Respiratory and Gastrointestinal Drugs

Question 1

Respiratory Drugs

Answer 1

• drugs that are used to treat or prevent a variety of diseases associated with the respiratory system
• usually administered orally or by inhalation
• 2 main medications
  
  • bronchodilators
  • corticosteroids

Question 2

Bronchodilators

Answer 2

• drugs used to treat bronchoconstriction and serve to dilate the bronchial passages
• classes include:
  
  • inhaled corticosteriods
  • beta-agonists
  • cholinergic antagonists
  • methylxanthines
• 2 prophylactic agent classes in addition to those above:
  
  • leukotriene modifiers
  • cromolyn

Question 3

Corticosteroids

Answer 3

• are glucocorticoids, inluding the synthetic versions of these hormones, which are given to inhibit inflammation
• glucocorticoid hydrocortisone (Cortisol) is the main drug used in this area primarily for asthma treatment

Question 4

Glucocorticoids

Answer 4

hormones produced in the adrenal cortex

Question 5

Beta-agonists

Answer 5

• also called Beta-adrenergic agonists
• are medications that relax muscles of the airways resulting in easier breathing
• short-acting agents that affect beta-adrenoceptors
• most often used in treatment of:
  
  • acute bronchospasms
  • exercise induced asthma
  • COPD
• drugs include:
  
  • albuterol (short-acting)
  • arformoterol (longer-acting)

Question 6

Cholinergic Antagonists

Answer 6

• block bronchoconstriction caused by activaction of the parasympathetic nervous system
• also used for COPD
• drugs include:
  
  • ipatropium (short-acting)
  • tiotropium (longer-acting)

Question 7

Methylxanthines

Answer 7

• exact mechanism is not understood
• act as bronchodilators through the relaxation of the bronchial smooth muscles helping constricted bronchial airways to dilate
• Theophylline is the standard agent of this class
  
  • its use has been mostly replaced by inhaled corticosteroids and beta-agonists

Question 8

Leukotriene Modifiers

Answer 8

• used as alternatives to inhaled corticosteroids
  
  • are less effective
• typically used for prophylactic treatment of chronic asthma
• also used for allergie
• common drugs:
  
  • montelukast (Singulair)
  • zileuton (Zyflo)

Question 9

Cromolyn

Answer 9

• not used frequently
• sometimes used as asthma treatment
• exact mechanism is unknown
  
  • it does prevent the release of inflammatory agents such as histamine

Question 10

Gastrointestinal Drugs

Answer 10

• GI drugs
• used for various GI conditions
  
  • ulcers
  • GI mobility
  • GI disease
• Classified by areas of GI tract they target:
  
  • stomach
  • duodenum
  • lower GI tract

Question 11

Upper GI tract

Answer 11

• Typical disorders:
  
  • acid reflux
  • gastric ulcers
• Ulcers typically caused by H. Pylori and antibiotics are an effective treatment
• OTC Pepto-Bismol has been shown to be somewhat bactericidal against H. Pylori
• When H. Pylori is not the cause treatments include reduction of pH (acidity) in stomach by:
  
  • antacids
  • proton pump inhibitors
  • H₂ antagonists

Question 12

Antacids

Answer 12

• include:
  
  • calcium carbonate (TUMS)
  • magnesium salts
  • aluminum salts
• side effects:
  
  • constipation from aluminum salts and calcium carbonate
  • diarrhea from magnesium salts
    
    • these medications are often used in combination to offset the side effects

Question 13

H₂ Antagonists

Answer 13

• work to prevent histamine-induced acid release
• used for short-term treatment of GERD and peptic ulcer
• typical drugs (-tidine):
  
  • cimetidine
  • ranitidine
  • famotidine

Question 14

Proton Pump Inhibitors

Answer 14

• inhibit the H+-K+-ATPase enzyme of the parietal cells in the stomach, reducing overall acid secretion
• superior to H₂ antagonists = more effective
• Medications include:
  
  • omeprazole (Prilosec)
  • esomeprazole (Nexium)
  • lansoprazole (Prevacid)

Question 15

Lower GI Tract

Answer 15

• Typical disorders:
  
  • diarrhea
  • constipation
  • Inflammatory bowel disease
  • IBS (irritable bowel syndrome)
  • OIC (opiod induced constipation)

Question 16

Diarrhea

Answer 16

• often caused by an infection, toxin, or drug
• antibiotics are used for bacterial infections
• for other causes:
  
  • opiate powders
    
    • diphenoxylate (Lomotil)
    • loperamide (Imodium)
  • absorbant powders
    
    • Kaopectate

Question 17

Constipation

Answer 17

• drug classifications:
  
  • bulk-forming agents
    
    • calcium polycarbophil
    • methylcellulose
    • psyllium (Metamucil)
  • stimulants
    
    • bisadocyl (Dulcolax)
    • danthron
    • phenolphthalein (ExLax)

Question 18

Inflammatory Bowel Disease

Answer 18

• ulcerative colitis and Crohn’s disease
• Treatment options used to control the inflammatory process include
  
  • steroids
  • 5-aminosalicyclate (5-ASA)

Question 19

IBS

Answer 19

• Irritable Bowel Syndrome
• involves bowel oversensitivity
• 2 types:
  
  • IBS-C
    
    • constipation as predominate symptom
    • linaclotide (Lizness) - reduces activation of colonic sensory neurons–reducing pain–and activates colonic motor neruons–increasing smooth muscle contraction, promoting bowel movement
  • IBS-D
    
    • diarrhea as predominate symptom
    • rifaximin (Xifaxin)

Question 20

OIC

Answer 20

• opioid induced constipation
• common side effect of long-term use of opiods for pain management
• 2 agents:
  
  • lubiprostone (Amitiza)
  • methylnaltrexone bromide (Relistor)