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RESPIRATORY DRUGS FOR PULMONARY DISEASE & BRONCHIAL DISORDERS

 

DRUGS USESD TO MAINTAIN AIRWAY PATENCY IN OBSTRUCTIVE PULMONARY DISEASE

The most common conditions associated with obstructive pulmonary disease are

  • Bronchoconstriction
  • Chronic inflammation
  • Loss of lung elasticity

Therapy for obstructive lung disease is aimed at preventing or reversing these processes.

TREATMENT OPTIONS

The method of treatment depends on the severity of the episode and the patient's response to previous therapy. Therapeutic options include:

  • Beta-adrenergic agonist
  • Xanthine derivatives
  • Anticholinergic drugs
  • Bronchodilators
  • Corticosteroids
  • Cormones
  • Leukotriene inhibitors

DRUGS USED IN BRONCHIAL DISORDERS

ALBUTEROL, TERBUTSLINE, PIRBUTEROL, METOPROTERENOL, LEVALBUTEROL

Therapeutic effects

  • Increase airflow
  • Decrease exacerbations
  • Prevent airway obstruction

Adverse effects

  • Vasodilation
  • Tachycardia
  • CNS stimulation
  • Hyperglycemia
  • Hypokalemia

EPINEPHRINE

Therapeutic effects

  • Rapid onset of action
  • Treatment of bronchospasm
  • Relief to bronchoconstriction

Adverse effects

  • Tachycardia
  • metabolic and GI abnormalities
  • CNS stimulation

IPRATROPIUM

Therapeutic effects

  • Long acting, treatment of COPD
  • Bronchospasm associated with COPD in adults

Adverse effects

  • Few systemic anticholinergic side effects because it is a quaternary ammonium compound which crosses into systemic circulation poorly

ISOPROTERENOL

Therapeutic effects

  • Increase airflow
  • alleviate symptoms
  • decrease exacerbations

Adverse effects

  • Tachycardia
  • CNS stimulation
  • GI distress

SALMETEROL

Therapeutic effects

  • First line agent for treatment of COPD
  • long term acting agent for asthma
  • Chronic treatment for asthma or bronchospasm in adults.

Adverse effects

  • Nasopharyngitis
  • Headache
  • Cough

LEUKOTRINE RECEPTOR ANTAGONIST

ZAFIRLUKAST, MONTELLUKAST

Therapeutic effects

  • Constrict bronchiolar smooth muscle
  • increase endothelial permeability
  • promote mucus secretion

Adverse effects

  • Headache
  • GI distress
  • increased respiratory infection in older patients

ZILEUTON

Therapeutic effects

  • Prevention of asthma symptoms
  • Prophylaxis and chronic asthma treatment

Adverse effects

  • Headache
  • GI symptoms
  • liver enzyme elevation

XANTHINE DERIVATIVES

AMINOPHYLLINE, THEOPHYLINE, DYPHYLLINE

Therapeutic effects

  • Relieve airflow obstruction in chronic asthma
  • anti-inflammatory effects
  • Used for maintenance therapy in moderate to severe asthma. Slow onset limits effectiveness in acute situations
  • Theophylline is being replaced by ipratropium bromide and sympathomimetic agents for non-asthmatic COPD

Adverse effects

  • Nausea
  • Vomiting
  • Headache
  • Insomnia
  • Tachycardia
  • Dizziness
  • neuromuscular irritability
  • seizure

CORTICOSTEROIDS

BECLOMETHASONE, TRIAMCINOINE, HYDROCORTISONE, METHYLPREDNISOLONE

Therapeutic effects

Treatment of;

  • Sneezing
  • itching
  • rhinorrhea

adverse effects

  • Sodium/water retention
  • subsequent cardiovascular problems
  • weakness
  • osteoporosis
  • peptic ulcers

FLUNISOLIDE, DEXAMETHASONE, PREDNISOLONE

Therapeutic effects

Treatment of;

  • Rhinorrhea
  • Nasal congestion
  • Chronic rhinitis

Adverse effects

  • Usually do not induce systemic toxicity.
  • Increase risk of oral infection

CORMONES

CORMOLYN, NEDOCROMIL

Therapeutic effects

  • It is an alternative treatment for mild persistent asthma
  • Prophylaxis of asthma attacks

Adverse effects

Minimal side effects

  • Throat irritation
  • Headache
  • Nausea

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