drugs affecting the respiratory system (dr.trully).ppt

7/28/2019 DRUGS AFFECTING THE RESPIRATORY SYSTEM (dr.trully).ppt

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Trully Sitorus

Depart. Of Pharmacology

Medical Faculty

Padjadjaran University



Drugs Used To Treat Asthma

Asthma is a chronic disease,

characterized by episodes of acute

bronchocontriction causing shortness of breath, cough, chest tightness, wheezing

and rapid respirations.

The goal therapy is to relieve symptomsand to prevent recurrence of asthmatic

attacks.



Principles in the treatment of asthma

I. Anti-inflammatory Drugs- Chromolin sodium

- Nedocromil sodium

- SteroidII. Bronchodilator

- Agonist adrenergic

- Xanthines- Anticholinergic

III. Avoidance of the causative factors, when

possible.



Agonist Adrenergic

Mechanism:

Increase cAMP levels in smooth muscle

Effects – Side effects• Bronchodilation

• CV effects

• Metabolic effects

• Pulmonary effects: cough is possible reaction toaerosol preparation

• GI effect: nausea, vomiting

• Uterine: relaxed uterine smooth muscle



Bronchodilator Agonist

Adrenergic

I. Selective (Beta 2 Adrenergic)

Salbutamol (Albuterol)Terbutalin

Metaproterenol

SalmeterolFormoterol



II. Non selective

(Beta 1-2 Adrenergic)

IsoproterenolMetoproterenol

(Alfa – Beta Adrenergic)

Adrenalin

Ephedrine



• Theophylline

• Aminophylline

Mechanism

• Inhibiting enzyme phosphodiesterase

• Adenosin antagonist

Indication

• Asthma bronchiale• Reduce dependence on adrenergic

• Nocturnal control of symptom

• Status asthmaticus

Methylxantine Bronchodilator



Pharmacokinetics

• Therapeutic range: 10 – 20 ug/ml

• The variability biotransformation is large

• Numerous drug interaction

Adverse effects• Hypersensitivities

• Anorexia, nausea, vomiting, headache, palpitation,tachycardia.

• Nervousness, insomnia, anxiety

• Tremor, convulsion

• Toxic dose: arrhythmias, coma and death



Contra indication

• Arrhythmias cordis

• Coronary heart disease

• Ulcus pepticum

Drug interaction

• Erythromycin

• Cimetidine• Propanolol

• Allopurinol

•Phenobarbital

•Phenitoin• Nicotine (smoking)



Anti Muscarinic Bronchodilators

Ipatropium

Mechanism:

Reduce bronchocontriction mediated by

vagal reflexes

Indication:

Chronic Obstructive Pulmonary Disease, AsthmaBronchiale, esspecially in patiens with concurrent

cardiac disease who cann’t tolerate B adrenergic or

methylxanthines



Adverse effects:Some atropine like effect

Contraindication:

Glaucoma

Urinary outlet obstruction

Dosage: Aerosol

Nebulizer



CROMOLYN AND NEDOCROMIL

• Mechanism

Cromolyn inhibits the release of mediators of

inflamation from mast cells .Cromolyn is not a bronchodilator.

• Major Indications

Prophylaxis of AsthmaYoung patients with Extrinsic, irritant – induced

asthma.



• Other Indication

Rhinitis

Allergic conjungtivitisHay Fever



CORTICOSTEROID

• Mechanism

Reduce the number and activity of inflammatory

cells.Reduce the release of mediators (Leukotrienes)

Corticosteroids may enhance the Beta adrenergic.

Major Indication

Asthma Bronchiale

Combination with bronchodilator agent.

Prophylaxis of asthma aerosol preparation.



• Other Indication

lupus eritromatosus, Nephrotic syndrome, Hayfever, Dermatitis allergica.

• Adverse Effects

Topical steroid : throat irritation, oral thrush,atrophy, pharyngeal candidiasis.

• PreparationInhaler : Beclomethasone, Flunisolide,Triamcinolone.



DRUGS USED IN RHINITIS OR

THE COMMON COLD• Pathophysiology

Viral infection and other inflammatory

conditions cause swelling and edema of themucous membrane of nasopharynx.

Symptom : Rhinorrhea and Congestion



DRUGS USED IN RHINITIS / COMMON

COLD

I. Antihistamines (AH1)

Sedative : cyclizine, dipenhydramine, ctm

II. Alpha Adrenoreceptor Agonist

Phenylephrine

Ephedrine – pseudoephedrine

III. CromolynIV. Corticosteroid



DRUG USED FOR COUGH

• Pathophysiology

Cough is a non specific sign of upper or lower airway irritation or inflamation and is mediated

through reflex vagal pathways.

Cough : Non productive

Productive



I. AntitusivesCodeine, dexthromethorphan

II. ExpectorantsGuaifenesin, terpin hydrate

III. Mucolytics

Acetylcystein, bromhexine

drugs affecting the respiratory system (dr.trully).ppt

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