Drugs Affecting the Respiratory System

Relax bronchial muscles, leading to expanded bronchial airways.
Types include beta-2 adrenergic agonists, methylxanthines, and anticholinergics (inhaled).

Usage: Effective in treating asthma and COPD; targets bronchospasm and bronchoconstriction.
Key drugs:
- Albuterol (short-acting)
- Salmeterol (long-acting)
Mechanism: Activate beta-2 receptors to induce bronchodilation.
Contraindications: Not recommended for pregnant patients, those with tachydysrhythmias, diabetes, hyperthyroidism, heart disease, or hypertension.
Side Effects: Noted as the 3T's – tachycardia, tremors, and difficulty sleeping.
Monitoring: Keep an eye on cardiac dysrhythmias and respiratory status.
Patient Education: Instruct to take inhaled beta-2 agonist before inhaled glucocorticoid and to avoid caffeine.

Usage: Primarily used for chronic asthma and COPD management.
Key drugs:
- Theophylline
- Phenytoin/rifampicin (may decrease theophylline levels)
- Fluoroquinolones (may increase theophylline levels)
Mechanism: Relaxation of bronchi smooth muscle, aiding in bronchodilation.
Contraindications: Caution in pregnant individuals, children, and those with heart/renal disease, diabetes, or hypertension.
Side Effects: Observed as SARG – seizures, arrhythmias, restlessness, and gastrointestinal upset.
Monitoring: Continuous cardiac monitoring for dysrhythmias, respiratory status checks, and blood levels to avoid toxicity.
Patient Education: Advise against caffeine consumption to minimize side effects.

Usage: Mainly prescribed for COPD management and occasionally for asthma.
Key drug: Ipratropium.
Mechanism: Blocks muscarinic receptors in the bronchi, leading to bronchodilation.
Contraindications: Not suitable for pregnant patients, those with a peanut allergy, narrow-angle glaucoma, or benign prostatic hyperplasia (BPH).
Side Effects: Results in severe dryness in various bodily functions (mouth, urination, sight, defecation).
Monitoring: Watch for dry mouth symptoms and assess respiratory status.
Patient Education: Encourage hydration and recommend sugar-free candy to relieve dry mouth.

Function: Relax bronchial muscles to expand airways.
Types: Include beta-2 adrenergic agonists, methylxanthines, and inhaled anticholinergics.

Usage: Treatment for asthma and COPD, specifically for bronchospasm and exacerbations.
Examples: Albuterol (short-acting), Salmeterol (long-acting).
Mechanism: Activates beta-2 receptors leading to bronchodilation.
Contraindications: Not recommended during pregnancy or for patients with tachydysrhythmias, diabetes, hyperthyroid conditions, heart disease, or hypertension.
Side Effects: Tachycardia, tremors, and insomnia (3T’s).
Monitoring: Cardiac dysrhythmias and respiratory status should be monitored.
Patient Education: Take inhaled beta-2 agonist before inhaled glucocorticoid; avoid caffeine.

Usage: Used for chronic asthma and COPD.
Examples: Theophylline; interactions with phenytoin/rifamp (reduce theophylline) and fluoroquinolones (increase theophylline).
Mechanism: Relaxes bronchial smooth muscle, resulting in bronchodilation.
Contraindications: Avoid in pregnancy, children, and patients with heart or renal diseases, diabetes, or hypertension.
Side Effects: Seizures, arrhythmias, restlessness, gastrointestinal upset (SARG).
Monitoring: Requires cardiac monitoring for dysrhythmias, respiratory status, and blood levels due to risk of toxicity.
Patient Education: Avoid caffeine.

Usage: Primarily for COPD, sometimes for asthma (bronchospasm).
Example: Ipratropium.
Mechanism: Blocks muscarinic receptors in the bronchi, leading to bronchodilation.
Contraindications: Not suitable for patients with pregnancy, peanut allergies, narrow-angle glaucoma, or benign prostatic hyperplasia (BPH).
Side Effects: Causes dryness – affecting mouth, urination, vision, and gastrointestinal function.
Monitoring: Observe for signs of dry mouth and respiratory status.
Patient Education: Maintain hydration; use sugar-free candy for dry mouth relief.

Usage: Long-term and short-term management of asthma.
Examples: Prednisone, Beclomethasone.
Mechanism: Prevents inflammation and mucus production; reduces edema.
Contraindications: Avoid in pregnancy, live vaccines, systemic infections, diabetes, renal diseases, and hypertension.
Side Effects: Potential for speech issues, hoarseness, mood changes, sleep disturbances, candidiasis, osteoporosis, hyperglycemia, and increased infection risk.
Monitoring: Track blood glucose levels, daily weight, and signs of infection.
Patient Education: Rinse mouth after use; do not stop abruptly; take after inhaled beta-2 agonists; use nystatin for candidiasis.

Usage: Long-term treatment for asthma.
Example: Montelukast.
Mechanism: Suppresses leukotrienes to reduce inflammation, bronchoconstriction, airway edema, and mucus production.
Contraindications: Avoid in pregnancy and renal disease.
Side Effects: May cause depression, suicidal ideation, and liver injury.
Monitoring: Assess mental and respiratory status.
Patient Education: Take at bedtime on an empty stomach, as food may decrease absorption.