Respiratory Drugs Study Guide PDF

Respiratory Drugs Diseases of the Lower Respiratory Tract Bronchial Asthma ================ Definition \ Pathophysiology Asthma Categories -----------------   Chronic Bronchitis ------------------  Emphysema ========= Alveol...

Respiratory Drugs Diseases of the Lower Respiratory Tract Bronchial Asthma ================ Definition \ Pathophysiology Asthma Categories -----------------   Chronic Bronchitis ------------------  Emphysema ========= Alveolar Destruction \ Reduced Gas Exchange  ##### Pharmacologic Overview Bronchodilators: Short-acting Beta-Agonists (SABAs)   ###### Bronchodilators: Long-acting Beta- Agonists (LABAs)  ###### Bronchodilators: Beta- Adrenergic Agonists: Newest LABA 1. Indacaterol (Arcapta Neohaler) 2. Vilanterol  3. Ellipta Delivery System  Bronchodilators: Types ======================  Nonselective Adrenergics \ Nonselective Beta- Adrenergics \ Selective Beta2 Drugs Beta-Adrenergic Agonists: Mechanism of Action  Beta-Adrenergic Agonists: Contraindications 1. Known Drug Allergy 2. Uncontrolled Hypertension 3. Cardiac Dysrhythmias 4. High Risk of Stroke Beta-Adrenergic Agonists: Adverse Effects ========================================= Alpha and Beta Effects - Insomnia - Restlessness - Anorexia - Vascular headache - Hyperglycemia - Tremor - Cardiac stimulation \ Cardiovascular Effects Central Nervous System Effects  ##### Beta-Adrenergic Agonists: Interactions 1. 2. 3. 4. Beta-Adrenergic Agonists: Albuterol (Proventil) =============================================== Albuterol \ Important Considerations   Dry Mouth \ Nasal Congestion Headache \ Anxiety Anticholinergics: Ipratropium (Atrovent) ======================================== Ipratropium (Atrovent) \ Other Anticholinergics 1. Tiotropium (Spiriva) 2. Aclidinium (Tudorza) 3. Umeclidinium (Incruse Ellipta)   Xanthine Derivatives: Drug Effects ==================================  Bronchodilation \ Increased Airflow \ CNS Stimulation \ Cardiovascular Stimulation  #### Xanthine Derivatives: Adverse Effects Xanthine Derivatives: Caffeine ============================== Over-the-Counter Use \ Pediatric Uses - Caffeine is used as a cardiac stimulant in infants with bradycardia. - Caffeine can also be used to enhance respiratory    Leukotriene Receptor Antagonists (LTRAs) \ Corticosteroids \ Mast Cell Stabilizers  ### Leukotriene Receptor Antagonists (LTRAs) {#leukotriene-receptor-antagonists-ltras-1}   LTRAs: Contraindications ======================== Known Drug Allergy \ Previous Adverse Drug Reaction \ Inactive Ingredients LTRAs: Adverse Effects ======================  Headache \ Nausea \ Diarrhea \ Dizziness #### Corticosteroids (Glucocorticoids) 1. 2. 3. 4. #### Corticosteroids: Mechanism of Action  ##### Corticosteroids: Mechanism of Action (Cont.) ##### Inhaled Corticosteroids Inhaled Corticosteroids: Indications ====================================  Asthma Management \ Persistent Asthma \ Combined Therapy   ### Inhaled Corticosteroids: Drug Interactions - May increase serum glucose levels, possibly requiring adjustments in dosages of antidiabetic drugs. - Cyclosporine and tacrolimus: May increase the risk of infections, particularly in patients with renal impairment. - Itraconazole, ketoconazole, and other strong inhibitors of CYP3A4: May increase the risk of adverse effects of inhaled corticosteroids. - Phenytoin, phenobarbital, and rifampin: May decrease the effectiveness of inhaled corticosteroids. Inhalers: Patient Education =========================== Inhaler Technique 1. Demonstrate and practice 2. Emphasize correct timing of inhalation and activation. 3. Provide a spacer for patients with coordination difficulties. \ Dose Tracking 1. Explain how to count remaining doses. 2. Encourage patients to refill prescriptions before running out. 3. Advise patients to keep inhalers in a safe and accessible location.