drugs affecting the respiratorycden.tu.edu.iq/images/new/2016/lectures/dr.ghadeer... · drugs used...
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مادة الادوية
المرحلة الثالثة
محمد غدير حاتم. م. م
2016-2017
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Drugs affecting the respiratory
system
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Drugs can be delivered to the
lung by inhalation, oral, paretral .
Inhalation is preferred because
the drug is delivered directly to
the target tissue with little side
effects.
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• Typical symptoms of asthma consist of:
• Recurrent reversible episodes of
• breathlessness (dyspnea), wheezing,
cough that is worse at night ( nocturnal
asthma), chest tightness, and flushing.
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Drugs used to treat asthma Asthma: is chronic disease characterized by episodes of
acute broncoconstriction ,shortness of
breath,cough,chest tightness and rapid respirations.
This disease is not progressive and death due to asthma
is infrequent.
The goal of Rx :
*relieve symptoms
*prevent recurrence of asthmatic attacks
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Air way obstruction in asthma is
due to:
1- contraction of s.m
2- inflammation of bronchial wall
3- increase mucous secretion
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Mucus & Sputum
Mucus is normal…Sputum is
abnormal viscous secretion (Main
ingredient: Mucus) that originates
in the lower airways.
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Adrenergic agonists Inhaled ß2 agonist are the drugs of choice for mild
asthma , ß2 agonist are potent bronchodilators that relax
airway s.m directly.
1- short acting drugs
-rapid onset(15-30)
-duration(4-6 hr)
-used for Rx of acute bronchoconstriction
-have no anti-inflammatory effect therefore not useful for
chronic asthma
-selective ß2 agent e.g. Terbutaline , Albuterol
-side effects :
tachycardia , hyperglycemia , hypokalemia and
hypomagnesemia.
Those are less if drugs are given by inhalation
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2- long acting
-salmeterol
-slow onset of action
-duration 12 hr
-not used for acute
attacks
-prescribed for regular
use
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Corticosteroids
-drugs of choice in moderate to severe asthma
-action on lung;
decrease no. and activity of cells involved in airway inflammation
reduce the response of airway s.m to allergens, irritants, cold air
-inhaled steroids
reduce the need for systemic corticosteroids
80-90% of inhaled glucocorticiods is deposited in the mouth and pharynx
and could cause candidiasis (mouth rinse)
-systemic steroids
*used in severe exacerbation (status asthmaticus)
*given IV
-spacers
it is large volume chamber attached to metered-dose inhaler and it is used to
decrease the deposition of drug in the mouth , the chamber reduce the
velocity of injected aerosol before it reach the mouth , so large drug particles are
more likely to reach the target tissue .
-Adverse effects :
inhaled type have less side effects , it can cause oral thrush.
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oral thrush.
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Cromolyn and nedocromil
-effective prophylactic anti-inflammatory
agents
-Not used for acute attack because they are
not bronchodilator
-Given by inhalation of microfine powder or
aerosoled solution
-Side effects: Bitter taste ,irritation of
pharynx and larynx
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Cholinergic antagonists
-block vagus stimulation of airway s.m which
Is responsible of contraction of muscle and
increase mucous secretion
-e.g. ipratropium
-they are less effective than beta agonist but
used for patients unable to tolerate beta
adrenergic agonist
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Xanthine Derivatives
Includes:
caffeine, theophylline
(aminophylline)
Relax smooth muscle
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Theophylline
-bronchodilator in chronic asthma
-well absorbed by GIT
-has narrow therapeutic window over dose cause
seizures or fatal arrhythmias
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Antileukotrienes drugs Leukotriene: One of a group of hormones that cause the
symptoms of hayfever and asthma. Derived from
arachidonic acid, the leukotrienes act by mediating
immediate hypersensitivity. Leukotriene modifiers that
prevent the production or action of leukotrienes are used
to treat hayfever and asthma.
-Zileuton , zafirlukast, montelukast
-Act on formation and function of leukotrienes
-Used for prophylaxis of asthma
-Not used for immediate bronchodilation
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Drugs used to treat allergic rhinitis Rhinitis: inflammation of nasal m.m charcterized by sneezing , nasal itching , watery rhinorrhea and congestion , occur due to inhalation of allergen e.g. dust , pollen , animal dander Which interact with mast cells which release histamine , leukotriens and promote bronchospasm and mucosal thickening.
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receptor blockers)-1antihistamines(H -A e.g. diphenhydramine , loratadine
Combination of antihistamine and decongestants
are the first line therapy
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adrenergic agonists – α -B e.g. phenylephrine , oxymetazoline
Those are nasal decongestants , they
constrict dilated arterioles in nasal mucosa
and reduce air way resistance
Those drugs should not be used more than
several days because rebound nasal
congestion occur upon discontinuance of
these drugs
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corticosteroids -C
e.g.beclomethazone , triamcinolone which are
used as nasal spray
Side effects :
Local nasal irritation , nasal bleeding , candidiasis
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cromolyn -D Used intra nasal before contact with allergen
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drugs used to treat chronic obstructive
pulmonary diseases
COPD
Its chronic irreversible obstruction of air way, can be
treated by bronchodilators like:
-anticholinrgic drugs
-Beta adrenergic agents
-theophyline
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Drugs used to treat cough
These drugs act by decrease sensitivity of cough
centers in the CNS to peripheral stimuli and decrease
mucosal secretions .
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Thank you