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Pharmacology, Chapter 32, COPD

What are some of the factors that can precipitate an asthma attack? Allergens, air pollutants, cold air, certain drugs, infections, and exercise are some of the factors that can trigger an asthmatic attack.
List four physiological changes that can occur in the respiratory tract during and asthma attack. - Mucosal Edema - Ciliary activity of the respiratory tract is usually depressed - Bronchoconstriction -Increased Mucus
What chemical mediators are released from mast cells? What effects do they produce? #1 Histamine: causes bronchoconstriction, increased vascular permeability that contributes to mucosal edema, and infiltration of leukocytes, particularly eosinophils.
What chemical mediators are released from mast cells? What effects do they produce? #2 Eosinophilic Chemotactic Factor of Anaphylaxis (ECF-A): are part of the general inflammatory and allergic reaction that often occurs in the lining of the respiratory tract in asthma. They worsen and prolong the asthmatic process.
What chemical mediators are released from mast cells? What effects do they produce? #3 Prostaglandins and Leukotrienes: two different chemical mediators that are both derived from arachidonic acid. You can find arachidonic acid in cell membranes, particularly in mast cells and other inflammatory cells.
Continued from Chemical Mediators #3 ....These two mediators are formed and released in inflammatory conditions such as asthma. Both mediators can cause bronchoconstriction, edema, and mucus production.
What are the causes of Chronic Bronchitis? *Caused by chronic irritation of the respiratory tract (cigarette smoke and environmental pollutants) *Degenerative changes in the respiratory lining and mucociliary escalator system. *Secretions thicken and interfere with respiratory gas exchange
Treatment for Chronic Bronchitis *Drug Therapy* Bronchodilators: *aimed at improving respiratory gas exchange *reducing the volume of mucus secretions
Symptoms of Chronic Bronchitis Productive cough Difficulty breathing Increased respiratory infections Restriction of physical activity
What is Emphysema? -Involves destruction of the alveoli -Increased by air pollution, tobacco smoke, and other irritants -Causes enlargement of the air spaces and leads to hyperinflation -Irreversible lung damage
Symptoms of Emphysema Difficulty expelling air from the lungs Reduced respiratory exchange Shortness of breath
Treatment for Emphysema -Respiratory exercises designed to increase the efficiency of respiration -Oxygen therapy -Drug therapy: Bronchodilators & Anti-inflammatory agents
What is Asthma? Inflammatory disease: factors stimulate the release of chemical mediators from mast cells and other cells involved in the inflammatory process.
Which chemical mediators are two main components of Asthma? Bronchoconstriction and Inflammation
Symptoms of Asthma... SOB, Wheezing, Feeling of Suffocation (like a fish without water). ,Mucosal edema, Increased production of mucus, and Bronchoconstriction
Treatment for Asthma *Drug Therapy* Bronchodilators Anti-Inflammatories Antiallergics
How many different types of Bronchodilators are there? 3 Different types of Bronchodilators: Sympathomimetics Anticholinergics Methylxanthines
What is the main effect of a bronchodilator? To relieve constriction! bronchodilator to "dilate"
Beta Adrenergic Drugs -Epinephrine and Isoproterenol are potent beta-adrenergic drugs -Albuterol, Terbutaline are considered “rescue” drugs as they take effect almost immediately -Salmeterol is long-acting and takes effect within 10 – 20 minutes.
Beta what? Beta "2" selective... because Beta 2 goes where? 2 The LUNGS!
Typically Beta Adrenergic Drugs are taken with... Usually administered in combination with anti-inflammatory corticosteroids
Long Term Use of Beta Adrenergic Drugs have some consequences? Yes! Long-term use has been associated with increased risk of asthma related mortality.
Methyl xanthine Drugs -Produce mild stimulation of the CNS, heart and kidneys. -Bronchodilation
Methyl xanthine Drugs Continued: Increases respiratory muscle contractility and mucociliary clearance, important in the treatment of chronic bronchitis and emphysema (COPD).
Anticholinergic Drugs Block actions of acetylcholine Bronchodilation Reduces volume of respiratory secretions *Not as potent as Beta Adrenergic Drugs*
What are the first line drugs for COPD? Anticholinergic Drugs!
Ipratropium Bromide (Atrovent) is indicated for both asthma and COPD.
Anti-inflammatory Drugs Referred to as “controller” drugs because they reduce and control the inflammatory response Bronchodilators are more effective and can reduce the dosage when used with anti-inflammatory drugs.
Corticosteroids Considered most potent anti-inflammatory and anti-allergic drugs Inhibits the inflammatory response in the respiratory airways
Prednisone and Prednisolone -provide systemic drug effects and are associated with potentially serious adverse effects. Primarily used during the initial acute phase of inflammation
Adverse Effects of Prednisone and Prednisolone Fluid retention, muscle wasting, metabolic disturbances, and increased risk of infections
Leukotriene Inhibitor Drugs Leukotrienes cause bronchoconstriction, mucus production, and inflammation
Leukotriene Inhibitors (zileuton) -prevents the synthesis of all the leukotrienes. -Adverse Effects- *Nausea, diarrhea, rash and headaches *Most serious are related to liver intoxicity: increased liver enzymes, fever, dark urine, clay-colored stools and jaundice
Which Leukotriene Inhibitors are better tolerated? Zafirlukast and Montelukast
Anti-Allergic Drugs Cromolyn Sodium: interferes with the antigen-antibody reaction to release mast cell mediators.
More about Cromolyn Sodium *Taken prophylactically on a daily basis *Not a bronchodilator, has no use in the treatment of acute asthma *Therapeutic effect takes several weeks to fully develop
Mucolytics? liquefy bronchial mucus, allowing clearance of mucus by coughing or suctioning.
Which drug is an effective Mucolytic? Acetylcysteine
Acetylcysteine? - is Irritating and can cause bronchospasm. ***Bronchodilator is added to the inhalation mixture to prevent bronchospasm***
Expectorants facilitate the removal of thickened mucus from the lungs.
Which is the most commonly used Expectorant? Guaifenesin
Action of Guaifenesin? Increases respiratory secretions and provide relief of non-productive coughing.
Created by: el_millor



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