Respiratory Care Pharmacology PDF - Rau's Chapter 1

Introduction to Respiratory Care Pharmacology z Rau’s Chapter 1 z Pharmacology and the Study of Drugs  Drugs: Any chemical that alters the organism's functions or processes  Pharmacology: The study of drugs (chemicals), including the...

Introduction to Respiratory Care Pharmacology z Rau’s Chapter 1 z Pharmacology and the Study of Drugs  Drugs: Any chemical that alters the organism's functions or processes  Pharmacology: The study of drugs (chemicals), including their origins, properties, and interactions with living organisms  Respiratory Care Pharmacology: The application of pharmacology to cardiopulmonary disease and critical care  Pharmacy: Preparation and dispensing of drugs  Pharmacognosy: Identification of sources of drugs  Pharmacogenetics: Interrelationship of genetic differences and effects  Therapeutics: Art of treating disease with drugs  Toxicology: Study of toxic substances and pharmacologic action z Naming Drugs Chemical Generic Code name name name Trade Official (Brand) name name z Sources of Drugs Animal Thyroid hormone, insulin, pancreatic dornase Khellin, atropine, digitalis, reserpine, eucalyptus oil, Plant pine oil, anise Mineral Copper sulfate, magnesium sulfate, mineral oil z Process of Drug Approval in the United States  Chemical isolation and identification  Animal studies  Investigational New Drug approval  Phase I  Phase II  Phase III  New Drug Application  Food and Drug Administration new drug classification system  Orphan drugs  Thez Prescription  Parts 1. Patient name, address, and date 2. Rx 3. Inscription 4. Subscription 5. Sig 6. Name of the prescriber  Over-the-counter drugs  Does not require a prescription  Generic substitution in prescriptions  Any manufacturer's version of the prescribed drug and not a specific brand  Generally, less expensive z Abbreviations used in Prescriptions  q every  po per os (by mouth)  qh every hour  prn as needed  qid four times daily  IM intramuscular  qod every other day  IV intravenous  qd every day  tid three times daily  q2h every 2 hours  q3h every 3 hours  q4h every 4 hours  See Table 1.3  z Respiratory Care Pharmacology: An Overview  Aerosolized agents given by inhalation  Five advantages  Related drug groups in respiratory care  Anti-infective agents  Neuromuscular blocking agents  Central nervous system agents  Antiarrhythmic agents  Antihypertensive and antianginal agents  Anticoagulant and thrombolytic agents  Diuretics  z Advantages of Aerosolized Agents Given by Inhalation AEROSOL DOSES ARE SIDE EFFECTS ARE THE ONSET OF ACTION DRUG DELIVERY IS THE INHALATION OF SMALLER THAN DOSES USUALLY FEWER AND IS RAPID. TARGETED TO THE AEROSOL DRUGS IS USED FOR THE SAME LESS SEVERE WITH RESPIRATORY SYSTEM, PAINLESS, IS PURPOSE AND GIVEN AEROSOL DELIVERY WITH LOWER SYSTEMIC RELATIVELY SAFE, AND SYSTEMICALLY. THAN WITH ORAL OR BIOAVAILABILITY. MAY BE CONVENIENT, PARENTERAL DELIVERY. DEPENDING ON THE SPECIFIC DELIVERY DEVICE USED.  z Adrenergic Agents β-Adrenergic  Relaxation of bronchial smooth muscle and bronchodilation, to reduce airway resistance (Raw) and to improve ventilatory flow rates in airway obstruction resulting from chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis (CF), acute bronchitis Ex. Albuterol, Arformoterol, Formoterol, Levalbuterol, Salmeterol, etc. α-Adrenergic  Topical vasoconstriction and decongestion. Used to treat upper airway swelling  Ex. Racemic Epinephrine  z Relaxation of cholinergically induced bronchoconstriction Anticholinergic to improve ventilatory flow rates in COPD and asthma. Agents EX. Glycopyrrolate bromide, Ipratropium Bromide, Tiotropium Bromide  z Mucoactive Agents  Modification of properties of respiratory tract mucus; current agents reduce viscosity and promote clearance of secretions.  Ex. Acetylcysteine, Dornase Alfa, Mannitol, Hyperosmolar Saline  z Antiasthmatic Agents  Prevention of onset and development of the asthmatic response through inhabitation of chemical mediators of inflammation  Ex. Cromolyn Sodium, Montelukast, Omalizumab, etc.  z Inhibition or Pneumocystic eradication of Jiroveci Carinii specific (PCP) infective *Pentamidine agents, such as Anti-infective Agents Pseudomonas Aeruginosa RSV In CF or *Ribavirin Influenza A and B *TOBI  z Exogenous Surfactants  Approved clinical use is by direct intratracheal instillation for the purpose of restoring more normal lung compliance in RDS of newborns  Ex. Beractant, Calfactant, Poractant Alfa, Lucinactant z Prostacyclin Analogs  Clinically indicated to treat pulmonary hypertension for the purpose of decreasing shortness of breath and increasing walking distance  Ex. Iloprost, Treprostinil