RESPIRATORY PHARMACOLOGY

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RESPIRATORY PHARMACOLOGY
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OVERVIEW

• Respiratory A P Review
• Drugs That Affect the Respiratory System
• Bronchodilators
• Sympathomimemtics
• Xanthine Dervivatives
• Mucokinetic Drugs
• Respiratory Stimulants
• Antihistamines

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Functions

• Provides area for gas exchange
• Moves air in and out of lungs
• Protects respiratory surfaces from dehydration,,
  temperature changes, other environmental
  variations
• Produces sounds for communication
• Olfactory senses
• Assists in the regulation of pH

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The Respiratory Mucosa

• Lines the respiratory system
• Epithelial tissue layer
• The Lamina Propria
• A connective tissue layer underneath the
  epithelial layer (Supports the epithelium)
• Goblet Cells Located in lamina propria and
  secrete mucus

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Mucus Sputum

• Mucus is normalSputum is abnormal viscous
  secretion (Main ingredient Mucus) that
  originates in the lower airways.

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Key Respiratory Points
Alveoli
Surfactant
Partial Pressures
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Brochodilators

• Primary treatment for COPD type disorders
• Classified as
• Xanthine Derivatives
• Sympathomimetics

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Sympathomimetics

• Non-selective adrenergic drugs
• EPI, racemic epi, EPI Inhalation
• Non-selective Beta adrenergic drugs
• Ephedrine
• Selective Beta2 receptor drugs
• Moderately selective
• Albuterol (Proventil, Ventolin)

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Xanthine Derivatives

• Includes caffeine, theophylline (aminophylline)
• Relax smooth muscle
• Stimulate cardiac muscle
• Stimulate CNS
• Increase diaphragmatic contractility
• Promotes diuresis through increased glomerular
  perfusion

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Other Meds

• Steroids
• Combat inflammation associated with asthma
• Examples
• Dexamethasone
• Vanceril
• Beclovent
• Methylprednisolone
• Muscarinic Antagonists (anticholinergics)
• Atrovent

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Atrovent

• Parasympatholytic bronchodilater
• Site specific, not systemic
• Dries up respiratory secretions
• Indications
• Allergic RXNs
• Asthma / COPD / Emphysema
• MUST BE USED IN CONJUNCTION WITH A BETA AGONIST

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Mucokinetic Drugs

• Move excess mucus, secretions, sputum
• Alter consistency so respiratory escalator can
  move fluids easier
• Examples
• Diluents (water / saline)
• Mucomyst

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Miscellaneous

• Direct Respiratory Stimulants
• Act directly on medullary center of brain to
  increase respiratory volume rate
• Reflex respiratory stimulants
• Spirits of ammonia
• Respiratory depressants
• Cough suppressants

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Antihistamines

• Histamine chemical mediator in the body
• Highest concentration in
• Skin, Lungs, GI tract
• Released when antigens enter body
• Keep them out!!!
• Contraction of smooth muscle of bronchioles

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Histamine

• H1 Act primarily on blood vessels bronchioles
• H2 Act primarily on the GI tract (Gut
  contractions)

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Antihistamines

• May have anticholinergic effects
• Tachycardia
• Constipation
• Inhibitions of secretions
• Examples
• Diphenhydramine (Benadryl)
• Hydroxyzine
• Newer H1 receptor antagonists
• Claritin
• Allegra

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Dystonia

• Group of disorders characterized by muscle
  contractions, repetitive movements, and abnormal
  postures
• It is theorized that an imbalance of dopamine in
  the brain may cause various dystonias
• Most often cause Haldol
• Treatment Diphenhydramine (due to
  anticholinergic properties)
• Treatment Botulinum Toxin

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Review

• Respiratory A P Review
• Drugs That Affect the Respiratory System
• Bronchodilators
• Sympathomimemtics
• Xanthine Dervivatives
• Mucokinetic Drugs
• Respiratory Stimulants
• Antihistamines