Respiratory Pharm PDF

1. Chronic Obstructive Pulmonary Disease (COPD) Pathophysiology: COPD is primarily caused by chronic exposure to irritants like smoking, leading to inflammation in the airways and destruction of lung tissue. It involves two main components: ○ Chronic Bronchitis: Chronic inflam...

1. Chronic Obstructive Pulmonary Disease (COPD) Pathophysiology: COPD is primarily caused by chronic exposure to irritants like smoking, leading to inflammation in the airways and destruction of lung tissue. It involves two main components: ○ Chronic Bronchitis: Chronic inflammation and mucus hypersecretion lead to narrowing of the bronchi. ○ Emphysema: Damage to alveolar walls, causing a loss of surface area for gas exchange. This results in airflow limitation that is progressive and not fully reversible. Drugs Used: 1. Bronchodilators (e.g., Beta-2 Agonists, Anticholinergics) ○ MOA: Relaxation of bronchial smooth muscle by beta-2 receptor stimulation or acetylcholine blockade. ○ Therapeutic Use: Relief of bronchospasm in COPD. ○ Side Effects: Tachycardia, tremor, dry mouth, blurred vision. ○ Contraindications/Interactions: Caution in patients with glaucoma, urinary retention, and heart disease. 2. Corticosteroids (e.g., Fluticasone, Budesonide) ○ MOA: Anti-inflammatory action by reducing airway inflammation. ○ Therapeutic Use: Chronic management of COPD, especially in patients with frequent exacerbations. ○ Side Effects: Oral thrush, hoarseness, osteoporosis, weight gain. ○ Contraindications/Interactions: Caution with systemic infections, diabetes, or fungal infections. 3. Phosphodiesterase-4 Inhibitors (e.g., Roflumilast)  ○ MOA: Reduces inflammation by inhibiting phosphodiesterase-4, leading to increased cAMP. ○ Therapeutic Use: Used for severe COPD to reduce exacerbations. ○ Side Effects: Diarrhea, weight loss, nausea. ○ Contraindications/Interactions: Liver disease, caution with theophylline. 2. Asthma Pathophysiology: Asthma is a reversible airway obstruction that results from inflammation in the small airways. ○ Key processes: Edema, excess mucus production, and bronchoconstriction. Asthma can be triggered by allergens, respiratory infections, exercise, or irritants. Drugs Used: 1. Short-Acting Beta Agonists (SABA) (e.g., Albuterol) ○ MOA: Beta-2 receptor stimulation, leading to bronchodilation. ○ Therapeutic Use: Fast relief during acute asthma attacks. ○ Side Effects: Tachycardia, palpitations, nervousness. ○ Contraindications/Interactions: Caution in patients with heart disease or hyperthyroidism. 2. Inhaled Corticosteroids (ICS) (e.g., Fluticasone, Budesonide) ○ MOA: Anti-inflammatory, reduce airway inflammation by suppressing immune responses. ○ Therapeutic Use: Long-term control and prevention of asthma symptoms.  ○ Side Effects: Oral thrush, hoarseness, systemic side effects (if high doses). ○ Contraindications/Interactions: Avoid in active infections, caution in children (risk of growth retardation). 3. Leukotriene Receptor Antagonists (LTRA) (e.g., Montelukast) ○ MOA: Block leukotriene receptors, preventing bronchoconstriction and inflammation. ○ Therapeutic Use: Asthma maintenance therapy, especially for allergic asthma. ○ Side Effects: Headache, gastrointestinal disturbances. ○ Contraindications/Interactions: Avoid in patients with a history of neuropsychiatric events. 4. Long-Acting Beta Agonists (LABA) (e.g., Salmeterol) ○ MOA: Beta-2 receptor stimulation for sustained bronchodilation. ○ Therapeutic Use: Long-term asthma control in combination with ICS. ○ Side Effects: Tachycardia, tremors, paradoxical bronchospasm. ○ Contraindications/Interactions: Should not be used alone in asthma due to increased risk of exacerbations. 3. Pneumonia Pathophysiology: Pneumonia is an infection of the lungs that leads to inflammation in the alveoli, causing fluid accumulation and impaired gas exchange. ○ It can be caused by bacteria (e.g., Streptococcus pneumoniae), viruses (e.g., Influenza), or fungi. ○ Common symptoms: cough, fever, chills, difficulty breathing, and chest pain. Drugs Used:  1. Antibiotics (e.g., Penicillin, Macrolides) ○ MOA: Penicillin inhibits bacterial cell wall synthesis; Macrolides inhibit bacterial protein synthesis. ○ Therapeutic Use: Treatment of bacterial pneumonia. ○ Side Effects: Diarrhea, allergic reactions, liver toxicity. ○ Contraindications/Interactions: Penicillin contraindicated in patients with penicillin allergies. 2. Antivirals (e.g., Oseltamivir) ○ MOA: Inhibits neuraminidase, preventing viral replication in the host. ○ Therapeutic Use: Treatment of viral pneumonia, particularly influenza. ○ Side Effects: Nausea, headache, fatigue. ○ Contraindications/Interactions: Caution in renal impairment. 3. Oxygen Therapy ○ MOA: Provides supplemental oxygen to maintain adequate blood oxygen levels. ○ Therapeutic Use: Severe pneumonia to improve oxygenation. ○ Side Effects: Oxygen toxicity with prolonged use at high concentrations. Interesting Facts: COPD is a leading cause of death worldwide, and more than 90% of cases are related to smoking. Asthma affects 8-10% of the population, with children being especially vulnerable. Environmental triggers like dust mites and pollen can exacerbate symptoms. Pneumonia is responsible for 1 in 10 deaths worldwide, with elderly individuals being most at risk.