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RS Pharmacology

Respiratory System Pharmacology- Treatment of Cough

Types of Drugs used in Cough: Antitussive Drugs Protussive Drugs
Purpose of the Cough reflex: A useful protective reflex Indicator of an underlying illness
How is the cough reflex induced? Mechanically or Chemically Mechanically: stimulation of large respiratory passages Chemically: stimulation of alveoli
Cough can refer to: Exhaustion Insomnia Musculoskeletal pain Hoarseness Urinary incontinence Dizziness, headache, syncope Fear of cancer, AIDS, or TB Nausea, vomiting, retching, and anorexia
What is the function of antiussive drugs? Controls, inhibits or eliminates cough Useful to suppress intensity and frequency of coughing when it is unproductive and distressing
What is the function of protussive drugs? Makes cough more effective
Treatment of Cough is usually done based on: Etiology or pathophysiological mechanism
Different causes of cough: Asthma Sinusitis Allergic or perennial non allergic sinusitis GERD Bronchitis Sarcoidosis CHF ACEI-induced cough
When is non-specific treatment of cough used? When definitive therapy cannot be given either because: a. the cause is unknown b. definitive therapy did not have the chance to work or will not work( cancer metastatic to lung)
What are the categories of non-specific treatment of drugs? 1) Drugs that may alter mucociliary factors 2) Drugs acting on the afferent limb 3) Drugs acting on the cough center 4) Drugs acting on the efferent limb 5) Drugs acting on the respiratory skeletal muscles
How do drugs that may alter mucociliary factors function? Increased volume of the secretions Decrease mucus production Change the consistency of mucus (i.e. Mucolytics) Increase mucociliary clearance
Examples of drugs that alter mucociliary factors: Ipecacuanha Squill Volatile oils Iodinated glycerol Aromatic chest rub Bromhexine Carbocisteine Ammonium chloride. Hydration Ipratropium bromide. Beta adrenergic agonists. Theophylline. Sodium chromoglycate. Beclomethasone.
Natural products which have direct effect on CNS and principally cause emesis which is preceded by increased secretions: Ipecacuanha and Squill
Which drugs have direct action on the bronchi and come in lemon, anise, and pine flavor? Volatile oils
Which drugs are excreted through bronchial glands and stimulate secretions directly? Iodinated glycerol
Which drugs can cause congenital hypothyroidism, so are contraindicated in pregnancy and during lactation? Iodinated glycerol
Which drugs increase lysosome activity leading to increased enzyme secretion and hydrolysis of mucopolysacharides? Bromhexine
Which drugs work as an aerosol through their SH group to reduce disulfide bonds in mucoproteins leading to enhancement of flow? Carbocisteine
Hydration can be done either: Orally or IV
Which drugs act on the afferent limb? Local anesthetics: Lidocaine Opoids
Which drug when applied topically, has transient antitussive effect and when administered Intravenously, could have a central effect? Lidocaine
Which drugs act on the cough center? Narcotic: Codiene Diamorphine Morphine Non narcotic: Dextromethorphan Diphenhydramine Pholcodine
Which drug acts on the efferent limb? Ipratropium Bromide
How is Ipratropium Bromide administered? As an aerosol
Ipratropium Bromide is effective in: Asthma Chronic bronchitis Persistent cough following URTI
Examples of drugs acting on the respiratory skeletal muscles: Nondepolarizing blockers like pancuronium
When are drugs acting on the respiratory skeletal muscles used? In patients who can not be mechanically ventilated because of uncontrollable spasms of coughing
Function of protussive therapy: Increases cough effectiveness with or without increasing frequency Increase superficial velocity or alter mucus factors Indicated when cough performs a useful function, and needs to be encouraged
In which cases is protussive therapy used? Bronchiectasis Cystic fibrosis Pneumonia Postoperative atelectasis
Drugs used in protussive therapy: Hypertonic Saline Aerosol Amiloride Aerosol Bronchodilators
Function of hypertonic saline aerosol: Improves cough clearance but not pulmonary function or subjective assessment
In which case is Amiloride aerosol used? Cystic fibrosis
What mechanical measures are used in protussive therapy? Manual compression of the lower thorax and abdomen Abdominal push manoevure to assist expiration Combining abdominal binding and muscle training of pectoralis major Combination of positive exp. pressure and chest physiotherapy in chronic bronchitis
Created by: Ulaisl



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