Respiratory Meds and Medications

Pharmacology

MDI

Metered Dose Inhaler; Pressurized canister in a boot-shaped shell; requires timing — presses short puffs into lungs while inhaling slow/deeply; can be used with spacer

DPI

Dry Powder Inhaler; No chemical propellant needed; breath actuated — requires taking a deep, fast breath to release the powder.

Nebulizer

Machine turns liquid medication into a fine aerosol mist; administered via mask or mouthpiece; best for patients who struggle with MDIs (infants, young kids, disabled, or severe COPD/asthma)

Antihistamine

Blocks histamine from binding to H1 receptors; stops allergy symptoms (sneezing, runny nose, itchy eyes), comes in 2 generations

First-Generation Antihistamine

Blocks histamine, but also affects other brain functions, causing drowsiness; Used for allergies, itching, sleep. Causes significant sedation and anticholinergic effects (dry mouth, blurred vision, constipation, etc.)

Second-Generation Antihistamine

Blocks histamine, with less effect on the brain, causing less drowsiness; Used for allergies. Less sedating than first-generation.

Diphenhydramine (include trade name, classification, indication/treatment, and notes)

Trade Name: Benadryl; Classification: First-Generation Antihistamine; Indication: Allergic reaction, insomnia, motion sickness, cough suppression. Also the active ingredient in “PM” medications. Notes: significant drowsiness, anticholinergic effects (dry mouth, blurred vision, constipation, etc.). Can impair cognitive function + coordination. Avoid in elderly patients. OTC

Cetirizine (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Zyrtec; CLASSIFICATION: Second-Generation Antihistamine; INDICATION: Allergic rhinitis (airborne allergens like pollen), urticaria (hives); NOTES: Less sedating than first-generation antihistamines. Can still cause some drowsiness in some individuals. OTC

Loratadine (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Claritin; CLASSIFICATION: Second-Generation Antihistamine; INDICATION: Allergies NOTES: OTC

Levocetirizine (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Xyzal; CLASSIFICATION: Second-Generation Antihistamine; INDICATION: Allergies NOTES: Rx and OTC

Fexofenadine (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Allegra; CLASSIFICATION: Second-Generation Antihistamine; INDICATION: Allergies NOTES: OTC

Leukotriene Receptor Antagonist

HOW IT WORKS: Blocks the action of leukotrienes, substances that cause inflammation and airway narrowing. KEY NOTES: Used for allergies and asthma. Helps prevent asthma symptoms.

Montelukast (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Singulair; CLASSIFICATION: Leukotriene receptor antagonist; INDICATION: Allergies/Asthma; NOTES: Rx

Corticosteroid

HOW IT WORKS: Reduces inflammation in the airways. KEY NOTES: Used for asthma and other inflammatory conditions. Can have systematic side-effects with long-term use.

Fluticasone (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Flonase/Flovent; CLASSIFICATION: Corticosteroid; INDICATION: Allergies/Asthma; NOTES: MDI Inhalation; Rx Only; Nasal sprays are OTC

Budesonide (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Pulmicort, Rhinocort CLASSIFICATION: Corticosteroid; INDICATION: Allergies/Asthma; NOTES: Nasal Inhaler, Rx only

Mometasone (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Nasonex; Asmanex; CLASSIFICATION: Corticosteroid; INDICATION: Allergies/Asthma; NOTES: Nasal Inhaler, Rx only, Nasal Sprays are OTC

Beclomethasone (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Quar, Beconase AQ; CLASSIFICATION: Corticosteroid; INDICATION: Allergies/Asthma; NOTES: Nasal Inhaler, Rx only

Adrenergic Bronchodilators

HOW IT WORKS: Relaxes the muscles in the airways KEY NOTES: A broad category that includes beta-agonists, primarily used as needed for acute symptoms relief or as a “pre-treatment” to prevent exercise-induced bronchoconstriction

Albuterol (include trade name, classification, indication/treatment, and notes)

TRADE NAME: ProAir, Proventil, Ventolin; CLASSIFICATION: Adrenergic Bronchodilators; INDICATION: Acute Asthma, bronchospasm, exercise-induced asthma; NOTES: MDI Inhalation

Long-Acting Beta (and Beta-2) Adrenergic Agonist, LABA

HOW IT WORKS: Long-lasting bronchodilator. Relaxes airway muscles for extended periods KEY NOTES: Used for asthma and COPD. Always used in combination with an inhaled corticosteroid in asthma.

Short-Acting Beta Adrenergic Agonist, SABA

HOW IT WORKS: Relaxes bronchial smooth muscles KEY NOTES: Fast-acting, “rescue” inhaler medication, quickly relieves asthma and COPD symptoms like wheezing, chest tightness, and breathlessness

Fluticasone/Salmeterol: (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Advair; CLASSIFICATION: Corticosteroid/Long-acting beta-adrenergic agonist; INDICATION: Asthma/COPD; NOTES: Combination DPI inhaler (Hint:Advair sounds like “Add-Air”

Albuterol/Budesonide: (include trade name, classification, indication/treatment, and notes)

TRADE NAME: AirSupra; CLASSIFICATION: Short-acting beta-adrenergic agonist/Corticosteroid; INDICATION: Asthma; NOTES: Combination MDI rescue inhaler, treats or prevents bronchospasm and reduces attack risks

Bronchodilator

HOW IT WORKS: Relaxes the muscles in the airways, making breathing easier; KEY NOTES: Used for asthma and COPD

Salmeterol: (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Serevent; CLASSIFICATION: Bronchodilator — Long-acting — Beta-Z Adrenergic Agonist; INDICATION: Asthma/COPD; NOTES: Relaxes airway muscles making it easier to breathe

Short-Acting Anticholinergic

HOW IT WORKS: Quickly opens airways by blocking a substance that causes them to tighten; KEY NOTES: Used for COPD, and sometimes asthma. Provides rapid relief.

Ipratropium: (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Atrovent; CLASSIFICATION: Short-acting anticholinergic; INDICATION: COPD, nasal congestion; NOTES: Rx only, MDI, and nebulizer

Long-Acting Anticholinergic

HOW IT WORKS: Long-lasting bronchodilator. Keeps airways open for extended periods; KEY NOTES: Used for COPD. Provides sustained relief.

Tiotropium: (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Spiriva; CLASSIFICATION: Long-lasting anticholinergic; INDICATION: COPD; NOTES: DPI Inhaler, nebulizer, Rx only

Antitussive

HOW IT WORKS: Suppresses cough reflex; KEY NOTES: Used to relieve coughing

Benzonatate: (include trade name, classification, indication/treatment, and notes)

TRADE NAME: Tessalon Perles; CLASSIFICATION: Antitussive; INDICATION: Cough; NOTES: Rx only