Pharm Unit 7-3

Front 1

antitussives
demulcent
expectorants

Back 1

What are used to treat coughs and mucus?

Front 2

Narcotic antitussives
Nonnarcotic antitussives

Back 2

What are the different types of antitussives?

Front 3

prevent coughing

should NOT be used indiscriminately; only when cough is nonproductive and is exhausting patient or is very painful.

Back 3

What are the therapeutic uses for antitussives?

Front 4

Antitussives

Back 4

Caution

COPD, asthma, chronic bronchititis, emphysema, bronchiectasis, cystic fibrosis (congenital disease with dysfunction of exocrine glands in lung causing overproduction of viscid mucus.

Front 5

secondary

Back 5

Use of antitussive is ___________ to treatment of source of cough. Example: in some asthmatics, cough is primary symptom - would use a bronchiodilator before an antitussive.

Front 6

Narcotic antitussive

Back 6

codeine etc

mech of action

depresses cough center in medulla of CNS

Front 7

Narcotic antitussive

Back 7

Side effects and cautions

potential for abuse

constipation
depresses respiration
cause drug dependency

Front 8

Nonnarcotic antitussives

Back 8

fewer GI symptoms (usually)

Mechanism of action

1. some are peripherally acting - reduces activity of lung stretch receptors, or benzocaine, a topical anesthetic whose usefulness has not been established.

2. may act centrally as do the narcotics, but do not have a narcotic side effects DEXTROMETHORPHAN - half as potent as codeine, no prescription necessary = an isomer of codeine that has no analgesic or additive properties

Front 9

Nonnarcotic antitussives

lung
anesthetic
DEXTROMETHORPHAN
analgesic

Back 9

fewer GI symptoms (usually)

Mechanism of action

1. some are peripherally acting - reduces activity of ____ stretch receptors, or benzocaine, a topical _________ whose usefulness has not been established.

2. may act centrally as do the narcotics, but do not have a narcotic side effects _____________- half as potent as codeine, no prescription necessary = an isomer of codeine that has no ___________ or additive properties

Front 10

Demulcents

Back 10

agents with a soothing effect (gargles, lozenges, syrups, even steam treatment)

Front 11

agents with a soothing effect (gargles, lozenges, syrups, even steam treatment)

Back 11

Define demulcents.

Front 12

Drugs that increase secretion of mucus in bronchi or modify it to reduce viscosity.

Back 12

Define Expectorants.

Front 13

Antitussives
Demulcents
Expectorants

Other drugs effecting mucus:
Mucolytic
Mucomyst
Ethanols
Diluents
Dornase

Back 13

What are ALL of the drugs that treat coughs and mucus?

Front 14

adrenergic agents

Back 14

Better than antihistamines for colds, useful for allergy stuffiness too

Front 15

nasal vasoconstriction

Back 15

What is the mechanism of action for adrenergic agents in treating nasal congestion?

Front 16

habituation occurs

Back 16

What is the caution for adrenergic agents in treating nasal congestion?

Front 17

antihistaminics

Back 17

Good for allergy, may help relieve cold symptoms

Front 18

Intranasal steroids

Back 18

For allergy. May increase risk of thrush and prevent healing of damaged nasal mucosa.

Front 19

Adrenergic agents
Antihistaminics
Intranasal steroids

Back 19

What are the names of the drugs groups that for nasal decongestion?

Front 20

habituation occurs

Back 20

What is the caution for adrenergic agents in treating nasal congestion?

Front 21

antihistaminics

Back 21

Good for allergy, may help relieve cold symptoms

Front 22

Intranasal steroids

Back 22

For allergy. May increase risk of thrush and prevent healing of damaged nasal mucosa.

Front 23

Adrenergic agents
Antihistaminics
Intranasal steroids

Back 23

What are the names of the drugs groups that for nasal decongestion?

Front 24

all over the body

Back 24

Where are H1 receptors found?

Front 25

only found in the stomach

Back 25

Where are the H2 receptors found?

Front 26

histamine

Back 26

1. Contraction of bronchial and intestinal smooth muscle H1 receptors.
2. Dilation of arterioles and capillaries and increases permeability - also mediaated by H1 receptors.
3. Increases gastric acid secretion - mediated by H2 receptors.

Front 27

general approaches to therapy

Back 27

1. produces opposite effects as histamine (epinephrine), i.e. good for counteracting symptoms of reaction that has occurred. Only minor effect on histamine release.

2. Histimine antagonists to prevent histamine reaction, i.e. compete with histamine for H1 or H2 receptor sites.

Front 28

epinephrine
histamine
Histimine antagonists

Back 28

1. produces opposite effects as histamine (___________), i.e. good for counteracting symptoms of reaction that has occurred. Only minor effect on ___________ release.

2. __________ ___________ to prevent histamine reaction, i.e. compete with histamine for H1 or H2 receptor sites.

Front 29

H1 antagonists

Back 29

these are the classical "antihistamines"

First generation types bind both centrally and peripherally. They are MORE sedating but also more useful as a sedative, for motion sickness, or in special cases for treating Parkinson's.

Second generation types caes less drowsiness. Note, however, that these newer agent can produce adverse cardiovacular effects.

Front 30

H1 antagonists

Back 30

Therapeutic uses

1. Antagonize allergic reactions (hives, watery eyes, stuffy nose -- but NOT asthma!) - prevent more symptoms from occuring, but less effective than epinephrine at counteracting reaction that has already occurred. Mechanism: Besides preventing action of histamine, acts as mild sedative so more able to ignore distressing symptoms.

2. Motion sickness - appear to depress CNS and decrease sensivity of inner ear. Not very effective at contolling nausea of other origins.

Front 31

asthma
less
histamine
decrease

Back 31

Therapeutic uses

1. Antagonize allergic reactions (hives, watery eyes, stuffy nose -- but NOT _______!) - prevent more symptoms from occuring, but _____ effective than epinephrine at counteracting reaction that has already occurred. Mechanism: Besides preventing action of ________, acts as mild sedative so more able to ignore distressing symptoms.

2. Motion sickness - appear to depress CNS and ________ sensivity of inner ear. Not very effective at contolling nausea of other origins.

Front 32

Side effects

H1 antagonists

Back 32

due to chemical similarity to some antipsychotics and to atropine

1. Antipsychotic-like - drowsiness, sedation, dizziness. In others may cause agitation and hallucinations. Higher therapeutic doses are usually sedating.

2. Antimuscarinic (atropine-like - dryness of mouth, blurred vision

Front 33

Cautions

H1 antagonists

Back 33

1. Potentiate other sedative-hypnotics, tranquilizers, and alchol
2. Avoid use in asthmatics (drying of bronchiole secretions) - recall from respiration notes that the asthma prophylactic CROMOLYN prevent the release of histamine by blocking degreanulation of mast cells. A similar agent lodoxamide is marketed in eye solutions for eye allergies. Neither agent is an antihistaminic that competes for H1 receptor sites.

3. Do periodic blood tests (check for blood dyscrasias)

Front 34

H2 antagonists

Back 34

block a second type of histamine receptor

These are not antihistamines as we know them.

nothing to do with allergy, has to do with stomach acid.

Front 35

H2 antagonists

Back 35

Therapeutic uses

1. decrease gastric secretion (ulcer patients)
2. unapproved use - to treat heartburn

Front 36

H2 antagonists

Back 36

Side effects

sedation
diarrhea
muscle pain
rash
dizziness
inhibits p450 enzymes, so decreases metabolism of other drugs in liver.
breast enlargement in men
mental confusion