drugs, respiratory drugs, .pptx

Respiratory drugs

1. RESPIRATORY DRUGS

2. ANTI-ASTHMATIC DRUGS Classified as: Bronchodilators( 2 types : adrenergic agonist and metylxanthines ) Anticholinergic. Mast cell stabilizers Corticosteroids. Anti-histamines.

3. Bronchodilators : adrenergic agonists Mechanism of action: They causes widening of the airway by relaxing bronchial smooth muscles by stimulating beta receptors

4. Drug examples & Doses S. No. Drugs Doses 1 Salbutamol 2-4 mg orally 2 Terbutaline 5mg orally. 3 Formoterol 80 mcg B.D. orally 4 Albuterol 200-400 mcg inhaled every 6 hrly.

5. Indications/uses Relieving the distress of asthma. Bronchospasm broncho- constriction Adverse Effects Nervousnes s . Anxiety. Tremor. Headache. Palpitations. Tachycardia. Arrhythmias Contraindications/ Precautions. Patient with uncontrolled arrhythmias. Prolonged use of albuterol may cause hypokalemia

6. Bronchodilators : Methylxanthine Mechanism of action : These drugs are weak CNS stimulants that are powerful smooth muscle relaxants thus they relax the smooth muscle of bronchi and helps in bronchodilation and can help in relieving breathlessness. They also have diuretic effect.

7. Drug examples & Doses S. No. Drugs Doses 1 Theophylline 200-400 mg TDS orally. 2 Etiophylline 250 mg TDS IV/IM 3 Aminophylline 250-500mg TDS IV slow.

8. Indication/Uses To treat and prevent bronchospasm. asthma Bronchitis emphysema Contraindications/ Precautions Hypersensitivity to any xanthine. Infection or irritation of rectum or lower portion. Give cautiously in neonates, in elderly patients, heart disorders hepatic disorders

9. Adverse effects Headache. Anxiety. Nausea. Seizures. Abdominal Cramping. Diarrhea. Respiratory arrest. Irritability. Insomnia. Vomiting. Peptic ulcer. Epigastric pain. Tachycardia

10. Mast cell Stabilizers Mast cell stabilizers works to prevent allergy cells called mast cell from breaking open and releasing chemicals that help to cause inflammation. They are not effective once the allergic reaction has occurred and mediators are released from mast cells. So they are useless during asthmatic attack. They are used in the prophylaxis of asthma. Mechanism of action- They inhibit mast cell activity, thus prevent the release of allergic mediators like histamine, serotonin, prostaglandins, cytokines. These chemical are essential for an inflammation and allergic reactions

11. Drug examples and Doses S. No. Drug Doses 1 Cromo l yn sodium 20mg 4times a day (Nebulization solution)

12. Indication / uses Prevent asthma symptoms from occurring or prophylaxis to asthmatic attack. To decrease inflammation or bronchospasm. To decrease allergic reactions. Rhinitis/conjunctivitis. Contraindications/ precautions Hypersensitivity. To be used carefully with renal dysfunction, hepatic dysfunction. Lactation, Cardiac arrhythmias

13. Anti-Inflammatory Drugs (Cortico-steroids) These drugs have anti- inflammatory as well as anti- allergic actions thus they are effective in bronchial asthma Mechanism of action- They prevent the release of or counteract the bronchial mediators (Kinins, serotonin, Histamine) that cause tissue inflammation responsible for edema and airway narrowing

14. Drug example and dose S. No Drugs Doses 1 Prednisolone 5-60mg per day in divided dose. 2 Be c lom e tha s one Dipropionate 100μgm (microgram) 6hrly by aerosol inhalation.

15. Indication/uses Chronic bronchitis. Allergic Rhinitis. Respiratory inflammatory disorders. Bronchial asthma. Prophylaxis in exercise induced asthma. Allergic reaction. Contraindications/precautions Acute bronchospasm. Use cautiously in patients who are immunosuppressed and in those taking prednisone or other corticosteroids. Use very cautiously in patients with viral respiratory infections

16. Adverse effects Hoarseness. Candidac infections. Oropharyngeal irritation. Bronchospasmafter inhalation of dry powder

17. Antihistamines Antihistamines are the drugs used in the treatment of allergic disorders and some other conditions. Mechanism of action: These drugs block the effect of histamine and its receptors. They also provide some sort of sedation. There are four types of antihistamines drugs. Highly sedatives. Moderate sedatives. Mild sedatives. Non sedatives.

18. Drug Example & Doses S. No Drugs Doses Highly Sedative 1 Diphenhydramine 25-50mg 2 Promethazine 25-50mg 3 Hydroxyzine 25-50mg Moderate Sedatives 4 Medizine 25-50mg 5 Buclizine 25-50mg 6 Phenivamine 25-50mg 7 Cyproheptadine 4mg

19. S. No. Drugs Doses Mild Sedatives 8 Chlorpheniramine 2-4mg 9 Cyclizine 50mg 10 Triprolidine 2.5-5mg Non Sedatives 11 Astemizole 10mg 12 Cetrizine 10mg 13 Lovatadine 10mg 14 Fexofenadine 120-180mg

20. Indications/Uses Allergic reactions (Hay fever, Vasomotor rhinitis urticaria, asthma, Anaphylaxis). Because of their anticholinergic actions they are used as antiemetics and useful in motion sickness. As hypnotics, Mild sedative/anxiolytics. Parkinsonism Contraindications/precautions Hypersensitivity. Lactation. Hypokalemia. Neonate. Coma. Special precautions in acute asthma and pregnancy, elderly, epilepsy.

21. Adverse effects Due to anticholinergic effect Drowsiness in common. Dryness of mouth. Blurring of vision. Urinary retention. Constipation. Delirium. Convulsions. Severe toxicity may causes death to cardiac and respiratory failure.

22. MUCOLYTICS (SPUTUM CLEARANCE) These drugs reduce the viscosity of sputum that helps to easily expel the sputum. Mechanism of action: Decrease mucous viscosity by breaking or altering mucoproteins present in sputum.

23. Drug example & Doses S No. Drugs Doses 1 Acetylcysteine 2.5 ml of 10-20% solution given by inhalation or nebulization 2 Bromhexine 8-16 mg TDS.

24. Indications/uses To treat abnormal viscous, or thick and hard mucus. As an antidote for acetaminophen overdose (acetylcysteine). Adverse effects Stomatitis . Drowsiness. Bronchospasm. Nausea/vomiting. Severe rhinorrhea Contraindications/precautions Hypersensitivity to these drugs. Cautiously in elderly, pregnant or breast f e eding mothers.

25. DECON G EST A NTS A Decongestant drugs used to relieve nasal congestion in upper respiratory tracts. Mechanism of action Decongestants are sympathomimetic drugs that act by stimulating the α (alpha) – adrenergic receptors. The decongestant effect due to vasoconstriction of the blood vessel in the nose sinuses etc. the vasoconstriction effect reduces swelling or inflammation and mucous formation in the nasal passage and make it easier to breath.

26. Drug examples and doses S. No. Drugs Doses 1 Ox y meta z o l i n e hydrochloride 0.05% solution or nasal spray. 2 Phen y lephri n e hydrochloride 10 mg 3 Pseu d o e phedrine hydrochloride 60 mg.

27. Indications /uses For temporary relief of nasal congestion due to common cold. Hay fever. Sinusitis. Upper respiratory tract allergens. To promote nasal and sinus drainage. Contraindications/precautions Hypersensitivity to these drugs. MAO (Monoamine oxidase) inhibiters drugs therapy. Use cautiously in older age patient they are more likely to experience adverse reaction. Nasal contestant should not be used for more than three days, and oral decongestant should not used more than 7days because prolonged use will result in rebound congestion.

28. Adverse Effects Arrhythmias. Tachycardia. Insomnia. Palpitation. Hypertension. Drowsiness. Hypersensitivity reactions including rash, urticaria

29. DRUGS FOR COUGH The drug which used in cough are: Antitussive. Expectorants. Bronchodilators.

30. Antitussives (Cough center suppressant) Opioids – Codeine, pholcodine. Non opioids – Noscapine, dextromethorphan. Antihistamine – Chlorpheniramine diphenhydramine

31. Expectorants Bronchial secretion enhances – sodium or potassium citrate, potassium iodide, ammonium chloride. Mucolytes – bromhexine ambroxol, acetylcysteine.

32. Bronchodilators – already explained Salbutamol, Terbutaline

33. ANTITUSSIVES They are used to suppress dry cough mostly because their aim to control rather than eliminate cough. These are also called cough center suppressants. Mechanism of action These are the drugs that act in the CNS to increase threshold of cough center

34. Drug example & Doses S. No Drugs Doses 1 Codeine ( Opioids ) 15-60mg up to every 4 hrs 2 Noscapine (Non opioids ) PO 15-30 mg itramin maleate 3 Dextromethorphan (Non opioids ) 10-30mg PO 4-8hrs max. 120/day 4 Chlor p h e nir a mine (Antihistamine) 4 mg PO 4-6 hrly 5 Dip h e n hydram i ne (Antihistamine) 25 mg PO 4hrly not to exceed 150 mg / day.

35. Indications/uses Dry & unproductive cough. Allergic cough. Spasmodic cough Adverse Effects Constipation. Drowsiness. Dryness of mouth. Irritability. Ataxia. Respiratory depression in higher doses. Addiction. Vertigo. Nausea, Headache Contraindication/precautions Respiratory Depression. Asthmatics. Convulsion disorder. Contraindicate while driving. Obstructive airway disease.

36. EXPECTORANTS These drugs help in removal of secretions of respiratory tract and mucolytic agents produce liquification of mucous making expectoration easier. Mechanism of action They increase bronchial secretions or reduce its viscosity, sodium and potassium citrate increase bronchial secretion by salt action also these drugs stimulate gastric mucosa or directly acting on mucous membrane of lungs to increase the secretion of mucous.

37. Indications/uses Chronic productive cough. Thick mucous production. Combinations with antitussives drugs for relieving cough. Adverse effect Allergic reactions / hypersensitivity. Rhinorrhea. Lacrimation. Gastric irritation. Contraindication/precautions History of peptic ulceration. Asthmatic patients. Severe hepatic or renal function.

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