Respiratory Drugs Overview

Respiratory Drugs Overview

• Bronchodilators relax airway muscles, facilitating improved airflow.

Beta2-adrenergic Agonists

• Utilized for bronchodilation, available in inhalation and systemic forms.
• Examples:
  • Albuterol: Short-acting, used as an inhaler.
  • Formoterol and Salmeterol: Long-acting options for COPD and asthma.
• Counteracted by beta-adrenergic blockers, which reduce bronchodilation effects.

Anticholinergics

• Administered via inhalation; effective bronchodilators.
• Primarily relieve symptoms of COPD and asthma.
• Ipratropium bromide (Atrovent) is most common; acts in 15-20 minutes and lasts 3-5 hours.

Corticosteroids

• Mode of action: Anti-inflammatory; used for both acute asthma attacks and chronic symptoms.
• Forms: Inhaled (Beclomethasone) and systemic (Prednisone).
• Special monitoring required for pediatric growth, elderly osteoporosis risk, and diabetic blood glucose levels.

Leukotriene Modifiers

• Block leukotrienes, reducing airway constriction and inflammation.
• Examples:
  • Montelukast (Singulair): Commonly used in mild to moderate asthma.

Mast Cell Stabilizers

• Prevent the release of inflammatory mediators from mast cells.
• Cromolyn sodium (Intal) is preferred for exercise-induced asthma and pediatric patients.
• Administered via inhaled or oral routes.

Methylxanthines

• Bronchodilator effect with decreased airway reactivity.
• Examples:
  • Theophylline: Therapeutic range is 10-20 mcg/mL; toxicity may occur with high-fat meals.
• Caffeine also impacts bronchodilation and CO2 sensitivity.

Expectorants

• Facilitate mucus clearance from the airways, reducing thickness.
• Guaifenesin (Mucinex) is commonly used; effective for non-productive coughs associated with respiratory conditions.

Antitussives

• Suppress cough reflex; used for non-productive coughs.
• Examples:
  • Dextromethorphan: Not to be used with MAOIs.
  • Codeine: Caution with CNS depressants due to increased risk of respiratory depression.

Mucolytics

• Breakdown thick mucus, making it easier to expel.
• Examples:
  • Acetylcysteine: Antidote for acetaminophen toxicity and used in bronchial disorders.
  • Risk of bronchospasm makes it less suitable for asthma patients.

Decongestants

• Cause vasoconstriction, reducing nasal inflammation.
• Types:
  • Topical (e.g., Oxymetazoline): Fast-acting with minimal side effects.
  • Systemic (e.g., Pseudoephedrine): Possible CNS stimulation and jitteriness; regulated due to potential misuse in methamphetamine production.

Colony Stimulating Factors

• Erythropoietin analog that stimulates RBC production.
• Examples:
  • Epogen and Procrit: Treat anemia by increasing hemoglobin through enhanced RBC generation.

Chronic Obstructive Pulmonary Disease (COPD)

• 15 million individuals diagnosed with COPD in the U.S. and 900,000 in Canada.
• Fourth leading cause of morbidity and mortality in the U.S.
• Pathophysiology consists of lower airway disorders that disrupt airflow and gas exchange, primarily through emphysema and chronic bronchitis.

Emphysema

• Characterized by destruction of lung elastic tissue, leading to hyperinflation and air trapping.
• Results in increased work of breathing, decreased gas exchange, and sensations of "air hunger."

Chronic Bronchitis

• Inflammation of the bronchi and bronchioles due to irritants (especially cigarette smoke).
• Causes thickening of bronchial walls and excessive mucus production, obstructing airflow and facilitating chronic infections.

Risk Factors for COPD

• Cigarette smoking is the primary risk factor.
• Other factors include alpha1-antitrypsin deficiency and asthma.

Complications of COPD

• Common complications include hypoxemia, respiratory infections, cardiac failure (cor pulmonale), dysrhythmias, and respiratory failure.

COPD Assessment

• Key assessment components include history of smoking, breathing problems, activity levels, and weight.
• Physical examination may reveal signs of respiratory distress, such as barrel chest.

Laboratory Assessment for COPD

• Arterial blood gases (ABGs) are used to assess carbon dioxide levels and oxygen saturation.
• Safe oxygen saturation targets for COPD patients are between 88-92%.

Management of COPD

• Emphasis on smoking cessation and self-management education, including the use of oxygen therapy and breathing techniques.
• Weight management, regular small meals, and anxiety reduction are essential for improving quality of life.

Prevention Strategies

• Highlight the importance of avoiding respiratory infections and promoting endurance through energy conservation.

Health Promotion and Maintenance

• Focus on coordination of care through self-management, education about drug therapy, and utilization of healthcare resources.

Evaluation of COPD Outcomes

• Goals include achieving stable gas exchange, effective breathing patterns, maintaining ideal body weight, and reducing anxiety.

Asthma Overview

• A chronic disease that affects individuals of all ages, particularly prevalent in children aged 10-17.
• Significant risk factors include family history, allergies, and previous respiratory infections.

Asthma Pathophysiology

• Characterized by reversible obstructive airway disease resulting from inflammation, bronchoconstriction, and accumulation of mucus.
• Two phases of asthma response: immediate (allergen activation) and late (inflammatory response).

Asthma Assessment

• Signs to observe include wheezing, shortness of breath, cough, and use of accessory muscles.
• Laboratory diagnostics include pulse oximetry, ABGs, and pulmonary function tests.

Asthma Triggers

• Common triggers include cold air, smoke, allergens, exercise, and certain medications.

Asthma Therapeutic Management

• Goal to improve airflow through assessing symptoms, avoiding triggers, and administering appropriate medications.
• Includes both rescue drugs (short-acting) and control medications (long-term).

Emergency Treatment Needs in Asthma

• Symptoms indicating need for immediate treatment include worsening wheezing, minimal or no aeration, and gray or blue lips.
• Status asthmaticus is a severe, life-threatening condition requiring urgent intervention.

Environmental Modifications for Asthma

• Strategies to reduce exposure to allergens include maintaining clean environments, using air filters, and managing humidity levels.

Education and Prevention Strategies for Asthma

• Ongoing collaboration and education with patients, families, and healthcare providers are crucial for effective asthma management and prevention of exacerbations.

Chronic Obstructive Pulmonary Disease (COPD)

• 15 million individuals diagnosed with COPD in the U.S. and 900,000 in Canada.
• Fourth leading cause of morbidity and mortality in the U.S.
• Pathophysiology consists of lower airway disorders that disrupt airflow and gas exchange, primarily through emphysema and chronic bronchitis.

Emphysema

• Characterized by destruction of lung elastic tissue, leading to hyperinflation and air trapping.
• Results in increased work of breathing, decreased gas exchange, and sensations of "air hunger."

Chronic Bronchitis

• Inflammation of the bronchi and bronchioles due to irritants (especially cigarette smoke).
• Causes thickening of bronchial walls and excessive mucus production, obstructing airflow and facilitating chronic infections.

Risk Factors for COPD

• Cigarette smoking is the primary risk factor.
• Other factors include alpha1-antitrypsin deficiency and asthma.

Complications of COPD

• Common complications include hypoxemia, respiratory infections, cardiac failure (cor pulmonale), dysrhythmias, and respiratory failure.

COPD Assessment

• Key assessment components include history of smoking, breathing problems, activity levels, and weight.
• Physical examination may reveal signs of respiratory distress, such as barrel chest.

Laboratory Assessment for COPD

• Arterial blood gases (ABGs) are used to assess carbon dioxide levels and oxygen saturation.
• Safe oxygen saturation targets for COPD patients are between 88-92%.

Management of COPD

• Emphasis on smoking cessation and self-management education, including the use of oxygen therapy and breathing techniques.
• Weight management, regular small meals, and anxiety reduction are essential for improving quality of life.

Prevention Strategies

• Highlight the importance of avoiding respiratory infections and promoting endurance through energy conservation.

Health Promotion and Maintenance

• Focus on coordination of care through self-management, education about drug therapy, and utilization of healthcare resources.

Evaluation of COPD Outcomes

• Goals include achieving stable gas exchange, effective breathing patterns, maintaining ideal body weight, and reducing anxiety.

Asthma Overview

• A chronic disease that affects individuals of all ages, particularly prevalent in children aged 10-17.
• Significant risk factors include family history, allergies, and previous respiratory infections.

Asthma Pathophysiology

• Characterized by reversible obstructive airway disease resulting from inflammation, bronchoconstriction, and accumulation of mucus.
• Two phases of asthma response: immediate (allergen activation) and late (inflammatory response).

Asthma Assessment

• Signs to observe include wheezing, shortness of breath, cough, and use of accessory muscles.
• Laboratory diagnostics include pulse oximetry, ABGs, and pulmonary function tests.

Asthma Triggers

• Common triggers include cold air, smoke, allergens, exercise, and certain medications.

Asthma Therapeutic Management

• Goal to improve airflow through assessing symptoms, avoiding triggers, and administering appropriate medications.
• Includes both rescue drugs (short-acting) and control medications (long-term).

Emergency Treatment Needs in Asthma

• Symptoms indicating need for immediate treatment include worsening wheezing, minimal or no aeration, and gray or blue lips.
• Status asthmaticus is a severe, life-threatening condition requiring urgent intervention.

Environmental Modifications for Asthma

• Strategies to reduce exposure to allergens include maintaining clean environments, using air filters, and managing humidity levels.

Education and Prevention Strategies for Asthma

• Ongoing collaboration and education with patients, families, and healthcare providers are crucial for effective asthma management and prevention of exacerbations.

Explore the various classes of respiratory drugs including bronchodilators, anticholinergics, corticosteroids, and leukotriene modifiers. Learn about their mechanisms, examples, and clinical applications, particularly for asthma and COPD. This quiz helps solidify your understanding of these crucial medications.