treatment options for COPD Flashcards
What are the treatment options for COPD?
- Stop smoking – slows COPD progress
- Immunization against infections
- Glucocorticoids largely ineffective (unless asthma already present) – unclear why
- Long acting bronchodilators – modest benefit but no effect on inflammation (help them to breath easier but dont prevent the disease progressing)
- Long-term oxygen therapy
What is a Cough?
Protective reflex removing foreign material /secretions
What are the two types of Cough?
- Productive (removes sputum from lungs)
- Dry ( no removal of sputem)
What is the treatment for a dry cough?
Anti-tissuves
What are the 3 types of Anti-tissuves?
- Opioids
- Demulcents
- Local anaesthetics
What is the mechanism of action of opioids?
- Opioid analgesics acting on poorly defined “cough centre” in brain
- Act on mu-opioid receptors
Give examples of 3 Opioids
Codeine
Dextromethorphan / pholcodine
Morphine
Side effect of codeine?
constipation
side effect of Dextromethorphan / pholcodine?
promotes respiratory depression
When are the anti-tissuves Demulcents used clinically?
For coughs originating above the larynx
What is the mechanism of action of Demulcents?
Form a protective coating over the irritated pharyngeal mucosa.
How are Demulcents given?
Given as syrups or lozenges
Give examples of local anaethetics
- Lidocaine
- Benzocaine
- Hexylcaine hydrochloride
- Tetracaine
What do local anaesthetics do?
Inhibit the cough reflex under special circumstances (e.g., before bronchoscopy or bronchography).
What is used to treat productive coughs?
Expectorants
How do Expectorants function?
- Expel bronchial secretions from the respiratory tract by decreasing broncial secretion viscosity.
- Increasing respiratory tract fluid / exert a demulcent action on the mucosal lining.
- Increase secretions through reflex irritation of the bronchial mucosa.
- Iodides, also act directly on the bronchial secretory cells and are excreted into the respiratory tract.
Give examples of two Expectorants
Guaifenesin (most commonly used expectorant in cough remedies)
Iodides
Guaifenesin side effects
No serious adverse effects but no clear evidence of its efficacy.
What is the mechanism of action of Iodides?
liquefy tenacious bronchial secretions (e.g., in late stages of bronchitis).
What types of iodides are used?
- Saturated solution of potassium iodide least expensive, most commonly used
- Iodinated glycerol is better tolerated than potassium iodide solution but less effective.
What are the side effects of Iodides?
Low patient acceptance due to unpleasant taste
side effects
- acneiform skin eruptions
- painful swelling of the salivary glands
Side effects are reversible and subside when the drug is stopped.
Prolonged use of iodides or iodinated glycerol can lead to hypothyroidism.
