chap 27
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| Ch.27 Drugs for Respiratory Tract Disorders include | • Anti-infammatory drugs
• Bronchodilators
• Antitussives
• Expectorants
• Antihistamines
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| Anti-infammatory drugs subclasses are | - Antileukotriene drugs
- Inhaled Steroids
- Mast Cell Stabilizers
- Oral Steroids
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| Bronchodilators subclasses are | • Selective Beta-2 agonists
• Other Bronchodilators
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| Oral Steroids include | Prednisone• prednisolone •methylprednisolone• dexamethasone
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| Inhaled Steroids include | Fluticasone (Flovent) (Flonase)
•Budesonide (Pulmicort) (Rhinocort)
•Mometasone (Asmanex) (Nasonex)
• Triamcinolone (Azmacort-off mkt) (Nasacort)
•Ciclesonide (---) (Omnaris)
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| Mast Cell Stabilizers include | Cromolyn Sodium (NasalCrom) & and other formulations some no longer on mkt
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| Antileukotriene drugs include | Montelukast (Singulair)
•Zafirlukast (Accolate)
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| Selective Beta-2 agonists include | Albuterol (Ventolin, Proventil, ProAir)
,Levalbuterol (Xopenex)
,Salmeterol (Serevent)
,Formoterol (Forodil)
,Aformoterol (Brovana)
,Terbultaline (Brethine)
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| Other Bronchodilators include | Ipratropium (Atrovent)
•Tiotropium (Spiriva)
•Theophylline (Theodur)
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| Antitussives | Codeine (usually in combination with Promethazine)
•Hydrocodone (in combination with other drugs) chlorpheniramine (Tussionex
•Dextromethorphan usually in combination with other OTC ingredients (Robitussin DM)
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| Expectorants | Guaifenesin (plain Robitussin, Mucinex)
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| Antihistamines | chap 26
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| Asthma characteristics | Inflammation & hyperresponsiveness
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| Rhinitis | Seasonal or non-seasonal
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| COPD | Chronic bronchitis
, Emphysema
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| Cromolyn sodium: Mast cell stabilizers indications | Allergic rhinitis, (vernal) seasonal conjunctivitis
, Long-term control asthma
, Prevent exercise-induced bronchospasm, systemic mastocytosis, ulcerative colitis, food allergy
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| Localized pain & irritation | Mast cell stabilizers adverse effects
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| Indications: prophylaxis and treatment of various forms of asthma (allergic asthma, aspirin-sensitive asthma) | Antileukotriene drugs
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| liver enzymes (liver failure, liver injury), hypersensitivity reactions, allergic granulomatous vasculitis | Antileukotriene drugs adverse effects
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| Indication:Treat or prevent acute bronchospasm | β2 Agonists - rapid acting
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| Adverse eff: tachycardia, palpitations, tremors | β2 Agonists - Rapid-acting
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| “Rescue inhalers” | albuterol (Proventil)
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| Indications: Treat asthmas & emphysema, not for acute bronchitis | β2 Agonists - Long-acting
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| Indications: COPD, rhinitis | Muscarinic blockers: Ipratropium (Atrovent), Tiotropium (Spiriva)
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| First-line treatment for COPD | tiotroprium (Spiriva)
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| Indications: COPD, asthma, premie apnea | theophylline (Theodur)
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| Adverse effects: GI, CNS, CV | theophylline (Theodur)
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| What to remember when administer theophylline (Theodur)? | Monitor serum levels
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| What is the first-line treatment for a cough? | controlling the infection, allergy, and other condition responsible for a cough
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| Opioids characteristics | have higher retio of antitussive effect to analgesic and euphoric effects
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| centrally acting antitussives | opioids: dextromethorphan, codeine, hydrocodone
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| antitussive | drugs to suppress coughing
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| Expectorants moa | Reduce viscosity of tenacious secretions by increasing respiratory tract fluid. Mobilization & expectoration of mucous
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| Indications: Thick tenacious respiratory secretions; Dry, non-productive cough; Sinusitis | guaifenesin (Mucinex)
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| Indications: prevent asthma attacks | Glucocorticoids: Inhalation preferred route of administration
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| Thrush (oral candidiasis); Suppress growth in children | Glucocorticoids (fluticasone, budesonide, triamcinolone): metered-dose inhalers (ise of spacer device)
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| Mast cell stabilizers are | nonsteroid compounds that stabilize the plasma membrane of mast cells and eosinophils and thereby prevents degranulation and release of histamine ... substances that cause airway inflammation
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| the most widely used opioid antitussive drug | Dextromethorphan
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| Indications: "nonprescription" products for cough and other respiratory tract conditions | Dextromethorphan
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| Codeine and hydrocodone can cause | little CNS depression or euphoria at doses that produce excellent antitussive (liquid cough preparations)
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| antileukotriene benefits | children more than adults, younger children more than older children
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| Rapid acting B2 agonists | albuterol, levalbuterol, terbultaline
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| Indication: prevent and treat acute bronchospasm | rapid acting B2 agonist
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| tachycardia, palpitaions, tremors | levalbuterol < albuterol
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| Long-acting B2 agonists | Salmeterol and formoterol
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| Indications: long term treatment of asthma and emphysema, particularly "prevent nocturnal asthmatic attacks, inhibit late phase of allergen-induced bronchoconstriction" | salmeterol and formoterol
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| dry mouth | ipratropium and tiotropium
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| Indications: primarily to treat COPD, reduces rhinorrhea in pt with allergic or viral rhinitis, infants with acute bronchitis | ipratropium
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| Expectorant moa | facilitating the coughing up of mucus and other material from the lungs,
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| Indications: pts with thick, tenacious respiratory tract secretions; pt with dry, nonproductive coughing; pt with sinusitis to increase airway hydration | Guaifenesin: oral nonprescriptive drug
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| Indicactions:primarily to treat chronic obstructive lung disorders and asthma, apnea, COPD, recurrent apnea in premature infants, obstructive sleep apnea, and periodic breathing | Theophylline (bronchidilators)
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| Reduce sleep quality via CNS stimulation | Theophylline (bronchidilators)
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| abdominal pain, nausea, vomiting; headache, anxiety, restlessness, insomnia, dizziness and seizures | Theophylline (bronchidilators)
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| hypotension,bradycardia, extra systoles, premature ventricular contractions, and tachycardia; seizure and serious arrhythmias occur at concentration over 25 mg/L | Theophylline (bronchidilators)
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| thoephyline is | a methylxanthine drug
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| the most efficacious anti-inflammatory drugs for allergic rhinitis | glucocortitoids
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| the only type of bronchodilator used to counteract acute asthmatic attacks | B2 agonists
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| primarily to treat pt with COPD | muscarinic antagonists
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| long-term basis to prevent bronchoconstriction in pt with asthma or emphysema | theophylline
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| bronchodilators moa | relax bronchial smooth muscle and prevent or relieve bronchospasm
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| Inhaled steroid vs oral steroids | adverse effects are reduced when ginve by inhalation. excessive deposition of drgus in the mouth cause oral candidiasis (thrush)
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| arformoterol (active isomer of formoteron | chronic bronchitis or emphysema
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| black-box warning | long-acting B2 agonists: risk of asthma-related death
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