bronchitis and pneumonia), Ventilator Support, and Smoking Cessastion
Pulmonary Diseases & Conditions
drugs used to relax bronchial smooth muscle (allow bronchioles to dilate to increase air flow and mitigate bronchospasm) to treat asthma, emphysema (COPD) and exercised-induced asthma (EIA);
can be given by mouth or injection, or nebulized as a liquid or powder
Bronchodilator drugs
triggered by acute infections, diseases like emphysema (COPD), part of asthma and EIA
bronchospasm
Sympathomimetic drugs, catecholamines
Stimulate beta-receptors in the smooth muscle around the bronchioles (mimic epinephrine) to relieve asthma
Use direct sympathetic stimulation to dilate bronchial smooth muscle
*includes epinephrine (prototype of mixed beta-1, 2 and alpha rc adrenergic agonist) and other non-selective sympathetic NS stimulants like cocaine, amphetamine, ephedrine, etc.
“Front door” bronchodilators (catecholamines)
causes bronchiole dilation
sympathetic stimulation
sympathomimetic drugs or parasympatholytic drugs
parasympatholytic drugs (anticholinergic, atropine-like drugs)
Produce effects complimentary to sympathetic agonists but by manner opposite of adrenergic agonists
Block the action of acetylcholine on muscarinic rc in smooth muscle around bronchioles
i.e. atropine or ipratropium
“Back door” bronchodilators
(chocolate, caffeine drugs, coffe)
Non-sympathetic
A group of drugs found to have bronchodilator effects, but not by mechanisms that manipulate the ANS
They act directly on the smooth around the bronchioles and the respiratory centers in the brain
Derived from a group of chemicals called xanthines (*methylxanthines are particularly useful)
*xanthine-type drugs include theophylline (Theo-Dur) found in black tea and caffeine in tea, coffee and soda
“Side door” bronchodilators
albuterol (Proventil, Ventolin): rescue therapy
- prototypical fast onset, short acting beta-2 selective bronchodilator
- is quick acting and lasts about 4-6 hours
- used as a rescue inhaler to treat acute wheezing
quick-acting bronchodilators better for every day use than epinephrine
salmeterol and formoterol: regular therapy
- 2 good, long acting beta-2 agonists (LABAs)
- extended durations of action (up to 12 hours)
- take about a 1/2 hour to work
- used as preventative, prophylactic treatment
- work well as ‘symptom-controllers’ *good in combo with 2x/day corticosteroid (to be anti-inflammatory)
long-acting bronchodilators better for every day use than epinephrine
The prototype ‘back-door’ bronchodilator that has less cardiac effects than atropine and is longer acting; it’s a metered dose inhaler or MDI
ipratropium
a dry-powder inhaler (DPI), a metered-dose inhaler (MDI), an oral tablet, and an inhalation solution for use with saline in a nebulizer machine
the 4 forms in which most beta-2 selective agonists are marketed and adminastered
Adrenergic drugs used to activate the alpha and beta receptors
- do not contain catechol in their nucleus
- i.e. ephedrine, phenylephrine, amphetamine, metatraminol and methoxamine
- used as treatment for various ailments like blood cell constriction, to get muscle relaxation, nasal and eye decongestion, and bronchiole dilation
Noncatecholamines
stimulate the beta 2 adrenergic receptors that cause bronchial smooth muscles to relax
“Front door” sympathomimetic bronchodilators
cause vasoconstriction
alpha receptors agonists
cause the heart rate to speed up
beta 1 receptors agonists
used preventatively
prophylactic
a popular combo of a beta 2 agonist (salmeterol) + a potent corticosteroid (fluticasone); easily inhaled as a powder (easier than using MDIs)
Advair (Sympathomimetic bronchodilator)
Singulair (montelukast), Accolate (zafirlukast) and Ultair (pranlukast)
Leukotriene rc blockers
white blood cells that release histamine, causing bronchoconstriction in an asthmatic or an allergy reaction in a person with hay fever
Mast cells
A series of shots aimed at producing ‘blocking anitbodies’ of the IgG type to prevent the IgE-allergen complex from causing mast cells to degranulate
(Basically a form of immunization against allergens)
Desensitization Immunotherapy
Group of drugs that suppress/reduce inflammation by suppressing almost all inflammatory products/mediators in the immune response
-NOT bronchodilators so they won’t work for for acute situations of bronchoconstriction (won’t relax bronchial smooth muscle)
-WILL dramatically decrease inflammation within 4-6 hours
(Inhibit part of the AA pathway)
Corticosteroids
examples of corticosteroid inhales excellent for maintenance therapy in asthma (to decrease acute attacks); side effects of locally inhaled are not as great as ones given systemically
beclomethasone (Vanceril MDI)
triamcinolone (Armacort MDI)
drugs used to treat URLs can also be used for ______
infections of the Upper Respiratory Tract
drugs that suppress cough and thin mucous secretions are used for pulmonary infections as well as __________
infections of the ear nose and throat
pen VK, amoxicillin, clarithromycin and azithromycin (macrolides), and ciprofloxacin/Cipro (fluoroquinolone)
*also used fro ENT infections
Oral antibiotics for lung infections (bronchitis, pneumonia)
Opioid cough suppressants and dextromethorphan (DXM)
best antitussive agents
most popular expectorant; found in Robitussin; comes from the guaiac tree
guaifenesin
Nicotine patch (NicoDerm), gum (Nicorette) and spray, Zyban, Chantix
Smoking Cessation drugs and therapies
remarketed antidepressant drug bupropion (Wellbutrin)
*found to have cured some people of the urge to smoke
Zyban
The newest andmost effective antismoking drug therapy:
- 1st in a new compound class–blocks nicotine receptors in the brain
- allows the person to wean themselves off the effects of nicotine, still smoking for part of therapy
- has been linked to serious neuropsychiatric symptoms including suicidal ideation and erratic behavior
Chantix
Sympathomimetic bronchodilators/”front door” beta-2 agonists, parasympatholytic bronchodilators/”back door” anticholinergic drugs, Xanthine/methylxanthine types/”side door” bronchodilators, Antihistamines, Leukotriene Rc Blockers, Mast Cell Stabilizers, Desensitization Immunotherapy for allergies, Inhaled Corticosteroids,
Antitussives & Expectorants, Antibiotics, Antifungals, Anti-smoking, and other misc
Pulmonary Drugs
Epinephrine–found in the OTC inhaler ‘Primatene Mist’
Ephedrine–usually an injection or a syrup
isoproterenol (Isuprel)
short acting inhaled agents: albuterol (Proventil MDI)
long acting inhaled agents (LABAs): formoterol and salmeterol (the Advair Diskus contains salmeterol + the corticosteroid fluticasone)
Sympathomimetic Bronchodilators (“front door”, beta-2 agonists)
ipratropium (Atrovent): atropine-like drug with anticholinergic effects
Parasympatholytic bronchodilators (“back door”)
caffeine/coffee/chocolate-like drugs (soda, theobromine in hot choc, theophylline); they relax bronchial smooth muscle and stimulate respiratory centers
Xanthine and methylxanthine type bronchodilators (“side door” drugs)
Antihistamines: 1st, 2nd and 3rd generation
Leukotriene Rc Blockers- Sinulair (Monteleukast)
Mast Cell Stabilizers (cromolyn sodium as liquid for nebulizers–inhalation)
Desensitization Immunotherapy–weekly shots
Inhaled Corticosteroids: MDIs
Antitussives (coughs) & Expectorants (mucolytics)
Antibiotics: penicillins, macrolides, fluoroquinolones
Antifungals: for lungs–systemic ones (Diflucan)
Antivirals: 2 oral flu drugs and TIV vaccine
ENT drugs also used as Pulmonary Drugs
a surfactant extracted from ground-up cow lungs used to treat lung disease of premature infants (hyaline membrane disease)
Survanta
