Respiratory Medications and Management

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Questions and Answers

What is the primary purpose of an asthma inhaler?

To deliver medicine that prevents asthma symptoms (correct)

To monitor respiratory function

To provide immediate relief for asthma attacks (correct)

To enhance physical endurance during exercise

Which of the following best describes the composition of asthma inhalers?

Corticosteroids and bronchodilators (correct)

Anti-inflammatories and antihistamines

Intermittent doses of pain relievers and antibiotics

Sip-based compounds and muscle relaxants

How does an asthma inhaler deliver medicine into the body?

Via oral ingestion with water

By being absorbed through the skin

By inhaling directly into the airways (correct)

Through subcutaneous injection

What distinguishes a generic name from a brand name in asthma medications?

Generic names refer to the official drug name, while brand names are company-specific. Signup and view all the answers

What is the primary advantage of using an inhaler compared to oral medication for asthma?

Inhalers deliver medicine directly to the site of action without as much time delay. Signup and view all the answers

What is the primary reason for monitoring theophylline levels in neonates?

To prevent potential toxicity due to the small therapeutic window Signup and view all the answers

At what concentration range is theophylline considered therapeutic for treating neonatal apnea?

6-11 µg/mL Signup and view all the answers

What does a trough level test for theophylline indicate?

The lowest concentration of the drug just before the next dose Signup and view all the answers

Which of the following symptoms would NOT typically be monitored for side effects of theophylline?

Bradycardia Signup and view all the answers

Why is the blood test for theophylline considered critical in medical practice?

It helps determine the correct dosage and identifies potential overdose risks Signup and view all the answers

Which of the following statements is TRUE regarding cough suppressants?

They act primarily on the medulla oblongata. Signup and view all the answers

Which type of drug primarily focuses on relieving airway constriction in respiratory conditions?

Bronchodilators Signup and view all the answers

What is the primary action of expectorants?

Thinning bronchial secretions Signup and view all the answers

Which condition is commonly treated with antibiotics?

Bacterial infections Signup and view all the answers

What role do corticosteroids play in controlling asthma?

They prevent the release of inflammatory chemicals. Signup and view all the answers

Asthma can be triggered by which of the following factors?

Genetic predisposition and weather changes. Signup and view all the answers

Why is it important to consult a doctor regarding asthma treatment?

As symptoms change, medication may need to be adjusted. Signup and view all the answers

Inhalers are primarily used for which purpose in asthma treatment?

To deliver medication directly into the lungs. Signup and view all the answers

Which of the following is NOT a common type of respiratory medication?

Antidepressants Signup and view all the answers

What is a unique characteristic of allergic asthma?

It is a common type of asthma triggered by allergens. Signup and view all the answers

What is the primary purpose of expectorants such as Guaifenesin?

To clear mucus or phlegm from the chest Signup and view all the answers

Which of the following is NOT a function of theophylline?

Decreasing mucus production Signup and view all the answers

What is considered the toxic level of theophylline?

20 µg/mL Signup and view all the answers

What adverse effect can occur at normal therapeutic ranges of theophylline?

Severe cardiac dysrhythmias Signup and view all the answers

What therapeutic plasma level of theophylline is recommended for treating acute bronchospasm in adults?

10-15 µg/mL Signup and view all the answers

Which medication is an example of a decongestant?

Pseudoephedrine Signup and view all the answers

What potential complication can arise from theophylline toxicity?

Seizures Signup and view all the answers

Which of the following conditions would typically NOT benefit from the use of antibiotics?

Uncomplicated acute bronchitis Signup and view all the answers

Which medication is primarily used to manage chronic obstructive pulmonary disease (COPD) symptoms?

Theophylline Signup and view all the answers

What is a common combination found in steroid inhalers for asthma treatment?

Salmeterol and fluticasone Signup and view all the answers

What side effect is specifically associated with the use of theophylline?

Fainting Signup and view all the answers

Which inhaler class is used for immediate relief during breathlessness in COPD patients?

Short-acting bronchodilators Signup and view all the answers

What is a characteristic symptom of chronic obstructive pulmonary disease (COPD)?

Chronic chest infections Signup and view all the answers

What is the primary benefit of quitting smoking for COPD patients?

It prevents further lung damage. Signup and view all the answers

Which of the following medications is best described as an antimuscarinic inhaler?

Ipratropium Signup and view all the answers

What defines a short course for steroid tablets in COPD management?

Five days Signup and view all the answers

What is the mechanism of action for expectorants in cough treatment?

Make mucus thinner and easier to expel Signup and view all the answers

Which of the following is a common side effect of long-term use of steroid tablets?

Weakened bones Signup and view all the answers

What type of medication is commonly prescribed for persistent cough with thick phlegm in COPD?

Mucolytics Signup and view all the answers

In the context of antibiotics for chest infections in COPD patients, what does a change in the color of sputum typically indicate?

Presence of infection Signup and view all the answers

Which of the following statements about COPD exacerbations is correct?

They are characterized by a worsening of symptoms. Signup and view all the answers

What is the main advantage of using an inhaler for asthma treatment compared to oral medication?

Inhalers provide a targeted delivery directly to the airways. Signup and view all the answers

Which of the following components is commonly found in asthma inhalers?

Corticosteroids Signup and view all the answers

How does the composition of inhalers typically differ from that of oral medications?

Inhalers provide a direct route to the airways requiring smaller doses. Signup and view all the answers

What distinguishes a generic name from a brand name in asthma medications?

Generic names refer to the official drug name, while brand names are created by companies. Signup and view all the answers

In the context of asthma treatment, which option best represents the role of bronchodilators?

They relax the airway muscles to improve airflow. Signup and view all the answers

Which of the following symptoms is NOT typically associated with severe respiratory distress in children?

Excessive physical activity Signup and view all the answers

What condition is characterized by inflammation and redness of the inside of the nose?

Allergic rhinitis Signup and view all the answers

Which of the following medications is NOT an antihistamine used for treating allergic respiratory disorders?

Albuterol Signup and view all the answers

What is the primary reason for using antihistamines in treating allergic reactions?

To block the action of histamine Signup and view all the answers

Which of the following statements about chronic rhinosinusitis is accurate?

It involves swelling of the sinus lining due to inflammation. Signup and view all the answers

What is a common method for managing respiratory allergies?

Avoiding allergenic triggers Signup and view all the answers

Which of the following conditions is an example of allergic respiratory disease?

Asthma Signup and view all the answers

What is a possible complication associated with untreated allergic rhinitis?

Increased respiratory infections Signup and view all the answers

What is the significance of monitoring theophylline levels in neonates?

It determines the correct dosage due to its narrow therapeutic window. Signup and view all the answers

At what concentration level is theophylline considered within the therapeutic range for treating neonatal apnea?

6-11 µg/mL Signup and view all the answers

What is a common method for measuring theophylline concentration in blood tests?

As a trough level measured before the next dose. Signup and view all the answers

Which of the following is a primary concern when there is too much theophylline in a patient's system?

Potential life-threatening toxicity. Signup and view all the answers

Which aspect of patient health is NOT commonly monitored when administering theophylline?

Cognitive function and memory. Signup and view all the answers

What is the primary action of bronchodilators in respiratory therapy?

They relax the muscles surrounding the airways. Signup and view all the answers

What is a common side effect of using cough suppressants that act on the central nervous system?

Sedation or drowsiness. Signup and view all the answers

What role do expectorants play in managing respiratory conditions?

They increase bronchial secretions. Signup and view all the answers

Which of the following best describes the mechanism of action of decongestants?

They cause local constriction of blood vessels. Signup and view all the answers

What underlying condition is asthma classified as?

Chronic lung disease. Signup and view all the answers

Which type of asthma trigger is NOT commonly associated with allergic reactions?

Genetic factors. Signup and view all the answers

How do corticosteroids impact the airways in asthma treatment?

They suppress the immune system. Signup and view all the answers

What effect might indiscriminate antibiotic use have on asthma management?

It can potentiate asthma symptoms. Signup and view all the answers

What is the primary reason for tracking asthma symptoms over time?

To identify effectiveness and adjust treatment. Signup and view all the answers

What is a characteristic feature of bronchial secretions when using expectorants?

They become clearer and less dense. Signup and view all the answers

What is the primary principle of HPLC for drug separation?

The distribution of drug samples between a mobile phase and a stationary phase Signup and view all the answers

How does a DAD detector improve the detection capability in HPLC?

By simultaneously collecting data at multiple wavelengths Signup and view all the answers

What is a significant advantage of using HPLC for testing soluble compounds?

It can separate nearly any soluble compound effectively Signup and view all the answers

What determines the time a sample spends on the stationary phase in HPLC?

The intermolecular interactions and polarity between molecules and packing material Signup and view all the answers

Why is HPLC testing particularly advantageous regarding sample integrity?

It allows for the reuse of cleaned columns and further testing Signup and view all the answers

What is the role of computational mathematics in HPLC?

To quantify the target analyte based on peak size Signup and view all the answers

What type of compounds can HPLC separate effectively?

Nearly any soluble compound, including biological compounds Signup and view all the answers

In HPLC, which factor does NOT influence the separation of components?

Size of the stationary phase packing material Signup and view all the answers

What are the primary types of medications typically found in asthma inhalers?

Corticosteroids and bronchodilators are typically found in asthma inhalers. Signup and view all the answers

Describe the significance of using inhalers over oral medications for asthma management.

Inhalers deliver medication directly to the airways, requiring a smaller dose compared to oral medications. Signup and view all the answers

How does the composition of asthma inhalers affect the dose required compared to tablets?

Inhalers require much smaller doses because the medicine goes directly into the airways. Signup and view all the answers

Explain the role of generics and brand names in asthma inhalers.

The generic name is the official name of the drug, while the brand name is the specific name given by different companies. Signup and view all the answers

What is the potential disadvantage of relying solely on oral medications for asthma treatment?

Oral medications may have more systemic side effects and take longer to act compared to inhaled medications. Signup and view all the answers

List two symptoms that may indicate severe allergic respiratory distress.

Seizures and slow, labored breathing. Signup and view all the answers

What is a common treatment approach for managing allergic respiratory disorders?

Avoiding allergens and using medications like antihistamines. Signup and view all the answers

Identify one chronic respiratory condition listed under allergic respiratory diseases.

Asthma. Signup and view all the answers

What role do antihistamines play in treating allergic respiratory disorders?

They block the action of histamine, reducing allergic symptoms. Signup and view all the answers

Describe the condition of chronic rhinosinusitis in a few words.

Inflammation of the sinus lining. Signup and view all the answers

What is the significance of bluish-colored fingernails and lips in allergic reactions?

They indicate potential hypoxia or lack of oxygen. Signup and view all the answers

Name one antihistamine that is commonly prescribed for allergy cough.

Fexofenadine (Allegra). Signup and view all the answers

What is often considered a primary limitation in the treatment of respiratory allergies?

There may be no definitive cure for the allergies. Signup and view all the answers

Explain why the therapeutic window of theophylline is considered narrow.

The therapeutic window of theophylline is considered narrow because the minimum efficacious concentration is very close to the minimum toxic concentration, which increases the risk of side effects and toxicity. Signup and view all the answers

What factors do doctors monitor in a patient receiving theophylline treatment for neonatal apnea?

Doctors monitor heart rate, central nervous system effects like headache and irritability, and respiratory rate. Signup and view all the answers

Describe the significance of measuring a trough level for theophylline.

A trough level measures theophylline concentration just before the next dose, ensuring it is at its lowest and helps in determining proper dosing. Signup and view all the answers

Discuss the primary risks associated with elevated theophylline levels in neonates.

Elevated theophylline levels can lead to life-threatening side effects, including severe cardiovascular and central nervous system issues. Signup and view all the answers

What are some common side effects that need monitoring during theophylline therapy?

Common side effects to monitor include headache, insomnia, irritability, and increased heart or respiratory rates. Signup and view all the answers

What is the primary reason antibiotics are not recommended for uncomplicated acute bronchitis?

Antibiotics are not effective against viral infections, which are the most common cause of uncomplicated acute bronchitis. Signup and view all the answers

How does guaifenesin function to alleviate cough symptoms?

Guaifenesin works by thinning mucus or phlegm in the lungs, making it easier to clear from the chest. Signup and view all the answers

Describe the mechanism by which pseudoephedrine relieves nasal congestion.

Pseudoephedrine reduces swelling of blood vessels in the nasal passages, thereby opening the airways and relieving congestion. Signup and view all the answers

What therapeutic plasma level of theophylline is recommended for treating acute bronchospasm in adults?

The recommended therapeutic plasma level of theophylline for acute bronchospasm in adults is around $10-15 ,\mu g/mL$. Signup and view all the answers

What severe complications can arise from theophylline toxicity?

Theophylline toxicity can lead to cardiac dysrhythmias and seizures. Signup and view all the answers

At what concentration of theophylline can death potentially occur?

Death can occur with theophylline levels around $80-100 ,\mu g/mL$. Signup and view all the answers

Explain the role of theophylline as a bronchodilator.

Theophylline acts as a bronchodilator by relaxing the muscles in the lungs and widening the airways to facilitate easier breathing. Signup and view all the answers

What considerations are important when evaluating theophylline therapy in elderly patients?

Elderly patients may experience adverse effects even within the normal therapeutic range of theophylline due to altered metabolism. Signup and view all the answers

What role does polarity play in the separation process of drug samples in HPLC?

Polarity influences the intermolecular interactions between drug molecules and the packing material, affecting their retention time during separation. Signup and view all the answers

What is one key advantage of using a DAD detector in HPLC over conventional UV detection methods?

A DAD detector collects data at multiple wavelengths simultaneously, allowing for a more comprehensive analysis of various target analytes. Signup and view all the answers

How does high performance liquid chromatography (HPLC) contribute to the quantification of theophylline in plasma?

HPLC separates theophylline from other plasma components, enabling accurate quantitative analysis due to its sensitivity and selectivity. Signup and view all the answers

In what way can HPLC be considered a cost-effective method for drug analysis?

HPLC allows for the reuse of cleaned columns and requires less expensive materials for analysis compared to other methods. Signup and view all the answers

What impact does sample retention time have on the interpretation of HPLC results?

Sample retention time is used to identify and quantify components based on their delayed passage through the stationary phase. Signup and view all the answers

What is the significance of certified reference standards in HPLC analysis?

Certified reference standards are essential for ensuring accurate signal identification and quantifying target analytes based on peak size. Signup and view all the answers

In HPLC, how does the use of a mobile phase influence the separation of drug components?

The mobile phase helps carry the sample through the column, affecting the interaction of drug components with the stationary phase and their elution times. Signup and view all the answers

What advantage does HPLC offer for future sample testing compared to destructive techniques?

HPLC allows for further testing of analytical samples since it does not destroy them during the analysis process. Signup and view all the answers

Study Notes

Respiratory Medications and Management

Respiratory medications are prescribed to manage patients with pulmonary diseases.
Each medication has a unique mechanism of action, and understanding these individual differences is crucial for safe and effective patient care.

Common Respiratory Medications

Cough suppressants:
- Suppress the coughing reflex.
- Most are narcotics like codeine, acting on the medulla oblongata of the brain to prevent coughing.
Bronchodilators:
- Treat breathing difficulty in conditions like asthma.
- Relax the muscles surrounding the airways that constrict in airway disorders, relieving constriction.
Expectorants:
- Increase the amount and thin bronchial secretions, making coughs more productive.
- This aids in clearing the airways and eases breathing.
Decongestants:
- Treat allergies, sneezing, and runny nose.
- Reduce swelling and edema by causing local constriction of blood vessels.
Antibiotics:
- Prescribed for true bacterial infections that worsen existing airway diseases.
- Not always necessary for inflammatory airway diseases.
Anti-inflammatory drugs:
- Corticosteroids (glucocorticoids) prevent the release of inflammatory chemicals.
- Control inflammation of the airways.
- Suppress the immune system.

Asthma

A non-communicable disease, commonly affecting both children and adults.
Characterized by chronic inflammation and narrowing of the small airways in the lungs.
Symptoms include cough, wheeze, shortness of breath, and chest tightness.

Asthma Triggers

Common triggers include allergies, stress, cold air, exercise, gastroesophageal reflux disease, pollution, smoking, bacteria/viruses, pets, household chemicals, and dust.
Individuals can have more than one trigger.

Facts about Asthma

Asthma can change over time, requiring regular doctor visits to track symptoms and adjust medications accordingly.
The type and dosage of asthma medications depend on symptoms and age.

Asthma Treatments

Inhalers: The most common treatment for asthma. Devices for breathing in medicine.
Tablets and other treatments: Required for severe asthma.

Asthma Inhalers

Devices containing medicine that is taken by inhaling (breathing in).
Primarily used for treating asthma to control symptoms.
The medicine goes directly into the airways, requiring much smaller doses than oral medications.
Contain various compositions, usually including corticosteroids and bronchodilators.

Inhalers for Asthma (Continued)

Examples of combination inhalers:
- Fostair® (formoterol and beclometasone)
- Seretide® (salmeterol and fluticasone)
- Symbicort® (formoterol and budesonide)

Side Effects of Asthma Inhalers

Side effects are minimal compared to liquid or tablet medications.
Some potential side effects include sore throat, cough, and oral thrush (fungal infection).

Chronic Obstructive Pulmonary Disease (COPD)

A group of lung conditions causing breathing difficulties, including:
- Emphysema: Damage to the air sacs in the lungs.
- Chronic Bronchitis: Long-term inflammation of the airways.

COPD Symptoms

Shortness of breath, especially during activity.
Persistent chesty cough with phlegm.
Chest infections.
Wheezing.
Chest tightness.
Fatigue.
Weight loss.

COPD Risk Factors

Smoking (most common)
Air pollution.
Chemical fumes.
Dust.
Family history of COPD.
Age.
Certain genetic conditions.

COPD Treatments

No cure exists, but treatment focuses on controlling symptoms and slowing progression.
It includes:
- Inhalers and tablets: Make breathing easier.
- Stopping smoking: Crucial for patients.
- Pulmonary rehabilitation: Exercise and education programs organized by healthcare workers.
- Surgery or lung transplant: Options for a small number of patients.

Stopping Smoking and COPD

Quitting smoking is the most effective way to prevent COPD from worsening.
Cessation can help prevent further damage to the lungs and airways.
Many patients require oxygen machines to assist with breathing in everyday activities to maintain normal blood oxygen levels.

Short-Acting Bronchodilator Inhalers for COPD

First treatment used for most people with COPD.
Used when shortness of breath occurs, up to a maximum of four times a day.
Deliver medicine directly into the lungs when breathing in.
The inhaler contains bronchodilators that relax and widen the airways, making breathing easier.
Two types:
- Beta-2 agonist inhalers: Salbutamol and terbutaline.
- Antimuscarinic inhalers: Ipratropium.

Long-Acting Bronchodilator Inhalers for COPD

For patients experiencing regular symptoms despite short-acting bronchodilators.
A single dose lasts for at least 12 hours, requiring use once or twice a day.
Two types:
- Beta-2 agonist inhalers: Salmeterol, formoterol, and indacaterol.
- Antimuscarinic inhalers: Tiotropium, glycopyronium, and aclidinium.

Steroid Inhalers for COPD

For patients experiencing shortness of breath even when using a long-acting inhaler or who develop frequent flare-ups (exacerbations).
Includes a steroid inhaler as part of treatment.
Steroids reduce inflammation in the airways and are often prescribed in combination with long-acting medication.

Theophylline Tablets or Capsules for COPD

Used for patients whose symptoms are not controlled with inhalers.
Theophylline is usually taken twice a day as tablets or capsules.
Exact mechanism is unclear but seems to reduce swelling (inflammation) and relax airway muscles.
Regular blood tests are required to monitor theophylline levels in the blood.

Possible Side Effects of Theophylline

Slow, fast, or irregular heartbeat.
Pounding or rapid pulse.
Fainting.
Chest pain.
Increased urine volume.
Persistent vomiting.

Steroid Tablets for COPD

Prescribed for patients with particularly bad flare-ups (exacerbations).
Typically a 5-day course of treatment is recommended to reduce airway inflammation.
Long-term use can lead to troublesome side effects:
- Weight gain.
- Mood swings.
- Weakened bones (osteoporosis)

Mucolytic Medicines for COPD

Used for patients with persistent chesty cough and thick phlegm.
Might require carbocisteine, a mucolytic medicine, to help thin phlegm and make it easier to cough up.
Carbocisteine is available as tablets or capsules and is typically taken three or four times a day.
If carbocisteine doesn't help, acetylcysteine, an alternative mucolytic medicine, is available.

Antibiotics for COPD

May be prescribed for signs and symptoms of chest infection like:
- Increased breathlessness.
- Increased coughing.
- Changes in sputum color (yellow, green, brown) and/or consistency (thicker).

Drugs for Cough

Dry cough: A preparation containing an antitussive like dextromethorphan.
Chesty cough: A preparation containing an expectorant like guaifenesin.
Antitussives: -Suppress the urge to cough.
- Coughing is a natural reflex.
- Antitussives prevent cough by acting on the part of the brain controlling the action.
Expectorants:
- Thin mucus.
- Help cough up mucus during a productive cough.
- Ideal for coughs that produce thick mucus.

Antibiotics (Continued)

First-choice antibiotics for adults aged 18 years and over include:
- Doxycycline: 200 mg on day 1, then 100mg daily for four days (5-day course).
Alternative choices:
- Amoxicillin: 500mg three times daily for 5 days.
- Clarithromycin: 250-500mg twice daily for 5 days.
- Erythromycin: 250-500mg four times daily, or 500-1000mg twice daily for 5 days.

Side Effects of Taking Too Much Cough Medicine

Antibiotics are not recommended for uncomplicated acute bronchitis.

Drugs for Treating Allergic Respiratory Disorders

Expectorants (e.g., Guaifenesin): Help clear mucus or phlegm from the chest during a cold or flu. Thins mucus in the lungs.
Decongestants (e.g., Pseudoephedrine): Provide short-term relief for blocked or stuffy noses. Reduce swelling in the blood vessels of the nose, opening the airways. Ease symptoms of colds and flu.
Theophylline: A bronchodilator that widens airways by relaxing muscles in the lungs. Sometimes found in medications that also contain guaifenesin.

Toxicity of Theophylline

Toxic levels: Above 20 µg/mL.
Adverse effects can occur within the therapeutic range, especially in elderly patients.
Severe complications include:
- Cardiac dysrhythmias (abnormal heartbeat).
- Seizures.
Levels of 80-100 µg/mL can be fatal.

Recommended Therapeutic Plasma Level for Theophylline

The reference range for theophylline in treating acute bronchospasm in adults is around 10-15 µg/mL.

Theophylline in Neonatal Apnea

Theophylline is used to treat neonatal apnea, which is the absence of breathing in a newborn for more than 15 seconds.
The reference range of theophylline in neonates is 6-11 µg/mL.
A neonate is a child under 28 days of age.

Why Blood Test for Theophylline is Necessary

Blood tests help determine the correct dosage of theophylline.
Too much theophylline can be life-threatening.
Theophylline has a narrow therapeutic window, meaning the difference between the effective dose and the toxic dose is small.
Doctors monitor the heart rate, central nervous system effects (headache, insomnia, irritability), and respiratory rate of patients taking theophylline.

How to Test for Theophylline

Theophylline blood tests are used to monitor the amount of theophylline in the blood.
The test is usually requested as a trough level, which is measured just before the next dose.
The trough level is when the blood concentration is expected to be at its lowest.

Respiratory Medications

Used to manage pulmonary diseases
Each medication has a unique mechanism of action
Important to understand implications of each medication for patients
Goal is to provide effective and safe treatment

Commonly Used Medications

Cough Suppressants: Suppress cough reflex, often narcotics acting on the medulla oblongata
Bronchodilators: Relax muscles surrounding airways to relieve constriction in airway disorders
Expectorants: Increase and thin bronchial secretions, making coughs more productive
Decongestants: Reduce swelling and edema, cause local vasoconstriction
Antibiotics: Used for bacterial infections, may not be necessary for inflammatory airway diseases
Anti-Inflammatory Drugs: Corticosteroids like glucocorticoids suppress inflammation and immune response

Asthma

Non-communicable disease, common chronic disease in children and adults
Caused by inflammation and narrowing of the airways
Symptoms include cough, wheeze, shortness of breath, and chest tightness

Triggers of Asthma

Allergic asthma is common
Other triggers include:
- Stress
- Cold air
- Exercise
- Gastroesophageal reflux disease
People can have multiple triggers

More Triggers of Asthma

Pollution
Smoking
Bacteria and viruses
Genetic predisposition
Pets
Household chemicals
Dust

Facts About Asthma

Asthma can change over time
Consult a doctor to track symptoms and adjust medications
Medication type and dosage depend on symptoms and age

Treatment of Asthma

Most common treatment is inhalers
Tablets and other treatments may be needed for severe asthma
Follow a personalized action plan advised by a doctor

Asthma Inhalers

Devices containing medicine inhaled for treatment
Deliver medicine directly to airways
Require smaller doses than oral medications

Medicines in Asthma Inhalers

Contain a corticosteroid and/or a bronchodilator
Generic names refer to the medicine, brand names specify the manufacturer
Different companies may use the same generic medicine

Side Effects of Asthma Medications

Drowsiness
Dizziness
Blurred vision
Coma
Constipation
Seizures
Blue fingernails and lips
Slow or labored breathing, shallow breathing, no breathing (especially in young children)

Allergic Respiratory Disorders

Include asthma, chronic rhinosinusitis, and allergic rhinitis
No cure for respiratory allergies, but avoiding triggers is crucial
Medications like antihistamines help control symptoms

Antihistamines for Respiratory Allergies

Block histamine, a key chemical in allergic reactions
Common antihistamines include:
- Cetirizine (Zyrtec)
- Desloratadine (Clarinex)
- Fexofenadine (Allegra)
- Levocetirizine (Xyzal)
- Loratadine (Claritin)

Medicine for Allergy Cough

Antihistamines block histamine-induced allergic symptoms, including cough
Common medications include fexofenadine (Allegra) and loratadine (Claritin)
Antibiotics do not cure allergic cough

Theophylline

Medication used to treat asthma and other respiratory conditions
Narrow therapeutic window, requiring blood tests to monitor dosage
Side effects can be serious, requiring careful monitoring
Theophylline levels are monitored to ensure effective treatment and avoid toxicity

Monitoring Theophylline Levels

Blood tests measure theophylline concentration
Trough levels are measured just before the next dose
Monitoring helps adjust dosage and prevent overdose

Theophylline Testing

High-performance liquid chromatography (HPLC) with ultraviolet detection is a common method
Method is simple, sensitive, and selective for quantifying theophylline

HPLC Method

Separates components of a sample based on their chemical structure
Uses a mobile phase and a stationary phase (column)
Different components elute at different times, allowing for separation
DAD (diode array detector) is a sensitive detection technique that collects data at multiple wavelengths

Advantages of HPLC

Separates a wide variety of compounds
Accurate peak identification by comparing to reference standards
Quantification based on peak size
Less expensive
Columns can be reused after cleaning
Non-destructive, allowing for further testing

What is Asthma?

A chronic condition that causes inflammation and narrowing of the airways in the lungs
Symptoms may include episodes of wheezing, coughing, shortness of breath, and chest tightness
Triggered by various factors like allergens, irritants, exercise, and cold air

Asthma

Asthma is a chronic lung disease that affects people of all ages.
The disease is caused by inflammation and narrowing of the airways in the lungs.

Asthma Inhalers

Contain medicine that is inhaled.
Used to treat asthma and control asthma symptoms.
Medicine in inhalers goes directly into the airways.
Require smaller doses of medicine compared to oral medication.

Types of Inhalers

Many types of inhalers are available.
Generic name is the official name of the drug/medicine.
Different companies use the same generic medicine to produce different brands.
Most inhalers contain a combination of a corticosteroid and a bronchodilator.

Drugs for Treating Asthma

Drowsiness, dizziness, blurred vision, coma, constipation, seizures, bluish-colored fingernails and lips, slow and labored breathing, shallow breathing, no breathing (especially in young children) are potential symptoms related to asthma medication.

Allergic Respiratory Diseases (ARD)

Includes asthma, chronic rhinosinusitis, and allergic rhinitis.

Chronic Rhinosinusitis

Swelling of the lining of the sinuses due to inflammation.

Allergic Rhinitis

Inflammation with redness and swelling inside the nose.

Cure for Respiratory Allergies

There may not be a cure for respiratory allergies.
Avoiding allergic triggers is important to prevent symptoms.
Medications like antihistamines can help control symptoms.

Antihistamines for Respiratory Allergies

Cetirizine (Zyrtec), Desloratadine (Clarinex), Fexofenadine (Allegra), Levocetirizine (Xyzal), and Loratadine (Claritin) are common antihistamines used.

Medicine for Allergy Cough

Antihistamines block histamine, which causes allergic symptoms.
Antihistamines help relieve allergy coughs.
Fexofenadine (Allegra) and loratadine (Claritin) are commonly used.
Antibiotics are not recommended for uncomplicated acute bronchitis.

Expectorants

Guaifenesin is an example of an expectorant.
It helps clear mucus or phlegm from the chest during a cold or flu.
Works by thinning mucus or phlegm in the lungs.

Decongestants

Pseudoephedrine is an example of a decongestant.
Provides short-term relief for blocked or stuffy noses.
Reduces swelling of blood vessels in the nose, opening the airways.
Helps ease symptoms associated with colds and flu.

Theophylline

A bronchodilator that makes breathing easier by relaxing lung muscles and widening airways.
Present in some medications containing other bronchodilators, such as theophylline.

Theophylline Toxicity

Toxic levels are considered to be higher than 20 µg/mL.
Adverse effects can occur within the normal therapeutic range, especially in elderly patients.
Severe complications include cardiac dysrhythmias, seizures, and death can be observed at levels of around 80-100 µg/mL.

Theophylline Recommended Therapeutic Plasma Levels

For acute bronchospasm in adults: 10-15 µg/mL.
For neonatal apnea: 6-11 µg/mL.

Why Blood Tests for Theophylline are Necessary

Help doctors determine the correct dose.
Indicate if the patient has too much theophylline in their body.
Too much theophylline can be life-threatening.
Theophylline levels need to be monitored due to its narrow therapeutic window and side effects.
Doctors commonly monitor the patient's heart rate, central nervous system effects, and respiratory rate.

How to Test for Theophylline

Theophylline test measures the amount of theophylline in the blood.
Usually requested as a trough level, measured just before the next dose.
This is when the blood concentration is expected to be at its lowest level.

Method of Theophylline Analysis

High performance liquid chromatography (HPLC) with ultraviolet detection (272 nm) is a common method for testing.
It's a simple, sensitive, and selective laboratory method.
Developed for quantifying theophylline in plasma.

Characteristics of HPLC

Used in pharmacology for quantitative drug analysis and separating components in mixed drug substances.
Sample separation occurs when the drug distribution occurs between a mobile phase and stationary phase within the column.
The time the sample spends on the stationary phase determines by the intermolecular interactions (or polarity) between the molecules and the column packing material.
Different elements of the drug sample are eluted at different time intervals.

DAD Detector

Also called photodiode-array (PDA) detector.
One of the most popular techniques for HPLC.
Unlike other UV detection methods, DAD collects data at multiple wavelengths simultaneously.
The molecular structure of target analytes absorb light at different wavelengths on the electromagnetic spectrum.
DAD allows for tunability of the detection wavelength allowing for the detection of thousands of target analytes.

Advantages of HPLC

Powerful for separating nearly any soluble compound, including vitamins, amino acids, and other biological compounds.
Comparing target peaks to certified reference standards ensures accurate signal identification.
Computational mathematics quantifies the target analyte based on peak size.
Less expensive.
Reuse of cleaned columns is possible.
Further sample testing is possible.
HPLC testing with DAD doesn't destroy analytical samples.

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Description

This quiz covers various respiratory medications and their management, focusing on their mechanisms of action. Understanding the differences in treatments such as cough suppressants, bronchodilators, expectorants, and decongestants is essential for effective patient care. Test your knowledge in respiratory pharmacology and improve your clinical skills.