RESPIRATORY SYSTEM Pharm

RESPIRATORY SYSTEM Chapter 9 Antituberculosis Drugs: First Line (C) Antimycobacterial (P) isoniazid (INH) 9 month treatment regime Most commonly used anti-TB drug Take one hour before or two hours after meal Adverse effects (increased r...

RESPIRATORY SYSTEM Chapter 9 Antituberculosis Drugs: First Line (C) Antimycobacterial (P) isoniazid (INH) 9 month treatment regime Most commonly used anti-TB drug Take one hour before or two hours after meal Adverse effects (increased risk with alcoholism, diabetes melitus, uremia, malnourished, or older) o Hepatotoxicity ▪ Hepatitis ▪ Alcoholics ▪ Elderly o Peripheral neuropathy Get baseline LFT’s (C) Rifampin Used with INH with active TB Affects the use of other drugs including antiretroviral drugs (NNRTIs and PIs), benzodiazepines, corticosteroids, cyclosporine, estrogens, fluconazole, methadone, metoprolol, phenytoin, propranolol, oral contraceptives, oral sulfonylureas, theophylline, verapamil, and warfarin(C) pyrazinamide, ethambutol ▪ ***Monitor PT/INR may need to increase dose on coumadin patients Take one hour before or two hours after meals Adverse effects o Hepatotoxicity Chapter 10 (C) Antivirals (P) rimantadine (Flumadine) Used to control outbreaks of Influenza A oseltamivir (Tamilfu) Used to treat flu virus Reduction of recovery for 1-2 days Take with or without food Life threatening arrhythmias (rare but serious) amantadine (Symmetrel)  Blocks the uncoating of the virus, preventing penetration to the host Side effects o Dizziness o Lightheadedness o Nervousness with anxiety o Inability to concentrate zanamivir (Relenza) Diskhaler delivery system Use cautiously with COPD and asthmatic patients Chapter 36 (C) Glucocorticoids (also known as steroids). Many side effects so patient need to be closely monitored. Used to control symptoms not cure underlying disease processes. Used with acute exacerbations of COPD not long term. Non-curative Reduction of inflammation (P) prednisone Side effects o Weight gain o Fluid retention o Night sweats o Insomnia o Hypokalemia (low potassium) ▪ Risk of cardiac arrhythmias o Anxiety ▪ Increased heart rate o Increases appetite o Easy bruising Long term side effects o Bone weakness o Osteoporosis o Weakened immune (O) prednisolone (Prelone, Orapred) methylprednisolone (Medrol, SOLUMedrol) beclomethasone (Beconase, AQ) Chapter 54 (C) Antitussives- cough prevention ***Be cautious…can prevent expectoration which can lead to accumulation of secretions*** (P) dextromethorphan (OTC) o Cough suppressant. Neurological level of the brain that triggers the cough reflex o Side effects include- hallucinations, confusion, agitation, increased heart rate (C) Nasal Decongestants (P) pseudoephedrine (Sudafed), (O) fluticasone Stimulant o Increased heart rate Shrinks swollen nasal mucous membranes Increases drainage of sinus secretion Side effect o Hypertension o Urinary retention o (Rare but life threatening) arrythmias (C) Antihistamines (P) diphenhydramine (Benedryl) Allergies Sedating Common side effect- fatigue, dry mouth Non-Sedating Antihistamines- treatment of allergies. Common side effect dry-mouth, headache, and abdominal pain. Serious side effect includes aggression and angioedema. Works at the histamine receptor level. Seasonal allergies cetirizine (Zyrtec) (O) loratadine (Claritin) Chapter 55 (C) Sympathomimetics – stimulant compounds (O) albuterol (Proventil, Ventolin, AccuNeb) o Opens up the bronci of the lungs (bronchial dialation) o Dx: Asthmatics, COPD exacerbation, allergic reactions that cause bronchial tightness o Relaxes the smooth muscles of the airway o Side Effects  ▪ Shakiness ▪ Anxiety ▪ Headache ▪ Tachycardia ▪ Bronchospasm ▪ Low potassium metaproterenol (Alupent) salmetrol Serevent), terbutaline (Brethine) (C) Anticholinergics (P) ipratropium bromide (Atrovent) (O) tiotroprium (Spiriva) (C) Xanthines (P) aminophylline (O) theophylline (C) Inhaled Steroids and Topical Steroid Nasal Decongestants (Nasal Sprays) (P) budesonide (Pulmocort) (for inhaled steroids) & (P) flunisolide (for nasal spray) (O) beclomethasone (Beconase), fluticasone aerosol (Flovent), triamcinolone acetonide (Azamacort) (C) Leukotriene Receptor Antagonists (P) zafirlukast (Accolate) (O) montelukast (Singulair) (C) Mast cell stabilizer (P) cromolyn (NasalCrom)