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Respiratory Pharmacology

Respiratory Pharmacology Set
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Sympathomimetic
mimics the sympathetic nervous system
Sympathetic Neuro-Receptors
Alpha: arteries and arterioles, B1: heart, B2: Lungs
Nor epinephrine
Sympathetic Nuero-transmitter
Adrenergic Bronchodilators
Drug class that directly stimulates Sympathetic Receptors
Effects of Epinephrine
Increased BP, Tachycardia, Skeletal Muscle Tremors, Short duration
Albuterol
Most common short acting bronchodilator
Levalbuterol
Single Isomer form of Albuterol (R Isomer)
Albuterol Dose
SVN: 2.5mg/3ml (unit dose), MDI 90 MCG/puff,
Levalbuterol Dose
SVN: 1.25mg/3ml (.31 &.63 mg/3ml) MDI: 45 MCG/puff
Long Acting Bronchodilators
For maintenance, duration 12hrs, Often used in combination w/ Corticosteroids
Long Acting Bronchodilator Rx <ADVair>
Salmeterol (Serevent) + Fluticasone (a synthetic corticosteroid.)= Advair
Advair
a bronchodilator and corticosteroid combination used to treat and prevent the symptoms of asthma.
Adrenergic AKA
Sympathomitmetic AKA
Muscarinic M2, M3
Parasympathetic Receptors in the airways
Atropine
Non-selective Parasympathalitic Agent (a muscarinic receptor antagonist)
Anticholinergic agents
block acetylcholine receptors & act as cholinergic anatgonists
Cholinergic agents
uses acetylcholine as its neurotransmitter.
antiadrenergic
an antagonist of the Sympathetic Nervous System
Sympatholitic Agents
an agent blocking the effect of the Sympathetic Nervous System
Antiadrenergic AKA
Sympatholytic AKA
Sympathomimetic Agents
mimics the sympathetic system
Methylated Xanthines (CH3)
Caffeine, Theophylline and Theobromine
Clinical Indications for use of Xanthines
Considered the primary agent of choice for Apnea of Prematurity
Cholinesterase
The enzyme that degrades the parasympathetic neuro-transmitter
COMT/MAO
the enzymes that degrades the sympathetic neuro-transmitter
Synergism
two or more agents working on the same target organ, resulting in a product greater than the sum of its parts
Additivity
two agents working together resulting in a sum equal to both parts
Therapeutic Index
The appropriate dose that reduces risk of overdosing or underdosing
Riboviran
Drug used in extreme cases of RSV. Delivered via (SPAG) Small Particle Aerosol Generator
Albuterol inhalers
Ventolin, Proventil, Pro-Air (trade names)
Long -Acting Bronchodilators(12 hrs)
Serevent(Salmetrol) , Foradil(Formoterol), Brovana(Arformoterol)
Fluticasone + Salmeterol=
Advair Diskus (dpi) 50mcg /Seretide
Formoterol +Budesonide=
Symbicort
Albuterol + Ipratropium=
Combivent or DUOneb
Purpose of Mucus in physiology
effective lubricant, protective barrier, and sticky trap for foreign particles and microorganisms
Factors that slow mucus clearance
lung disease(COPD,CF), Airway drying, Narcotics, Airway Trauma, Cigarrette Smoking, Atmosphere pollutants
Mucolytics
agents that destroy or dissolve mucus, degrade mucin, helpful in opening airways
Mucomyst generic name
N. Acetylcysteine trade name
Pulmozyme generic name
the trade name or Dornase alfa-used with CF
N. Acetylcysteine
mucolytic,(mucomyst) may cause bronchospasm (use w/bronchdilator), limited shelf life (refrig)
Dornase Alfa
mucolytic,(Pulmozyme) disrupts DNA polymers, effective in CF
Bronchoalveolar Lavage (BAL)
bronchoscope passed through mouth or nose into the lungs, a fluid is squirted into a small part of the lung and then recollected for examination.
Chronotropic Drugs mode of action
Drugs that change the HR by affecting signals to the SA node
Ionotropic Drug's mode of action
Drugs that affect the myocardial contractility
Side effects to corticosteroid use
Osteoporosis, adrenal suppresion, mood changes
Three Classifications of Antiinflammatory Agents
Corticosteroids, Leukotriene Antagonists, and Mast Cell Stabilizers
Common ACE inhibitors
CaptroPRIL, LisinoPRIL, EnalaPRIL, BenzaPRIL
Angiotensins effect on Blood Pressure
Blood vessels constrict and raise blood pressures
Angiotensin Converting Enzyme Inhibitors Mode of Action(ACE Inhibitors)
Blocks the conversion of Angiotensin I to Angiotension II
bradykinin defined
substance released by damaged tissue that promotes inflammation
Antithrombotics defined
Prophylactic Drug to treat Formation of Clots (blood thinners)
Drugs used to treat Thrombosis
Coumadin, Heparin, Lovenox
Leukotrienes
Initiate and mediate the inflammatory response (singulair is a Leukotriene Antagonist)
Mast Cell Stabilizers
inhibit the release of inflammatory chemicals from mast cells and make the airways less likely to narrow.
Chronotropics which increase Heart Rate
Atropine and Isoproternol
Chronotropics which decrease Heart Rate
Adenosine and Metoprolol (Beta Blockers)
Combined Inhaled Medicines Defined
Bronchodilators that combine a controller inhaler and a quick relief inhaler, or combine 2 controller inhalers into one.
Pharmacodynamic Defined
The drugs affect on the Body
Pharmacokinetic Defined
The Body's affect on the Drug
Tachyphylaxis Defined
rapidly decreasing response to a drug following administration of initial doses
The First Pass Effect
drug metabolism that occurs within the liver acts to reduce the effect
Peripheral Airway Deposition
<2.0 - 5.0 microns>
Upper Airway Deposition
<5.0 - 10.0 Microns>
Parenteral Defined
a, Subcutaneous, intramuscular, or intravenous method of administration; treatment by injection.
20% increase to heart rate over baseline
Considerations to stop treatment of SABA (Sign of Side Effect)
Adrenergic Antagonists
The most common Sympatholytic Agent (Drugs that inhibit the actions of the sympathetic nervous system by any mechanism)
Possible side effects of thiazide diuretics
Hypokalemia, metabolic alkalosis, dehydration(leads to hypotension)