Respiratory drugs:

Question 1

1.Bronchodilatators:

Answer 1

Dilation - cAMP (beta2-agonists, xanthine derivatives)
Constriction – Acetylcholine
Bronchodilators: (adverse effects of adrenergic agonists)
-β1-receptor activity causes cardiac effects (tachycardia, arrhythmias) - ephedrine, isoproterenol
-β2-adrenoreceptor agonists cause skeletal muscle tremor
- α-adrenoceptor activity causes vasoconstriction and hypertension
- tachyphylaxis

Question 2

Indications of bronchodilatators:

Answer 2

• Anaphylaxis
• allergic bronchitis
• asthma (Fe), RAO (horse)
• pulmonary edema
• pneumonia
• pleural effusion
• pneumothorax
• tracheal collapse and hypoplasia?

Question 3

Antitussive drugs:

Answer 3

• Codeine vs morphine
• Dihydrocodeine
• Hydrocodone
• Butorphanol
• Tramadol
• Dextromethorphan

Question 4

Mucolytics and expectorants:

Answer 4

Indication: Bronchitis, bronchopneumonia, tracheitis, rhinitis, sinusitis, RAO as adjunctive therapy.

• N-acetylcysteine
• Carbocystein

Question 5

Expectorants:

Answer 5

Expectorants: directly on the mucous membrane of airways, or indirectly by stimulating gastric mucous membrane.

• Bromhexin
• Ambroxol
• Dembrexine
• Guaifenesin

Question 6

Effects of Antitussives and Mucolytic, expectorants

Answer 6

Antitussive: any medicine used to suppress or relieve coughing
Mucolytic: destroying or dissolving mucus
Expectorants are drugs that loosen and clear mucus and phlegm from the respiratory tract.

Question 7

1. Sympathomimetics substances working as bronchodilatators:

Answer 7

• Act on beta2-receptors Bronchodilation
  
  • Non specific sympathomimetics (beta1,beta2,alpha1 – not isoproterenol)
    
    • Adrenaline
    • Isoproterenol
    • Ephedrine
  • Specific sympathomimetics (beta2 agonists)
    
    • Salbutamol
    • Terbutaline (long lasting)
    • Clenbuterol (long lasting)
    • Salmeterol

Question 8

Anticholinergic substances working as bronchodilatators:

Answer 8

Parasympatholytics:
Acetylcholine antagonists (M3-receptors)
-Brochodilation + decreased mucous secretion
-Atropine
-Glycopyrrolate – safe,long action
-Ipratropium -safe, not cross BBB

Question 9

Xanthine derivatives working as bronchodilatators:

Answer 9

Caffeine, theophylline, theobromine
-Good absorption, enterohepatic circulation, small therapeutic index
Derivatives of theobromine:
-Aminophyllin
-Propentphyllin
-Pentoxyfillin
Methylxanthines:
-Therapeutic uses
-Treat: acute or chronic asthma that is unresponsive to β-adrenoceptor agonists; they can be administered prophylactically.
-These agents are used to treat chronic obstructive lung disease (COPD) and emphysema.
-The adverse effects of methylxanthines include arrhythmias, nervousness, vomiting and
gastrointestinal bleeding.

Question 10

Three groups of respiratory anti-inflammatory drugs:

Answer 10

1. Inhalational glucocorticoids,2. Chromones, 3. Leukotriene antagonists

Question 11

What does Inhalational glucocorticoids do?

Answer 11

• Decrease cytokine production.
• Decrease mucous production.
• Many side-effects

Question 12

Drugs of Inhalational glucocorticoids,

Answer 12

• Beclomethasone

- Fluticasone

Question 13

effect of Chromones,

Answer 13

• Inhibit mast cell degranulation.

- Eye drop

Question 14

Drug of Chromones,

Answer 14

• Na-chromoglycate

- Nedocromil

Question 15

Drugs of Leukotriene antagonists

Answer 15

Inhibitors:
-Zileuton
Antagonists:
-Zafirlukast