Respiratory Drugs Flashcards
movement of air from the atmosphere through the upper and lower airways to the alveoli
Ventilation
process whereby gas exchange occurs at the alveolar-capillary membrane
Respiration
blood flow at the alveolar capillary bed
Perfusion
● the movement if molecules from higher to lower concentration
● takes place when oxygen passes into the capillary bed to be circulated and carbon dioxide leaves the capillary bed and diffuses into the alveoli for ventilatory excretion
Diffusion
Upper respiratory tract consists of
nares
● nasal cavity
● pharynx
● larynx
URI (Upper respiratory tract infections)
common cold (most prevalent URI)
● acute rhinitis
● sinusitis
● acute pharyngitis
Drugs to manange cold symptoms
anti-histamines (H1 blockers)
● decongestants (sympathomimetic amines)
● antitussives
● expectorants
H1 blockers/antagonists
● compete with histamine/prevents histamine
response
Antihistamine
Antihistimine has 2 types
H1 - when stimulated, extravascular smooth muscles (nasal cavity lining) constrict.
H2– when stimulated, increase in gastric secretions (peptic ulcer)
cause drowsiness, dry mouth, and other anticholinergic symptoms
First generation antihistamine
First gen antihistamine
Brompheniramine Tannate
Chlorpheniramine
Clemastine fumarate
Diphenhydramine
Cyproheptadine
Levoceterizine
Azelastine and fluticasone
Its primary use is to treat rhinitis. Competes with histamine for binding at H1 receptor sites and antagonizes histamine effects.
Diphenhydramine
Are frequently called nonsedating antihistamines because they have little to no sedative effects.
Cause fewer anticholinergic symptoms.
2nd generation antihistamine
2nd Gen Antihistamine
Azelastine – nasal spray Cetirizine
Fexofenadine
Loratadine
Desloratadine
results from dilation of nasal blood vessels caused by infection, inflammation, or allergy. With this dilation, a transudation of fluid into the tissue spaces occurs that results in swelling of the nasal cavity.
Nasal Congestion
Are administered by nasal spray or drops or intablet, capsule, or liquid form.
Nasal Decongestant(Sympathomimetic Amines)
Stimulate the alpha-adrenergic receptors, producing vasoconstriction of the capillaries within the nasal mucosa. The result is shrinking of the nasal mucous membranes and a reduction in fluid secretion.
Nasal Decongestant mechanism of action
Are available in tablet, capsule, and liquid form, and are used primarily for allergic rhinitis, including hay fever and acute coryza (profuse nasal discharge).
These drugs are contraindicated or used with extreme caution in patients with hypertension, cardiac disease, hyperthyroidism, and diabetes mellitus because they can increase these health problems.
Systemic decongestant (alpha-adrenergic agonists)
Areeffectivefortreatingallergicrhinitisbecausethey have an anti-inflammatory action, thus decreasing the allergic rhinitis symptoms of rhinorrhea, sneezing, and congestion.
These drugs may be used alone or in combination with an H1 antihistamine.
Are sprayed or inhale into the nose.
Intranasal glucocorticoids
Act on the cough-control center in the medulla to suppress the cough reflex.
If the cough is nonproductive and irritating, an antitussive may be taken.
Antitussives
Loosen bronchial secretions so they can be eliminated by coughing.
Expectorants
The most common expectorant in such preparations is guaifenesin.
To ease expelling secretions from the lower respiratory tract.
To produce a productive, less frequent cough. Mechanism of Action:
Reduces viscosity and adhesiveness of tenacious secretions.
Dextromethorphan hydrobromide
Is caused by airway obstruction with increased airway resistance of airflow to lung tissues.
COPD
Is an inflammatory disorder of the airway walls associated with a varying amount of airway obstruction.
This disorder is triggered by stimuli such as stress, allergens, and pollutants.
When activated by stimuli, the bronchial airways become inflamed and edematous, leading to constriction of air passages.
Inflammation aggravates airway hyper responsiveness to stimuli, causing bronchial cells to produce more mucus, which obstructs air passages. This obstruction contributes to wheezing, coughing, dyspnea, chest tightness, and bronchospasm, particularly at night or in the early morning.
Asthma
Is characterized by bronchospasm (constricted bronchioles), wheezing, mucous secretions, and dyspnea.
There is resistance to airflow caused by obstruction of the airway.
Bronchial asthma
Is a progressive lung disease caused by smoking or chronic lung infections.
Bronchial inflammation and excessive mucous secretion result in airway obstruction.
Productivecoughingisaresponsetoexcessmucous production and chronic bronchial irritation.
Chronic bronchitis
Dilation of the bronchi and bronchioles is abnormal secondary to frequent infection and inflammation.
The bronchioles become obstructed by the breakdown of the epithelium of the bronchial mucosa, and tissue fibrosis may result.
Bronchiectasis
Is a progressive lung disease caused by cigarette smoking, atmospheric contaminants, or lack of the alpha1 -antitrypsin protein that inhibits proteolytic enzymes that destroy alveoli (air sacs).
Emphysema
Is a decrease in total lung capacity as a result of fluid accumulation or loss of elasticity of the lung.
Pulmonary edema, pulmonary fibrosis, pneumonitis, lung tumors, thoracic deformities (scoliosis), and disorders that affect the thoracic muscular wall,
Restrictive Lung Disease
Used to assist in opening narrowed airways.
Sympathomimetics (adrenergics)
Parasympatholytics (anticholinergic drugs,
ipratropium bromide)
Methylxanthines (caffeine, theophylline)
Bronchodilators
Used to decrease inflammation.
Glucocorticoids
Reduce inflammation in the lung tissue.
Leukotrine modifiers
Acts as an anti-inflammatory agent by suppressing the release of histamine and other mediators from the mast cells.
Cromolyn
