Respiratory Tract Drugs(2)

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Unformatted text preview: at. 35 35 36 36 Example of a metered-dose inhaler, open nebulizer, closed nebulizer, and air jet nebulizer. air 37 38 38 Anti-Inflammatory Drugs Anti-Inflammatory Foundation of asthma therapy Taken daily for long-term control Principal anti-inflammatory drugs are the Principal glucocorticoids glucocorticoids 39 Anti-Inflammatory Drugs – Glucocorticoids Glucocorticoids Include budesonide (Pulmicort) and Include fluticasone (Flovent) fluticasone Considered the most effective antiasthma Considered drugs available drugs Usually administered by inhalation, but IV Usually and oral are also options and 40 Anti-Inflammatory Drugs – Glucocorticoids Glucocorticoids Mechanism of action--suppress inflammation – Decreased synthesis and release of inflammatory Decreased mediators mediators – Decreased infiltration and activity of inflammatory Decreased cells cells – Decreased edema of the airway mucosa Adverse effects: – Minor when taken acutely – Can be severe when used long-term (adrenal Can suppression, osteoporosis, hyperglycemia, and others) others) 41 Anti-Inflammatory Drugs – Leukotriene Modifiers Leukotriene Suppress effects of leukotrienes Less effective than inhaled glucocorticoids Available agents: – Zileuton (Zyflo) – Zafirlukast (Accolate) – Montelukast (Singulair) 42 Anti-Inflammatory Drugs – Cromolyn Cromolyn Used for prophylaxis, not quick relief Suppresses inflammation; not a Suppresses bronchodilator bronchodilator Route – inhalation: Route inhalation: – Nebulizer – MDI Adverse effects – Safest of all antiasthma medications – Cough – Bronchospasm 43 Bronchodilators Bronchodilators Provide symptomatic relief but do not alter Provide the underlying disease process (inflammation) (inflammation) In almost all cases, patient taking a In bronchodilator should also be taking a glucocorticoid for long-term suppression of inflammation inflammation Principal bronchodilators are the beta2adrenergic agonists 44 Bronchodilators – Beta2-Adrenergic Bronchodilators -Adrenergic Agonists Agonists Include albuterol, salmeterol, terbutaline Most effective drugs for relief of acute Most bronchospasm and prevention of exercise-induced bronchospasm exercise-induced Use in asthma: both quick relief and Use long-term control long-term 45 Bronchodilators – Beta2-Adrenergic Bronchodilators -Adrenergic Agonists Agonists Mechanism of action – Activate beta2 receptors in smooth muscle of lung, promoting bronchodilation and thereby relieving bronchospasm bronchospasm – Also suppress histamine release in lung and Also increase ciliary motility increase Adverse effects – Inhaled preparations Systemic effects – tachycardia, angina, and tremor – Oral preparations Excessive dosage – angina pectoris, tachydysrhythmias Tremor 46 Bronchodilators – Methylxanthines Bronchodilators Theophylline – Benefits derive primarily from bronchodilation – Narrow therapeutic index – Plasma level 10 to 20 mcg/mL – Toxicity is related to theophylline levels Other methylxanthines...
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