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Chapter 37 Respiratory Drugs
Terms in this set (54)
what are the four categories of asthma?
Intrinsic, extrinsic, exercise induced, and drug induced
what is intrinsic asthma?
occurring in patients with no history of allergies
what is extrinsic asthma?
occurring in patients exposed to a known allergen
what is status asthmaticus?
prolonged asthma attack that does not respond to typical drug therapy
*may last minutes to hours
what is chronic bronchitis?
continuous inflammation and low-grade infection of the bronchi
what is emphysema?
air spaces enlarge as a result of the destruction of alveolar walls; the surface area where gas exchange takes place is reduced; effective respiration is impaired
what do bronchodilators do?
relax bronchial smooth muscle, which causes dilation of the bronchi and bronchioles that are narrowed as a result of the disease process
what are the three classes of bronchodilators?
what are the two types of beta-adrenergic agonist bronchodilators?
short-acting beta agonist (SABA) inhalers or long-acting beta agonist (LABA) inhalers
examples of SABA inhalers
examples of LABA inhalers
*formoterol (Foradil, Perforomist)
when are beta adrenergic agonists used?
during acute phase of asthmatic attacks
what do beta-adrenergic agonists do?
quickly reduce airway constiction and restore normal airflow
what are the three types of beta-adrenergic agonists?
nonselective adrenergics, nonselective beta-adrenergics, and selective beta2 drugs
what do nonselective adrenergics do?
stimulate alpha, beta1 (cardiac), and beta2 (respiratory receptors
example of a nonselective adrenergic drug
what do nonselective beta-adrenergics do?
stimulate both beta1 and beta2 receptors
example of a nonselective beta-adrenergic agonist
what do selective beta2 drugs do?
stimulate only beta 2 receptors
example of a selective beta2 drug
albuterol (Proventil, others)
mechanism of action for beta-adrenergic agonists
begins at the specific receptor stimulated and ends with dilation of the airways
indications for beta-adrenergic agonists
*relief of bronchospasm related to asthma, bronchitis, and other pulmonary diseases
*treatment and prevention of acute attacks
*used in hypotension and shock
*to produce uterine relaxation to prevent premature labor
adverse effects of beta-adrenergic agonists: alpha and beta (epinephrine)
Insomnia, restlessness, anorexia, vascular headache, hyperglycemia, tremor, cardiac stimulation
adverse effects of beta-adrenergic agonists: beta1 and beta2 (metaproterenol)
cardiac stimulation, tremor, anginal pain, vascular headache, hypotension
adverse effects of beta-adrenergic agonist: beta2 (albuterol)
hypotension or hypertension, vascular headache, tremor
what kind of action do anticholinergics have?
slow and prolonged
examples of anticholinergics
Ipatropium bromide (Atrovent) and tiotropium (Spiriva)
what are anticholinergics used to prevent?
what are anticholinergics not used for?
acute asthma exacerbations
mechanism of action for anticholinergics
*ACh causes bronchial constriction & narrowing of airways
*anticholinergics bind to the ACh receptors preventing ACh from binding
*result: bronchoconstriction is prevented and airways dilate
adverse effects of anticholinergics
dry mouth or throat, nasal congestion, heart palpitations, GI distress, headache, coughing, anxiety
what are xanthine derivatives?
plant alkaloids:caffeine, theobromine, and theophylline
which of the plant alkaloid xanthine derivatives is used as a bronchodilator?
what are the two synthetic xanthines?
aminophylline and dyphilline
mechanism of action for xanthine derivatives
*increased levels of energy producing cAMP
*results in decreased cAMP levels, smooth muscle relaxation, bronchodilation, and increased airflow
xanthine derivatives drug effects
*bronchodilation by relaxing smooth muscle in airways resulting in relief of bronchospasms and greater aiflow into and out of the lungs
*Cause CNS and cardiovascular stimulation
xanthine derivative indications
*dilation of airways in asthma, chronic bronchitis, and emphysema
*mild to moderate cases of acute asthma
*adjunct drug in management of COPD
adverse effects of xanthine derivatives
nausea, vomiting, anorexia, gastroesophageal reflux during sleep, sinus tachycardia, extrasystole, palpitations, ventricular dysrhythmias, increased urination, and hyperglycemia
what is a newer class of asthma medications?
Leukotriene receptor antagonists
How do Leukotriene receptor antagonists dilate?
they are nonbronchodilating
Leukotriene receptor antagonist (LTRAS) drugs
LTRAS Mechanism of action
LRTAs prevent leukotrienes from attaching to receptors on cells in the lungs and in circulation, thus Inflammation in the lungs is blocked, and asthma symptoms are relieved
LTRAS drug effects
prevent smooth muscle contraction of the bronchial airways, decrease mucus secretion, prevent vascular permeability, decrease neutrophil and leukocyte infiltration to the lungs preventing inflammation
Prophylaxis and long-term treatment and prevention of asthma in adults and children 12 years of age and older
NOT meant for management of acute asthmatic attacks
Montelukast is also approved for treatment of allergic rhinitis
LTRAS drug zileuton's adverse affects
headache, nausea, dizziness, insomnia, liver function
LTRAS drug zafirlukast's adverse effects
headache, nausea, diarrhea, liver function
what are corticosteroids used for?
corticosteroids do not relieve symptoms of what?
acute asthma attacks
what are the two forms of corticosteroids?
oral or inhaled (inhaled forms reduce systemic effects)
how long till full effects of a corticosteroid are seen?
mechanism of action for corticosteroids
*stabilize membranes of cells that release harmful bronchoconstricting substances (Leukocytes)
*Increase responsiveness of bronchial smooth muscle to beta-adrenergic stimulation
examples of inhaled corticosteroids
*beclomethasone dipropionate (Beclovent)
*budesonide (Pulmicort Turbuhaler)
*dexamethasone sodium phosphate (Decadron Phosphate Respihaler)
indications for inhaled corticosteroids
adverse effects of inhaled corticosteroids
pharyngeal irritation, coughing, dry mouth, oral fungal infections, systemic effects are rare
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