Pharmacology for COPD and Asthma Treatments

Anti-inflammatory Agents

• Salicylates (Aspirin):

  • Used for mild to moderate pain and inflammatory conditions.
  • Reduces the risk of stroke and myocardial infarction (MI).
  • Caution: May cause bleeding issues, Reye's syndrome, impaired kidney function, nausea, vomiting, heartburn, tinnitus, and acidosis.

• NSAIDs (Ibuprofen):

  • Relieves symptoms of rheumatoid arthritis, osteoporosis, mild to moderate pain, and reduces fever.
  • Caution: May cause cardiovascular issues, hypertension, renal or hepatic dysfunction, headaches, dizziness, myocardial infarction (MI), stroke, and constipation.

• NSAIDs (Acetaminophen):

  • Used for mild to moderate pain, cold/flu symptoms, and musculoskeletal pain.
  • Caution: May result in severe liver toxicity or failure, rashes, and fever.
  • Not recommended for chronic alcoholism.

Antiarthritis

• Gold Compounds (Auranofin):
  • Used for rheumatoid arthritis in adults.
  • Caution: May cause diabetes, congestive heart failure (CHF), hypertension, renal or hepatic dysfunction, skin rash, nausea, vomiting, and mouth sores.

TNF blockers (Entanercept)

• ↓ symptoms of rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis.

• Caution: May cause acute infection, cancer, or sepsis.

• Colchicine:

  • Used for gout flares
  • Caution: May cause renal or hepatic dysfunction, gastrointestinal upset, rhabdomyolysis, or blood dyscrasias.

Immune Stimulants

• Interferons (Interferon Alfa-2b):

  • Used for hairy cell leukemia, malignant melanoma, AIDS sarcoma, and chronic hepatitis B and C.
  • Caution: May cause cardiovascular disease, myelosuppression, central nervous system (CNS) effects, anorexia, skin discoloration, and flu-like symptoms.

• Interleukins (Aldekeleukin):

  • Used for metastatic renal cell carcinoma and metastatic melanoma.
  • Caution: May cause effects from E. coli products, pregnancy complications, renal or liver/cardiovascular dysfunction, central nervous system (CNS) abnormalities, skin rash, and fever.

Colony Stimulating Factors (Filgrastim)

• Used for patients undergoing chemotherapy, to prevent infections, and bone marrow transplants.
  • Caution: May increase infection risk in chemo patients. -Common side effects include headache, fatigue, hair loss, and bone pain.

Immune Suppressants

• T+B Cell Suppressors (Cyclosporine):
  • Used prophylactically for organ transplants, organ rejection, and rheumatoid arthritis treatment.
  • Caution: May be teratogenic, linked to cancer, and cause tremors, high blood pressure, abnormal gum growth, and other issues.

Monoclonal Clonal Antibodies (Bevacizumab)

• Used for metastatic colorectal cancer, lung cancer, glioblastoma, and renal cell carcinoma. -Caution: Associated with fever and potential teratogenic effects.
  • Common side effects include gastrointestinal perforation, headache, and hemorrhaging.

Vaccines

• Active immunity develops through exposure to a pathogen
• Passive immunity receives antibodies from another source(breastmilk, meds.)
• Vaccines develop active immunity to diseases

Antibiotics

• Aminoglycosides (Gentamicin):

  • Used to treat serious bacterial infections.

• Carbapenems (Ertapenem):

  • Used in treating community-acquired pneumonia, GI infections, and skin infections
  • Caution for poor renal function

• Cephalosporins (Cefaclor):

  • Used for respiratory, dermatological, urinary tract, and middle ear infections.

• Fluoroquinolones (Ciprofloxacin):

  • Used for respiratory, dermatological, urinary tract infections, eye and ear infections, and various other issues.

• Penicillins (Amoxicillin):

  • Treats infections by susceptible bacteria, including those caused by Heliobacter.

• Sulfonamides (Trimethoprim-sulfamethoxazole/Cotrimoxazole):

  • Used to treat urinary tract infections, acute otitis media, chronic bronchitis, and traveller's diarrhea.

• Tetracyclines (Tetracycline):

  • Used to treat susceptible bacteria.

• Isoniazid:

  • Used to treat and prevent Tuberculosis (TB) and infections in family members.
  • Caution: Potential for severe renal or hepatic disease

• Clindamycin:

  • Used to treat serious infections.

• Vancomycin: Important for treating severe conditions involving septicemia, infective endocarditis, skin and bone infections, and lower respiratory infections; also targets C. diff.

• Erythromycin:

  • For respiratory, dermatological UT and GI infections.

• Linezolid:

  • Used in resistant bacterial infections.

• Aztreonam:

  • Effective against lower respiratory tract, skin, urinary tract, and other infections.

• Oseltamivir:

  • For treatment of influenza A and B.

• Acyclovir: Treats various Herpes and Cytomegalovirus infections

Chemotherapy

• Various categories of chemotherapy drugs, including aminoglycosides, carbapenems, cephalosporins, fluoroquinolones, penicillins, etc., are listed.

• Specific warnings regarding those drugs, such as potential side effects or precautions, are also included.

Other (Metronidazole/Mebendazole)

• Used to treat infections from intestinal parasites like Trichomoniasis.

• Used in the treatment of whipworm, pinworm, roundworm, and hookworm infections

Diuretics

• Thiazide/Thiazide-like (Hydrochlorothiazide):

  • First-line treatment for hypertension.
  • May cause hypovolemia, renal disease, GI upset, hypotension and orthostatic hypotension

• Loop Diuretics (Furosemide):

  • Quickly and extensively increases urine output (diuresis); treating conditions like pulmonary edema (fluid buildup in the lungs).
  • Possible side effects = gout, hypokalemia, alkalosis, hypokalemia, vertigo,

• Carbonic Anhydrase Inhibitors (Acetazolamide):

  • Used in combination with other diuretics for glaucoma.
  • Caution for Pregnancy, renal/hepatic failure, and COPD

• Osmotic Diuretics (Mannitol):

  • Increase fluid output by drawing water into the renal tubules, used to treat elevated intracranial pressure.

• Potassium-Sparing Diuretics (Spironolactone):

  • Helps balance potassium levels in the body, usually in combination with other drugs.
  • Caution : hyperkalemia, voice changes, breast growth, period irregularity

Urinary

• UTI Anti-infective (Fosfomycin):

  • Treatment for uncomplicated urinary tract infections.

• Anti-spasmodics (Oxybutin):

  • Used for neurogenic or overactive bladders, can cause Blurry vision, urinary hesitancy, dry mouth and sweating.

• Urinary Analgesic:

  • Pain relievers for Urinary Tract Infections, often associated with urine discoloration (orange)

• Bladder Protectant:

  • Supports bladder health in conditions like cystitis (kidney infections).

• Benign-Prostatic Hyperplasia (Doxazosin/Finasteride):

  • Treatments for enlarged prostate.
  • Sexual dysfunction is a side effect

Eyes

-Prostaglandin Analogs (Lantanaprost):

• Treat glaucoma by increasing outflow of aqueous humor

• Beta-Adrenergic Blockers (Timolol):

  • Helps treat open-angle glaucoma.

• Alpha-Adrenergic Agonists:

  • Apraconidine and Brimonidine. Reduce intraocular pressure in glaucoma

• Cholinergic Agonists (Pilocarpine):

  • Emergency treatment for angle-closure glaucoma

• Cycloplegics + Mydriatics:

  • Dilate eye pupils

Upper Respiratory

• Antitussives (Dextromethorphan):

  • Reduce coughing symptoms, cautioned on use during pregnancy, head injuries and individuals who need to cough to clear their airways

• Topical Nasal Decongestants (Tetrahydrozoline):

  • Relieve uncomfortable nasal congestion, can cause localized discomfort, and are not recommended for long-term use.

• Oral Decongestants (Pseudophedrine/Phenylephrine):

  • Treat nasal congestion, cautioned for use in individuals with certain conditions and when combined in certain ways

• Steroid Nasal Decongestants (Fluticasone):

  • Treat nasal congestion and inflammation associated with rhinitis.

Lower Respiratory

• Bronchodilators (Theophylline):
  • Relieve or prevent asthma and COPD symptoms

Sympathomimetics (Allbuterol):

• Anticholinergics (Ipratropium):

  • Used to maintain bronchospasm in COPD

• Inhaled Steroids (Budesonide):

  • Used in preventing and treating asthma

• Leukotriene Receptor Antagonists (Zafirlukast):

  • Prevent asthma attacks, use cautiously around certain medications.

-Immune Modulators (Omalizumab): - For severe asthma, avoid in children under 6.

• Lung Surfactant (Beractant):
  • Treatment for premature babies with respiratory distress syndrome.

Anti-histamines (Diphenhydramine/Guaifenesen):

• Mucolytics (Acetylcysteine):
  • Used to soften mucus in the airways and make them easier to clear.

Gastric Motility

• Chemical Stimulants (Sema, Bisacodyl):

  • Short-term treatment for constipation.

• Bulk-forming laxatives (Psyllium):

  • Treat constipation, ensure sufficient water intake.

• Osmotic Laxatives (Mag. Citrate):

• Treat constipation by pulling water into the stool

• Do not use after abdominal surgery.

• Lubricants (Docusate):

• Soften/soften stool

• Opioid Antagonists (Methylnaltrexone Bromide):

• Treat constipation caused by opioid use.

GI Stimulants (Metoclopromide)

• Treat GI movement issues, caution in individuals with certain conditions

• Treat diarrhea, cautioned for individuals with specific conditions

Anti-Diarrheals (Loperamide)

• Slows gut motility, cautioned in individuals with specific conditions.

IBS-D Drug (Alosetron/Lincosamides):

• Severe IBS-D treatment (Alosetron).

• Treatment for serious infections (Lincosamides).

Gastric Enzymes (Histamine antagonists cimetidine/antacids Sodium Bicarb.)

• Histamine antagonists & antiacids for short-term peptic/ulcer issues

Proton-pump Inhibitors (Protonix/Omeprazole):

• Short-term treatment for ulcers and indigestion.

GI Protectant (Sucralfate)

• Maintains ulcers/ulcer treatment.

• Avoid with antacids

Prostaglandins (Misoprostol)

• Prevent ulcers, use cautiously

Digestive Enzymes (Pancrelipase):

• Replaces deficient pancreatic enzymes, including N/V & proteinuria problems/risks.

Antiemetics (Phenothiazines Prochlorperazine/Non-phenothiazines Metoclopramide):

• Treat nausea and vomiting associated/triggered by various conditions/treatments.

5-HT3 Receptor Blockers (Ondansetron)

• First-line treatment for nausea and vomiting

• Caution in those with specific conditions.

Blood Pressure

• ACE Inhibitors (Captopril/ARB Losartan):

• Calcium Channel Blockers (Diltiazem):

• Vasodilators (Nitroprusside):

• Beta blockers (Metoprolol):

Anti-arrhythmics

• Class I (Lidocaine/Class II (Propranolol/Class III (Amiodarone)):

• Anti-anginal (Nitrates):

Lipid Lowering

• Bile Acid Sequestrants):

• HMG COA Inhibitor (Atorvastatin/Cholesterol Absorption Inhibitor (Ezetimibe):

Anti-Anxiety

• Benzodiazepines (Diazepam):

• Barbituates (Phenobarbital):

• Anti-depressants (Tricyclic):

• MAOIs (Phenelzine):

• SSRIs (Fluoxetine/Venlafaxine):

• SNRIs (Duloxetine):

Anti-Psychotics

• Typical (Haloperidol):

• Atypical (Clozapine):

• Bipolar (Lithium):

• ADHD/Narcolepsy (Methylphenidate):

Anti-Seizure

• Hydantoins (Phenytoin/Benzos + Barbituates/Succinimides/Valproic Acid/Other (Carbamazepine):

Anti-Parkinsonism

• Dopaminergics (Carbidopa + Levodopa):

• Anticholinergics (Benztropine):

Muscle Relaxants

• Centrally Acting (Baclofen):

Disjunctive NMJ Blocking Agents (Succinylcholine):

PAIN - Opioids

• Opioids Agonist (Morphine/Opioid Antagonists (Naloxone):

• Anti-Migraine (Ergot Derivatives/Triptans):

Nervous System - General and Local Anesthetics

• Nonbarbituate General Anaesthetic (Midazolam/NB General Anaesthetic (Propofol):

• Anaesthetic Gas (Nitrous Oxide):

Endocrinology (Pituitary/Adrenal Cortical/Thyroid/Parathyroid):

-Posterior Pituitary (Desmopressin)/Adrenal Cortical Agents (Prednisone)/Thyroid Hormones (Levothyroxine)/Antithyroid Agents (Methimazole)/Parathyroid Agents (Calcitrol):

Reproductive

• Estrogens (Estradiol/Progestins (Norethindone Acetate)/Estrogen Receptor Modulators (Raloxifene):

• Fertility Drugs (Clomiphene, Oxytocin, Tocolytics (Hydroxyprogesterone caprole)/Male Repro Agents (Androgens (Testosterone):

Erectile Dysfunction (Sildenafil)

Test your knowledge on the pharmacological treatments for COPD and asthma, focusing on various medications such as anticholinergics, inhaled steroids, and leukotriene receptor antagonists. This quiz covers potential side effects, critical cautions, and mechanisms of action for essential respiratory therapies. Prepare to enhance your understanding of these crucial drugs used in respiratory medicine.