Respiratory Pharmacology and Therapeutic Modalities

Vocabulary practice flashcards covering respiratory pathology, bronchodilators, delivery devices, mucolytics, expectorants, antitussives, antihistamines, decongestants, and smoking cessation aids.

Restrictive Lung Defect

A respiratory impairment characterized by difficulty getting air into the lungs.

Obstructive Lung Defect

A respiratory impairment characterized by difficulty getting air out of the lungs.

Ventilation Impairment

A respiratory problem characterized by fluid in the lungs, making it difficult for $O_2$ to enter the bloodstream.

Perfusion Impairment

A condition in respiratory distress where the lungs are too dry to maintain proper vascular circulation and gas exchange.

Bronchodilators

Medications that relax the smooth muscles of the bronchial tree, decrease the work of breathing, and are indicated for asthma and many forms of COPD.

Bronchodilator Classifications

The three therapeutic categories of bronchodilators: Sympathomimetics (adrenergics), Anticholinergics (parasympatholytics), and Xanthine derivatives.

Dry Powder Inhalers (DPIs)

Delivery devices that should not be used during acute respiratory distress because the patient must be able to generate sufficient respiratory effort on their own.

Small-Volume Nebulizers (SVNs)

Aerosol delivery devices that create a mist to be inhaled via mouthpiece or mask through slow, deep breaths with a sustained breath hold over an $8\text{--}12\,\text{min}$ period.

Corticosteroids (Respiratory)

Agents used to relieve inflammation, reduce swelling, decrease bronchial hyper-responsiveness to triggers, suppress symptoms, increase vital capacity, and decrease airway resistance; administered systemically for short-term bursts and require patients to rinse their mouth after inhalation.

Inhaled Anticholinergics

A class of inhaled bronchodilators indicated for use in COPD, but not for asthma.

Agents That Treat Bronchospasm

Acute rescue medications used for active bronchospasm, including Short-Acting Beta Agonists (SABAs) and Atrovent HFA.

Agents That Prevent Bronchospasm

Long-term maintenance agents, including Theophylline, inhaled corticosteroids (e.g., Pulmicort), Singulair, Nasalcrom, and Long-Acting Beta Agonists (LABAs).

Mucolytics

Agents that liquefy pulmonary secretions; nebulized acetylcysteine is noted to be not more effective than adequate hydration.

Expectorants

Drugs that increase secretions, reduce viscosity, and help expel sputum, commonly formulated in cough syrups (e.g., Guaifenesin [Mucinex, Robitussin]) for productive wet coughs following respiratory infections.

Antitussives

Medications that prevent coughing when a productive cough is not required, most commonly producing cough suppression by acting centrally on the brain stem.

Benzonatate (Tessalon)

A non-narcotic antitussive that suppresses cough peripherally by anesthetizing receptors within the lungs.

First-Generation Antihistamines

Non-selective antihistamines that antagonize all histamine receptor types and have broad indications (allergy, antiemetic, sleep aid, urticaria, anaphylactic reaction, vertigo, motion sickness), but produce marked sedation and anticholinergic side effects.

Second-Generation Antihistamines

Histamine antagonists that are more selective for the $H_1$ receptor, resulting in fewer CNS effects, less sedation, and fewer anticholinergic side effects than first-generation drugs.

Decongestants

Agents that constrict blood vessels, causing shrinkage of swollen mucous membranes to open nasal airway passages; topical nasal sprays cause fewer systemic effects but can produce rebound congestion after a few days.

Pseudoephedrine (Sudafed PSE)

An oral decongestant kept behind the pharmacy counter with purchase restricted to $3.6\,\text{g/day}$; it can increase blood pressure and must be used with caution in patients with hypertension.

Nicotine Replacement Therapy (NRT)

Smoking cessation therapy that lessens withdrawal symptoms by lowering nicotine levels in the body using forms such as Nicorette gum, Commit lozenges, Nicoderm CQ patch, and Nicotrol inhaler or nasal spray.

Bupropion (Wellbutrin)

An oral antidepressant used in smoking cessation to decrease cravings and lessen nicotine withdrawal; treatment should start $1\text{--}2\,\text{weeks}$ prior to the target quit date.

Varenicline (Chantix)

A smoking cessation drug that acts as a partial agonist/antagonist at nicotinic receptors in the brain, providing a mild nicotine-like sensation while blocking nicotine from binding, thereby reducing cravings, easing withdrawal, and making smoking less rewarding.

Varenicline Adverse Effects

Reported adverse reactions including nausea, vomiting, sleep disturbances, abnormal dreams, and serious neuropsychiatric symptoms.