Respiratory Drugs

Front 1

Bronchodilators

Back 1

substance that dilates the bronchi and bronchioles, decreasing airway resistance and thereby facilitating airflow

Front 2

Types of Bronchodilators

Back 2

Sympathomimetics
Xanthines
Anticholinergics
Other Asthma Drugs

Front 3

Sympathomimetics used to treat asthma

Back 3

β2-agonist

Front 4

Types of β2-agonist

Back 4

Short-acting Inhaled: Albuterol, Levalbuterol
Long-acting Inhaled: Formoterol, Salmeterol
Oral: Albuterol, Terbutaline

Front 5

Short-acting Inhaled β2-agonist

Back 5

All patients with asthma use these drugs prn to relieve an ongoing attack. Use before exercise. Nebulizer for severe acute attack

Front 6

Long Acting Inhaled β2-agonist

Back 6

Patients who experience frequent attacks. Dosing is done on a fixed schedule, not prn. Not first choice for long-term control, should not be used alone.

Front 7

Oral β2-agonist

Back 7

Only for long-term control. Onset is slow; cannot abort an ongoing attack. Not a first-line therapy and should not be used alone

Front 8

Mechanism of Sympathomimetics

Back 8

Selective stimulation of beta2 receptors
Promote bronchodilation; relieve bronchospasm
Suppress histamine release in lung
Increase ciliary motility

Front 9

Inhaled Sympathomimetic Adverse Effects

Back 9

Tachycardia
Angina
Tremor

OCCUR LESS FREQUENTLY WHEN INHALED

Front 10

Oral Sympathomimetic Adverse Effects

Back 10

Angina
From beta 1 simulation

Tachydysrhythmias
From beta 1 stimulation

Tremor
From stimulation of beta 1 receptors in skeletal muscle

Front 11

Advantages of Inhalation Drug Therapy

Back 11

Therapeutic effects are enhanced
Systemic effects are minimized
Relief of acute attacks is rapid

Front 12

Types of Inhalation Drug Therapy

Back 12

Metered-Dose Inhalers
Dry-Powder Inhalers
Nebulizers

Front 13

Metered-Dose Inhalers

Back 13

Small. hand-held, pressurized devices that deliver a measured dose of drug with each activation

Front 14

Dry-Powder Inhalers

Back 14

Used to deliver drugs in the form of a dry, micronized powder directly to the lungs

Front 15

Nebulizers

Back 15

A small machine used to convert a drug solution into a mist. Takes several minutes to deliver the same amount of drug contained in 1 puff from an inhaler

Front 16

Methyxanthines

Back 16

Excite the central nervous system
Bronchodilate
Cardiac Stimulate
Vasodilate
Diurese

Front 17

Types of Methyxanthines

Back 17

Theophylline
Aminophylline
Oxtriphylline
Dyphylline

Front 18

Theophylline

Back 18

Produces bronchodilation by relaxing smooth muscle of the bronchi. Has a narrow therapeutic range, so dosage must be carefully controlled

Front 19

Administration of Theophylline

Back 19

Oral
IV

Front 20

Oral Theophylline

Back 20

Used for maintenance therapy of chronic stable asthma. Long duration of action, therefore may be appropriate for patients who experience nocturnal attacks. 200-300 mg 2-3 times a day

Front 21

IV Theophylline

Back 21

Have been employed in emergencies, but is no more effective than beta2 agonists and glucocorticoids, and is more dangerous. No faster than 25 mg/min

Front 22

Theophylline: Absorption

Back 22

Food slows down absorption but not extent

Front 23

Theophylline metabolized by?

Back 23

Liver

Front 24

Theophylline: Toxicity

Back 24

At levels above 30 mcg/mL. Reactions include dysrhythmias, convulsions, death from cardiovascular collapse.

Treatment: Stop drug, administer activated charcoal with cathertic, lidocaine, IV diazepam

Front 25

Theophylline: Drug Interactions

Back 25

Caffeine

Front 26

IV Aminophylline

Back 26

Preferred route. Go slow! Usual dose is 6 mg/kg.

Front 27

Oral Aminophylline

Back 27

Available in tablets and solution

Front 28

Rectal Aminophylline

Back 28

Suppositories and solution

Front 29

Aminophylline

Back 29

Long-term control of reversible airway obstruction caused by asthma or COPD
Increases diaphragmatic contractility
Respiratory and myocardial stimulant in premature infant apnea (apnea of prematurity)

Front 30

Cromolyn

Back 30

Effective drug for prophylaxis of asthma not for aborting ongoing attack

Front 31

Cromolyn: Mechanism

Back 31

Suppresses inflammation
Not a bronchodilator
Stabilizes the cytoplasmic membrane of MAST cells, thereby preventing the release of histamine
Inhibits eosinophils, macrophages and other inflammatory cells

Front 32

Cromolyn: Uses

Back 32

Chronic asthma
Exercise-Induced Bronchospasm
Allergic Rhinitis

Front 33

Cromolyn: Administration

Back 33

Nebulized
PO
Intranasal

Front 34

Anticholinergics

Back 34

Improve lung function through blockade of muscarinic receptors in the bronchi, thereby causing brochial dilation (COPD)

Front 35

Anticholinergics agent

Back 35

Ipratropium
tiotropium

Front 36

Ipratropium

Back 36

Atropine derivative; relieve bronchospasm
Blocks muscarinic cholinergic receptors and promote bronchodilation
Effective against allergen-induced asthma and exercised-induced bronchospasm

Front 37

Ipratropium: Adverse Effects

Back 37

Systemic effects rare
Dry mouth and pharyngeal irritation can occur.

Front 38

Ipratropium: Contraindication

Back 38

Peanut-allergy when using Combivent MDI

Front 39

Ipratropium: Therapeutic effect

Back 39

Begins within 30 seconds, reach 50% of their max in 3 min, and persist about 6 hours

Front 40

Leukotriene Modifiers

Back 40

Suppress effects of Leukotriene, compounds that promote bronchoconstriction as well as eosinophil infiltration, mucus production, and airway edema

Front 41

Leukotriene Modifiers Agents

Back 41

Zileuton
Zafirlukast
Montelukast

Front 42

Zileuton

Back 42

Blocks leukotriene synthesis. Approved for prophylactic and maintenance therapy of asthma in adults and children 12 or older.

Front 43

Zafirlukast

Back 43

Block leukotriene receptors. Approved for maintenance therapy of chronic asthma in adults and children 5 and older. Food reduces absorption by 40%; administer 1 hour before meals or 2 hours after

Front 44

Montelukast

Back 44

Block leukotriene receptors. Approve for maintenance therapy of asthma in all patients over 1

Front 45

Antihistamines

Back 45

Block the effects of histamine at the H1 receptor. They do not block histamine release, antibody production, or antigen-antibody reactions.

Front 46

Antihistamines: Side effects

Back 46

Most antihistamines have anticholinergic properties and may cause constipation, dry eyes, dry mouth, and blurred vision. In addition, many antihistamines cause sedation.

Front 47

Antihistamines: Indication

Back 47

Relief of symptoms associated with allergies, including rhinitis, urticaria, and angioedema, and as adjunctive therapy in anaphylactic reactions. Some antihistamines are used to treat motion sickness (dimenhydrinate and meclizine), insomnia (diphenhydramine), Parkinson-like reactions