أدوية الجهاز التنفسي

Drugs Acting on the Respiratory Tract

• The respiratory tract includes the nasal cavity, larynx, pharynx, trachea, bronchus, goblet cells, mucus, cilia, epithelial cells, terminal bronchiole, and alveolar sacs.

Drugs Acting on the Lower Respiratory Tract

• This section focuses on drugs used to treat lower respiratory tract disorders.

Learning Objectives

• Define key terms related to obstructive pulmonary disease.
• Describe the pathophysiology and correlate it with symptoms of obstructive pulmonary disease.
• Describe the actions, indications, pharmacokinetics, contraindications, and drug-drug interactions of drugs used to treat lower respiratory tract disorders.
• Discuss the use of these drugs across the lifespan.
• Compare and contrast drugs used to treat obstructive pulmonary disorders.
• Outline nursing considerations for patients receiving these drugs, including important teaching points.

Key Terms

• Asthma
• Bronchoconstriction
• Atelectasis
• Bronchodilator
• Cheyne-Stokes respiration
• Chronic Obstructive Pulmonary Disease (COPD)
• Cystic Fibrosis
• Leukotriene Receptor Antagonists
• Mast Cell Stabilizer
• Pneumonia
• Pneumothorax
• Respiratory Distress Syndrome (RDS)
• Sympathomimetics
• Xanthines

Manifestations of COPD

• Air is trapped in the lower respiratory tract.
• Alveoli degenerate and fuse together.
• Gas exchange is impaired.
• Prevention and treatment involves reducing environmental irritants and quitting smoking.

Changes in the Airway With COPD

• Describes changes like inflammation, mucus buildup, and airway narrowing associated with COPD.

Adult Respiratory Distress Syndrome (ARDS)

• Characterized by progressive loss of lung compliance.
• Causes include cardiovascular collapse, major burns, and severe trauma.
• Rapid depressurization or a drop in pressure contributes to this condition.
• Treatment involves reversing the underlying cause and providing ventilatory support.

Bronchodilators/Anti-asthmatics

• Used for facilitating respiration by dilating airways.
• Xanthines and sympathomimetics are listed as examples.

Anticholinergics

• Used for patients who cannot tolerate sympathomimetic effects.
• Anticholinergics block vagally mediated reflexes by antagonizing the action of acetylcholine.
• Maintenance treatment for bronchospasm in COPD.

Inhaled Steroids

• Highly effective in treating bronchospasm.
• Reduces airway inflammation.
• Used in asthma and chronic steroid-dependent bronchial asthma.
• Well-absorbed from the respiratory tract and metabolized in the liver.

Xanthines (e.g., Theophylline)

• Direct effect on smooth muscles of the respiratory tract and blood vessels.
• Used as prophylaxis and for symptomatic relief of bronchial asthma and bronchospasm associated with COPD.

Alpha1-Protease Inhibitor (e.g., Zemaira)

• Used to treat alpha-1-protease deficiency (a chronic hereditary disorder).
• Neutralizes neutrophil elastase, which is increased by smoking or lung infection.
• Protects from tissue destruction.

Nursing Considerations for Xanthines

• Assess patient history and physical exam and allergy information.
• Monitor vital signs, cardiac auscultation, peripheral perfusion, and baseline ECG.
• Evaluate skin, liver, and renal function, and record theophylline levels.

Sympathomimetics (e.g., Albuterol)

• Mimic sympathetic effects, dilating bronchi and increasing respiration rate.
• Used to treat acute asthma attacks and prevent exercise-induced asthma.
• Contraindications depend on the severity of the underlying condition.

Anticholinergics (e.g., Ipratropium)

• Blocks vagally mediated reflexes, preventing acetylcholine's action on bronchi, which constricts airways.
• Used to maintain treatment of bronchospasm associated with COPD.

Prototype Summary of Inhaled Steroids (e.g., Budesonide)

• Treatment of asthma, including chronic steroid-dependent bronchial asthma.
• Reduces airway inflammation and increases airflow in narrowed airways.

Management of Chronic Asthma in Adults

• A table outlines management steps (1-6) for chronic asthma, based on severity and response to treatment.
• Steps involve increasing inhaled corticosteroid doses, possibly adding long-acting beta agonists, or other medication options.

Nursing Diagnosis for a Patient taking Budesonide

• Risk for injury related to immunosuppression.

يتناول هذا الاختبار الأدوية المستخدمة لعلاج اضطرابات الجهاز التنفسي السفلي ويفحص المفاهيم الأساسية المتعلقة بالأمراض الرئوية المسدودة. كما يتناول الإجراءات والتفاعلات الدوائية لهذه الأدوية وكيفية استخدامها عبر مراحل العمر المختلفة.