DRUGS AFFECTING THE RESPIRATORY SYSTEM (dr.trully).ppt
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Transcript of DRUGS AFFECTING THE RESPIRATORY SYSTEM (dr.trully).ppt
7/28/2019 DRUGS AFFECTING THE RESPIRATORY SYSTEM (dr.trully).ppt
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Trully Sitorus
Depart. Of Pharmacology
Medical Faculty
Padjadjaran University
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Drugs Used To Treat Asthma
Asthma is a chronic disease,
characterized by episodes of acute
bronchocontriction causing shortness of breath, cough, chest tightness, wheezing
and rapid respirations.
The goal therapy is to relieve symptomsand to prevent recurrence of asthmatic
attacks.
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Principles in the treatment of asthma
I. Anti-inflammatory Drugs- Chromolin sodium
- Nedocromil sodium
- SteroidII. Bronchodilator
- Agonist adrenergic
- Xanthines- Anticholinergic
III. Avoidance of the causative factors, when
possible.
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Agonist Adrenergic
Mechanism:
Increase cAMP levels in smooth muscle
Effects – Side effects• Bronchodilation
• CV effects
• Metabolic effects
• Pulmonary effects: cough is possible reaction toaerosol preparation
• GI effect: nausea, vomiting
• Uterine: relaxed uterine smooth muscle
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Bronchodilator Agonist
Adrenergic
I. Selective (Beta 2 Adrenergic)
Salbutamol (Albuterol)Terbutalin
Metaproterenol
SalmeterolFormoterol
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II. Non selective
(Beta 1-2 Adrenergic)
IsoproterenolMetoproterenol
(Alfa – Beta Adrenergic)
Adrenalin
Ephedrine
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• Theophylline
• Aminophylline
Mechanism
• Inhibiting enzyme phosphodiesterase
• Adenosin antagonist
Indication
• Asthma bronchiale• Reduce dependence on adrenergic
• Nocturnal control of symptom
• Status asthmaticus
Methylxantine Bronchodilator
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Pharmacokinetics
• Therapeutic range: 10 – 20 ug/ml
• The variability biotransformation is large
• Numerous drug interaction
Adverse effects• Hypersensitivities
• Anorexia, nausea, vomiting, headache, palpitation,tachycardia.
• Nervousness, insomnia, anxiety
• Tremor, convulsion
• Toxic dose: arrhythmias, coma and death
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Contra indication
• Arrhythmias cordis
• Coronary heart disease
• Ulcus pepticum
Drug interaction
• Erythromycin
• Cimetidine• Propanolol
• Allopurinol
•Phenobarbital
•Phenitoin• Nicotine (smoking)
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Anti Muscarinic Bronchodilators
Ipatropium
Mechanism:
Reduce bronchocontriction mediated by
vagal reflexes
Indication:
Chronic Obstructive Pulmonary Disease, AsthmaBronchiale, esspecially in patiens with concurrent
cardiac disease who cann’t tolerate B adrenergic or
methylxanthines
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Adverse effects:Some atropine like effect
Contraindication:
Glaucoma
Urinary outlet obstruction
Dosage: Aerosol
Nebulizer
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CROMOLYN AND NEDOCROMIL
• Mechanism
Cromolyn inhibits the release of mediators of
inflamation from mast cells .Cromolyn is not a bronchodilator.
• Major Indications
Prophylaxis of AsthmaYoung patients with Extrinsic, irritant – induced
asthma.
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• Other Indication
Rhinitis
Allergic conjungtivitisHay Fever
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CORTICOSTEROID
• Mechanism
Reduce the number and activity of inflammatory
cells.Reduce the release of mediators (Leukotrienes)
Corticosteroids may enhance the Beta adrenergic.
Major Indication
Asthma Bronchiale
Combination with bronchodilator agent.
Prophylaxis of asthma aerosol preparation.
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• Other Indication
lupus eritromatosus, Nephrotic syndrome, Hayfever, Dermatitis allergica.
• Adverse Effects
Topical steroid : throat irritation, oral thrush,atrophy, pharyngeal candidiasis.
• PreparationInhaler : Beclomethasone, Flunisolide,Triamcinolone.
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DRUGS USED IN RHINITIS OR
THE COMMON COLD• Pathophysiology
Viral infection and other inflammatory
conditions cause swelling and edema of themucous membrane of nasopharynx.
Symptom : Rhinorrhea and Congestion
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DRUGS USED IN RHINITIS / COMMON
COLD
I. Antihistamines (AH1)
Sedative : cyclizine, dipenhydramine, ctm
II. Alpha Adrenoreceptor Agonist
Phenylephrine
Ephedrine – pseudoephedrine
III. CromolynIV. Corticosteroid
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DRUG USED FOR COUGH
• Pathophysiology
Cough is a non specific sign of upper or lower airway irritation or inflamation and is mediated
through reflex vagal pathways.
Cough : Non productive
Productive