Ch 35: Drugs Affecting Lower Respiratory System

Front 1

Mucolytics

Back 1

Breaks down mucus and help the high-risk respiratory pt cough up thick, tenacious secretions to improve breathing and airflow

acetylcysteine

Front 2

Bronchodilators:

1. Beta Agonists
   
2. Respiratory Anticholinergenics
   
3. Xanthine Derivatives
   

Back 2

• Beta Agonists: albuterol
• Respiratory Anticholinergenics: ipratropium bromide
  
• Xanthine Derivatives: theophylline
  

Front 3

Anti-Inflammatory Agents

1. Inhaled Glucocorticoid Steroids
   
2. Mast Cell Stabilizers
3. Leukotriene Receptor Antagonists

Back 3

• Inhaled Glucocorticoid Steroids: flunisolide
  
• Mast Cell StabilizersLeukotriene: cromolyn sodium
• Receptor Antagonists: zafirlukast
  

Front 4

acetylcysteine

Back 4

Pharmacotherapeutics

• Liquefies thick, tenacious secretions whose respiratory disorder make it difficult to mobilize and cough up secretions related to CAL, cystic fibrosis, pneumonia, tb and atelactisis
• Treating acetaminophen overdose, hepatorenal syndrome, and toxic renal effects by cisplatin therapy

Pharmacokinetics

• Delivered directly to resp. sys. via nebulizer or direct instillation(bronchoscopy)
  
• Onset: 1 minute Peak: 5-10 min
• Metabolized by liver and excreted in urine

Pharmacodynamics

• Affects mucoproteins in respiratory secretions
• Splits disulfide bonds that are responsible for holding mucous material together. Results in decrease in the tenacity and viscosity of secretions

Contraindications/Precautions

• Hypersensitivity
  

Adverse Affects

• Common: Nausea, Vomiting and rhinorrhea
• Serious: Bronchospasm and bronchoconstriction

Drug Interactions

• None

Pt Teaching

• Correct use of special equipment
• Report all adverse effects; no alcohol

Front 5

albuterol

Back 5

Beta Agonists (sympathomimetics)

Pharmacotherapeutics

• Used as bronchodilator in managing CAL
  

Pharmacokinetics

• Oral(30 min) or inhaled(5-15min)
  
• Inhalation: Kidneys excrete 80-100% within 72 hours; 10% in feces
• Oral: 75% kidney excretion; 4% in feces

Pharmacodynamics

• Moderately selective beta-2 agonist
• Selectively stimulates receptors of smooth muscle in lungs, uterus, skeletal muscle vasculature
• Relaxation of bronchial smooth muscle after binding to beta-2 receptors
• Relaxation relieves bronchospasm, airway resistance, mucous drainage, increases vital capacity

Contraindications/Precautions

Hypersensitivity

Adverse Affects

• Common: throat irritation, palpitations, tachycardia, anxiety, tremors, ^ BP
• Serious: Bronchospasm, urticaria, angioedema

Drug Interactions

• digoxin
  
• diuretics

Pt Teaching

• This rescue drug should be used first for all SOB or wheezing