Respiratory Care Pharmacology: Chapter 1 Notes

• Study notes for Rau's Chapter 1: Introduction to Respiratory Care Pharmacology

Pharmacology and the Study of Drugs

• Drugs are chemicals altering an organism's functions or processes.
• Pharmacology is the study of drugs, including their origins, properties, and interactions with living organisms.
• Respiratory Care Pharmacology is applying pharmacology to cardiopulmonary disease and critical care.
• Pharmacy involves preparing and dispensing drugs.
• Pharmacognosy is the identification of sources of drugs.
• Pharmacogenetics studies the interrelationship of genetic differences and their effects.
• Therapeutics is the art of treating disease with drugs.
• Toxicology studies toxic substances and their pharmacologic actions.

Naming Drugs

• Drugs have various names, including chemical, code, generic, official, and trade names.

Sources of Drugs

• Drugs can be derived from animal sources like thyroid hormone, insulin, and pancreatic dornase.
• Plant sources include khellin, atropine, digitalis, reserpine, eucalyptus oil, pine oil, and anise.
• Mineral sources include copper sulfate, magnesium sulfate, and mineral oil.

Process of Drug Approval in the United States

• The approval process includes chemical isolation and identification, animal studies, and investigational new drug approval.
• Investigational New Drug approval has phases I, II, and III.
• The process also requires a New Drug Application and considerations for Food and Drug Administration drug classification and if needed, Orphan drugs.

The Prescription

• Prescriptions consist of parts such as the patient's name, address, and date; the Rx symbol; inscription; subscription; Sig; and the prescriber's name.
• Over-the-counter drugs do not require a prescription.
• Generic substitution in prescriptions allows for any manufacturer's version of the prescribed drug, which is generally less expensive.

Abbreviations used in Prescriptions

• Common abbreviations used in prescriptions include:
  • q (every)
  • qh (every hour)
  • qid (four times daily)
  • qod (every other day)
  • qd (every day)
  • q2h (every 2 hours)
  • q3h (every 3 hours)
  • q4h (every 4 hours)
  • po (per os, by mouth)
  • prn (as needed)
  • IM (intramuscular)
  • IV (intravenous)
  • tid (three times daily)
  • See Table1.3

Respiratory Care Pharmacology: An Overview

• Aerosolized agents are given via inhalation.
  • They have five advantages.
• Related drug groups in respiratory care include:
  • Anti-infective agents
  • Neuromuscular blocking agents
  • Central nervous system agents
  • Antiarrhythmic agents
  • Antihypertensive and antianginal agents
  • Anticoagulant and thrombolytic agents
  • Diuretics

Advantages of Aerosolized Agents Given by Inhalation

• Aerosol doses are smaller than systemic doses for the same purpose.
• Aerosol delivery usually results in fewer and less severe side effects compared to oral or parenteral delivery.
• The onset of action is rapid.
• Drug delivery is targeted to the respiratory system, resulting in lower systemic bioavailability.
• The inhalation of aerosol drugs is painless, relatively safe, and can be convenient, depending on the delivery device.

Adrenergic Agents

• Beta-Adrenergic agents relax bronchial smooth muscle and cause bronchodilation.
  • These reduce airway resistance (Raw) and improve ventilatory flow rates in airway obstruction.
  • Obstruction results from chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis (CF), or acute bronchitis.
  • Examples include Albuterol, Arformoterol, Formoterol, Levalbuterol, and Salmeterol.
• Alpha-Adrenergic agents cause topical vasoconstriction and decongestion.
  • They're used to treat upper airway swelling.
  • An Example is Racemic Epinephrine.

Anticholinergic Agents

• These agents relax cholinergically induced bronchoconstriction.
  • Which improves ventilatory flow rates in COPD and asthma
  • Examples include Glycopyrrolate bromide, Ipratropium Bromide, and Tiotropium Bromide.

Mucoactive Agents

• These agents modify the properties of respiratory tract mucus.
  • Current version reduces viscosity and promote clearance of secretions.
    • Examples include Acetylcysteine, Dornase Alfa, Mannitol, and Hyperosmolar Saline.

Antiasthmatic Agents

• These agents prevent the onset and development of the asthmatic response.
  • Through inhabitation of chemical mediators of inflammation
  • Some examples include Cromolyn Sodium, Montelukast, and Omalizumab.

Anti-infective Agents

• These agents inhibit or eradicate specific infective agents.
  • Examples include *Ribavirin for the treatment of RSV
  • *Pentamidine for the treatment of Pneumocystic Jiroveci Carinii (PCP)
  • *TOBI for the treatment of Pseudomonas Aeruginosa, particularly in CF or Influenza A and B.

Exogenous Surfactants

• Their approved clinical use is by direct intratracheal instillation.
  • Restores more normal lung compliance in RDS of newborns
  • Examples include Beractant, Calfactant, Poractant Alfa, and Lucinactant.

Prostacyclin Analogs

• Are clinically indicated to treat pulmonary hypertension.
  • Specifically to decrease shortness of breath and increase walking distance
  • Examples include Iloprost and Treprostinil.

Study notes covering Chapter 1's introduction to respiratory care pharmacology. Key topics include the definition of drugs, pharmacology, drug naming conventions, and sources of drugs. The notes also cover pharmacognosy, pharmacogenetics, therapeutics and toxicology.