Drugs Affecting the Respiratory System

What are signs of disorders of the upper respiratory tract?

• Vasodilation

  • red, warm, swollen

• Mucus

• Watery discharge

What are disorders of the upper respiratory tract mediated by?

histamine

What types of drugs treat upper respiratory dysfunction?

• antihistamine

  • bendry

  • cetirizine

• decongestants

  • pseudoephedrine

  • topical oxymetazoline

• Expectorants

  • guaifenesin

• Antitussives

  • Dextromethorphan

  • Opiods (Codeine)

How does pseudoephedrine work?

induces release of NE from neurons

• NE agonizes a1 receptors

  • vasoconstriction

Adverse effects of Pseudoephedrine

Systemic (oral)
 Lower dose at nose, more systemic
adverse effects
- CNS stimulant effects
 Insomnia, nervousness, anxiety, etc
- Less common/rare
 Tachycardia, mydriasis, Raynaud’s
hypertension, etc

Oxymetazoline method of action?

• agonist of a1 receptors

  • vasoconstriction

• nasal spray

Adverse effects of Oxymetazoline?

-Nasal burning, dryness
-Rebound nasal congestion
-Rare:
 High bp, tachycardia, severe
headache

 Do NOT use >3 days!

Which receptor does pseudoephedrine and oxymetazoline act on and potential side effects?

• a1 receptors

  • INCREASED BP maybe

Asthma inhale or exhale?

exhaling

Asthma dry or mucus?

dry

What causes asthma?

inflammatory disorder, triggers cause attacks

COPD two disorders?

Chronic bronchitis and Emphysema

COPD inhale or exhale?

Both

COPD dry or mucus

increased mucus production

What is the big mediator for asthma?

Leukotrienes

How does the irritant in asthma effect Vagus?

• Turns of PSNS

• Muscarinic stimulation

  • bronchoconstriciton

Bronchodilators for asthma work on what receptors?

B2 receptors

Albuterol?

Short acting B2 agonist

Salmeterol

Long acting B2 agonist

Formoterol

Long acting B2 agonist

Stimulation of B2 receptors promotes what?

Bronchodilation

B2 agonists at high does can stim what receptor?

B1

B2 agonist used for asthma or COPD?

Asthma

Adverse effects of B2 agonist?

• Tremor

• Tachycardia

Rescue inhaler

Albuterol

Which asthma drugs do you take to control it regularly?

Salmetrol

Formoterol

Indacarol

ultra long acting B2 agonist used for asthma

Drugs ending in -ol used for?

asthma

Muscarinic antagonist used for?

Primarily COPD

How do muscarinic antagonist work?

• block vagal mediated bronchoconstriction

• Decreased mucus hyper secretion

Ipratropium

muscarinic antagonist used for COPD

Tiotropium

muscarinic antagonist used for COPD

Ipratropium or Tiotropium longer acting?

Tiotropium

Do muscarinic antagonist cause tremor?

No, B2 agonists do

Isporterenol?

non-selective B agonist

Propranolol

competitive B antagonist

Beclomethasone type of drug

Glucocorticoid

Budesonide drug type?

Glucocorticoid

Fluticasone drug type?

Glucocorticoid

How do GCs help pulmonary function?

• decreased production of prostaglandins and leukotrienes

  • they are pro inflammatory compounds

Are glucocorticoids used for first line tx os astma?

No, moderate or severe

What are leukotrienes?

• bronchoconstrictors

  • 10-100x stronger than histamine

Zileuton

Lipoxygenase Inhibitor (this is where I stopped pick up here)