kopp part 1 -10/31 pharmacology Notes

Pharmacology Principles Overview

  • Introduction to respiratory pharmacology as it pertains to respiratory therapy.

    • General definitions:

    • Pharmacokinetics: "What the body does to a drug."

    • Pharmacodynamics: "What the drug does to the body."

  • Major phases of drug movement through the body classified as ADME (Absorption, Distribution, Metabolism, Excretion).

Drug Administration Methods

  • Review of drug administration methods emphasizing inhalation as the primary method in respiratory therapy, citing its rapid effects and localized impact.

  • Comparisons drawn between inhalation and other methods (oral, intravenous, etc.), noting pros and cons associated with each method.

Classification of Respiratory Drugs

  • Bronchodilators:

    • Mainly beta-2 agonists, classified into short-acting (SABA) and long-acting (LABA).

    • Short-acting examples include albuterol (Ventolin) and levalbuterol (Xopenex).q4hrs or q6hrs SABA

    • Long-acting examples include salmeterol q12hrs . LABA

    • Causes tachycardia

    • Side effect off continuous albuterol is low potassium 3.5to 5.2 mEq /L

  • Anticholinergics:

    • Function to block acetylcholine at receptor sites to prevent bronchoconstriction (e.g., ipratropium (Atrovent)).

    • Target :muscarinic receptors in smooth airway muscles

  • Action: block acetylcholine (parasympathetic neurotransmitter) inhibit reflex bronchoconstriction

  • Result: bronchodilation and reduced mucus secretion

  • Drugs: SAMA ipratropium bromide - Atrovent- q6

  • Drugs LAMA Tiotropium (Spiriva)DPI , aclidinium (Tudorza), Umeclidinium (Incruse), Glycoprrolate- q12 or q24

  • COPD- first line maintenance therapy

  • Asthma: used in combination with beta-agonist during exacerbations

  • Combination therapy : often paired with beta 2 agonist (e.g. ipratropium + albuterol=Duoneb liquid combivent inhaler version

  • Corticosteroids:

    • Function as anti-inflammatory agents, utilized primarily for long-term management and not for acute events (e.g., budesonide, beclomethasone).

    • Target inflammatory cells (e.g. eosinophil, mast cells, T-lymphocytes)

    • Action: suppress cytokine production, reduce vascular permeability and inhibit mucus secretion Drugs

    • Results: decreased airway inflammation, edema and hyperresponsiveness

  • Drugs: budesonide (Pulmicort)180-360mcg BID, fluticasone(Flovent) 100-500mcg BID, beclomethasone(QVAR) 40-160mcg BID, mometasone (Asmanex)220mcg QD or BID

  • no value an acute event

  • Takes 24-36 hrs to take effect

  • Less side effects

  • Rinse mouth prevent oral thrush

  • Combination drugs

  • Trelegy=Fluticasone (corticosteroid) + Umeclidinium (LAMA) + Vilanterol ( LABA) maintance

  • Airsupra = Albuterol sulfate (SABA) + Budesonide (corticosteroid) can be a rescue offers fast relief and anti-inflammatory

Coordination and Effectiveness in Inhaler Use

  • Correct usage of MDIs (metered-dose inhalers) critical for achieving optimal drug delivery:

    • Using spacers can enhance drug deposition into the lungs, emphasizing the importance of patient education in inhaler use.

Continuous Monitoring and Care in Clinical Settings

  • Continuous monitoring of vital signs and blood gases is essential,

    • In-depth understanding of both patient needs and medication administration is paramount in respiratory therapy.

  • Caution against common respiratory therapy errors, focusing on the critical nature of drug impact on respiratory system function.

Conclusion

  • Importance of being proactive in learning both through theoretical instruction and practical application.

  • Students are encouraged to communicate effectively within clinical environments and engage in continual self-improvement through feedback from experienced professionals.