Respiratory and Gastrointestinal Drugs Quiz

Respiratory and Gastrointestinal Drugs

• Objectives include matching drug indications with classes, listing brand and generic names for prototypical drugs, discussing mechanisms of action for drug classes, describing side effects with relevant mechanisms, outlining drug administration routes, discussing drugs of choice for specific diseases, and identifying drug interactions.

Respiratory Drugs

• Antitussives

  • Suppress coughs associated with common colds and dry coughs.
  • Examples include Benzonatate (Tessalon), Codeine, Dextromethorphan, Diphenhydramine, Hydrocodone, and Hydromorphone.
  • Primary side effect is sedation.

• Decongestants

  • Cause vasoconstriction in nasal mucosa blood vessels.
  • Administered orally or as nasal sprays.
  • Examples include Phenylephrine (Sudafed PE), Pseudoephedrine (Chlor Trimeton; Sudafed), and Oxymetazoline (Afrin).
  • Possible side effects include elevated blood pressure, headache, dizziness, and nervousness.

• Antihistamines

  • Antagonize histamine receptors in the body.
  • Four types of histamine receptors: H1, H2, H3, and H4.
  • H1 receptors are involved in allergic and respiratory issues.
  • H2 receptors regulate gastric acid.
  • H3 receptors affect sleep and cognitive function.
  • H4 receptors mediate inflammation.
  • First-generation antihistamines have significant side effects like sedation, anticholinergic effects, dizziness, and gastrointestinal distress, and cross the blood-brain barrier.
  • Examples of first-generation include Diphenhydramine (Benadryl) and Chlorpheniramine.
  • Second-generation antihistamines are more selective for H1 receptors and have fewer side effects.
  • Examples include Cetirizine (Zyrtec), Desloratadine (Clarinex), Fexofenadine (Allegra), and Loratadine (Claritin).

• Mucolytics & Expectorants

  • Mucolytics: Decrease mucus viscosity.
    • Example: Acetylcysteine
  • Expectorants: Facilitate mucus production and removal.
    • Example: Guaifenesin

• Mucoactive agents

• Further information on mucoactive agents isn't provided

• Drugs for obstructive pulmonary disease

  • Treat bronchospasm, inflammation, and mucus plugging in obstructive pulmonary diseases.
  • Include bronchodilators (beta-adrenergic agonists, xanthine derivatives, anticholinergics) and anti-inflammatory agents (glucocorticoids).

• Beta-adrenergic agents

  • Stimulate beta-2 receptors in respiratory smooth muscle, causing bronchodilation.
  • Examples: Albuterol (Ventolin), Levalbuterol (Xopenex), Salmeterol (Serevent).
  • Administration routes include inhalation, oral, or subcutaneous.
  • Inhaled forms avoid systemic circulation adverse effects.

• Xanthine Derivatives

  • Chemical compounds (theophylline, caffeine, theobromine) with bronchodilating properties.
  • Debate exists about the exact mechanisms.
  • Examples include Aminophylline, Dyphylline, and Theophylline.
  • Adverse effects include toxicity (overlapping therapeutic and toxic blood levels), possible arrhythmias, and seizures.

• Anticholinergic drugs

  • Block muscarinic cholinergic receptors, preventing acetylcholine-induced bronchoconstriction, leading to bronchodilation.
  • Often the initial choice for treating COPD.
  • Side effects can include dry mouth, constipation, urinary retention, tachycardia, blurry vision, and confusion.

• Glucocorticoids

  • Powerful anti-inflammatory drugs, controlling inflammation in asthma, by preventing bronchoconstriction.
  • Can be administered intravenously, via inhalation, or orally.
  • Examples: Budesonide (Pulmicort), Cortisone (Cortone), and Prednisone (Sterapred).

• Cromolyn sodium

  • Prevents bronchospasm in asthma.
  • Inhaled form, taken before triggers.
  • Also prevents allergic rhinitis.

• Leukotriene inhibitors

  • Used to control airway inflammation.
  • Montelukast (Singulair) is an example.
  • Potential side effect is liver toxicity.

• Asthma

  • Characterized by bronchial smooth muscle spasm, airway inflammation, and mucous plugging.
  • Inhaled glucocorticoids are the primary treatment.
  • Leukotriene inhibitors, beta agonists, and theophylline act as supplements.

• COPD

  • Treatment focuses on maintaining airway patency and preventing airflow restriction.
  • Anticholinergics and long-acting beta-2 agonists are often used.

• Cystic Fibrosis

  • Management focuses on maintaining airway patency by limiting mucus formation using bronchodilators, mucolytics, or expectorants.
  • Systemic glucocorticoids can also help control airway inflammation

Gastrointestinal Drugs

• GI Drugs

  • Gastric acid is essential for activating digestive enzymes and controlling bacteria. Excessive acid can cause ulcers and hemorrhages of the stomach lining.
  • Antacids neutralize stomach acid.
  • H2 receptor blockers reduce gastric acid secretion, used to treat issues like GERD.
  • Proton pump inhibitors completely inhibit acid production, particularly used for long-term management of stomach ulcers, and GERD.

• Antacids

  • Neutralize stomach acids.
  • Examples include aluminum hydroxide, magnesium hydroxide, and calcium carbonate.
  • Potential side effects include constipation (aluminum), diarrhea (magnesium), and electrolyte imbalances.
  • Avoid using with other drugs within 2 hours to maintain proper absorption.

• H2 Receptor Blockers

  • Reduce gastric acid production by blocking histamine H2 receptors.
  • Examples include Cimetidine (Tagament), Famotidine (Pepcid), and Rantidine (Zantac).

• Proton Pump Inhibitors

  • Inhibit the H+/K+ ATP pump in stomach cells, shutting down acid production.
  • Examples include Esomeprazole (Nexium), Lansoprazole (Prevacid), Omeprazole (Prilosec).

• Other GI Drugs:

  • Emetics: Induce vomiting.
  • Atiemetics: Reduce nausea and vomiting
  • laxatives: Promote bowel evacuation. Types include bulk-forming, stimulant, hyperosmotic, and lubricant laxatives. General side effects of prolonged use of laxatives include nausea, cramping, and electrolyte imbalances.