Respiratory System.pdf

Preface Agam is a group of budding medicos, who are currently doing their under graduation in various Medical Colleges across Tamil Nadu and Pondicherry. The group was initiated on 18th November 2017, in the vision of uniting medicos for various social and professional causes. We f...

Preface Agam is a group of budding medicos, who are currently doing their under graduation in various Medical Colleges across Tamil Nadu and Pondicherry. The group was initiated on 18th November 2017, in the vision of uniting medicos for various social and professional causes. We feel delighted to present you Agam pharmacology notes prepared by Agam Divide and Rule 2019 Team to guide our fellow medicos to prepare for university examinations. This is a reference work of 2017 batch medical students from various colleges. The team took effort to refer many books and make them into simple notes. We are not the authors of the following work. The images used in the documents are not copyrighted by us and is obtained from various sources. Dear readers, we request you to use this material as a reference note, or revision note, or recall notes. Please do not learn the topics for the 1st time from this material, as this contain just the required points, for revision. Acknowledgement On behalf of the team, Agam would like to thank all the doctors who taught us Pharmacology. Agam would like to whole heartedly appreciate and thank everyone who contributed towards the making of this material. A special thanks to Kareeshmaa H C, who took the responsibility of leading the team. Agam heartily thanks Bala Diwakar T, for his contribution towards making this material.  INDEX Chapter 1: Drugs for Cough and Bronchial Asthma. Essay 1. Bronchial Asthma Drugs Classification. Inhalation Steriods. Anti IgE Antibody…………… 1 Short Notes 2. Sympathomimetic Drugs……………………………… 4 3. Mechanism and Pharmacological Action of Methylxanthine……………………………………….. 5 4. Mast Cell Stabilizers……………………………………… 7 5. Treatment of Status Asthmaticus………………….. 8 Short Answers 6. 2 Opioid Antitussives…………………………………….. 9 7. 2 Leukotriene Antagonists…………………………….. 9  1 1. DRUGS FOR BRONCHIAL ASTHMA INHALATIONAL CORTICO STEROIDS (ICS) They are glucocorticoids with high topical and low systemic activity They have poor absorption and marked first pass metabolism It has been Advocated as step one for all the asthma patients to prevent bronchial remodeling but currently they are not necessarily used in mild and episodic asthma patients. Peak effect is seen after 4-7 days of administering ICS and the effects persists for few weeks after discontinuation. Dosage: initially 100 - 200µg BD, titrate dose upward for every 3 – 5 days, maximum dose of 400µg QID, beyond which no further benefit generally occurs. They are safe during pregnancy. Respiratory System Agam Pharmacology  2 FUNCTIONS: i. Suppress bronchial inflammation. ii. Increases the peak expiratory flow rate iii. Reduce need for β2 agonist inhalations iv. Prevent episodes of acute asthma ADVERSE DRUG EFFECTS: ▪ Hoarseness of voice ▪ Dysphonia ▪ Sore throat ▪ Symptomatic/ asymptomatic oropharyngeal candidiasis *prevention: ADR can be minimized by usage of spacers and gargling of mouth after every dose. Oral candidiasis can be prevented/ treated by topical nystatin or clotrimazole.* ▪ Dose> 600µg/day causes mood changes, osteoporosis, growth retardation in children, early cataract, etc. DRUGS ❖ Beclomethasone dipropionate: Effective in perennial rhinitis ❖ Budesonide: Non-halogenated glucocorticoid with high topical: systemic activity ratio They are preferred in severe cases Contraindicated in presence of nasal infection and nasal ulcers. ❖ Fluticasone propionate: High potency Respiratory System Agam Pharmacology  3 Longer duration Negligible oral bioavailability Preferred in patients requiring higher doses ❖ Flunisolide: Topical steroid used for prophylaxis and treatment of seasonal and perennial rhinitis. ❖ Ciclesonide: It is a prodrug that is cleaved by esterases in the bronchial epithelium to release the active moiety. Oral bioavailability