Drugs for Respiratory Tract Conditions

Drugs Acting on the Respiratory Tract

• Diagram shows the respiratory tract, including nasal cavity, pharynx, larynx, trachea, bronchi, bronchioles, terminal bronchioles, alveolar sacs, goblet cells, mucus, cilia, and epithelial cells.

Drugs Acting on the Lower Respiratory Tract

• Key terms related to obstructive pulmonary disease include asthma, atelectasis, bronchodilator, Cheyne-Stokes respiration, chronic obstructive pulmonary disease (COPD), cystic fibrosis, leukotriene receptor antagonists, mast cell stabilizers, pneumonia, pneumothorax, respiratory distress syndrome (RDS), sympathomimetics, and xanthines.

COPD Manifestations

• Air is trapped in the lower respiratory tract.
• Alveoli degenerate and fuse together.
• Gas exchange is impaired.
• Strategies to prevent and treat COPD include reducing environmental irritants and smoking cessation.

Changes in the Airway With COPD

• Diagram shows normal and COPD airway changes, emphasizing inflammation, excess mucus production, and abnormal airway structure.

Adult Respiratory Distress Syndrome (ARDS)

• Characteristics: progressive loss of lung compliance and increasing hypoxia.
• Causes: cardiovascular collapse, major burns, severe trauma.
• Rapid depressurization/drop in pressure.
• Treatment: reversal of the underlying cause combined with ventilatory support.

Bronchodilators/ Anti-asthmatics

• Used to facilitate respiration by dilating airways.
• Xanthines and sympathomimetics are examples.
• Anticholinergics are a new type of drug, used to treat alpha-1-protease deficiency.

Enzyme Therapy: Alpha-1-Protease Inhibitor (Human)

• Zemaira is a drug used for the treatment of alpha-1-protease deficiency.
• This disorder leads to progressive emphysema, usually appearing in the thirties or forties.
• In sufficient amounts, it neutralizes neutrophil elastase.
• It provides protection from tissue destruction.

Xanthines

• Caffeine and theophylline are examples.
• Direct effect on the smooth muscles of the respiratory tract.
• Used in asthma prophylaxis and treatment.
• Adverse effects include nausea, vomiting, diarrhea, insomnia, headache, irritability, hyperglycemia, hypotension, cardiac arrhythmias, tachycardia, seizures and brain damage.
• Substances in cigarettes increase the metabolism of xanthines in the liver.

Nursing Considerations for Xanthines

• Assess patient history, allergies, and baseline physiological parameters (pulse, blood pressure, and ECG).
• Monitor liver function and renal function.
• Monitor theophylline levels in the blood.

Sympathomimetics

• Mimic effects of the sympathetic nervous system: dilation of bronchi with increased rate and depth of respiration.
• Beta-selective adrenergic agonists are agents used in asthma.
• Used for acute asthma attacks and prevention of exercise-induced asthma.

Anticholinergics

• Patients who cannot tolerate sympathomimetics might respond to these drugs.
• These drugs block vagally mediated reflexes by antagonizing the action of acetylcholine.
• Used for maintenance treatment of bronchospasm associated with COPD.

Inhaled Steroids

• Very effective treatment for bronchospasm.
• Decrease inflammation in the airway.
• Used for treating chronic asthma.
• Well-absorbed from the respiratory tract, mostly metabolized and excreted by the liver.

Prototype Inhaled Steroids (Pulmicort)

• Used for prevention and treatment of asthma and chronic steroid-dependent diseases.
• Decreases airway inflammation.
• Available as inhalation (rapid onset, and short duration of action).
• Adverse effects include irritability, headache, rebound congestion, local infection, and others.

Management of chronic asthma in adults

• A table summarizing management of chronic asthma in adults based on severity levels and treatment steps (with reliever and preventer therapies).

Nursing Diagnosis for Budesonide

• Risk for injury related to immunosuppression.