Respiratory therapy drugs

– Used systemically to increase blood pressure •  Agents - Increase heart rate and – Relaxation of bronchial smooth muscle
– Some inhibition of inflammatory mediator – Relaxation of vascular smooth muscle – Relaxation of other smooth muscle (e.g. • Useful as a tocolytic agent (terbutaline) • L-Epinephrine (Adrenalin):  ,  ,  – given SC for asthma attack (esp. pediatrics) • D, L-Epinephrine or Racemic Epinephrine (Vaponefrin, MicroNefrin):  ,  ,  • Isoproterenol (Isuprel): ( ),  ,  – actually a prodrug (inactive) that is converted to colterol (a  specific catecholamine) (5-8) • Metaproterenol (Alupent, Metaprel): ( ), • Terbutaline (Bricanyl, Brethine): 2 • Albuterol (Ventolin, Proventil):  – not useful in acute attack, a maintenance bronchodilator – not recommended for rescue due to cumulation • Phenylephrine (Neo-Synephrine):  , Belladonna alkaloids (tertiary amines) : botanical derivatives from Atropa belladonna (Nightshade), Datura spp (Family: Solanaceae) – drying effect on secretions – CNS effects – Other side effects • preanesthetic agent • motion sickness • does not readily cross blood:brain barrier - reduced – May work by combining with adenosine – inhibit release of allergic mediators – respiratory stimulant - increasing CO sensitivity of medullary respiratory centers – increase diaphragmatic contractility • dilation of renal blood vessels, increase urine • constriction of cerebral blood vessels • stimulation of ventilatory, cardiac, and vasomotor • Increased glandular secretion and increased motility – therapeutic serum level 10-20 g/ml – cardiac arrythmias & seizures: >40 g/ml • Metabolized by liver (hepatic microsomal – cirrhosis, CHF, etc. decrease hepatic blood flow – Drugs that damage liver (e.g. erythromycin, • Theophylline: Aerolate, Elixophyllin, Slo- ethylenediamine): Aminophyllin, Somophyllin – glucocorticoids (hydrocortisone or cortisol) – gonadocorticoids (anabolic steroids) • Mineralocorticoids: ↑ Na+, ↓ K+, fluid • Glucocorticoids: gluconeogenesis → ↑ • Mineralocorticoids: ↓ Na+, ↑ K+, rapid diuresis → renal suppression, ↓ blood pressure, arrythmias, death • Glucocorticoids: ↓ glucose, usually • Cushingoid Effects
• Addisonian Effects
– thin, fragile, dry, parchment- like skin – osteoporosis & vertebral compression • Abrupt withdrawal → Addisonian crisis – Hydrocortisone (Cortisol): Solu-Cortef – Methylprednisolone: Medrol (Oral), Solu- – Prednisone: Colisone, Deltasone, Winpred – Dexamethasone: Decadron (Oral, IM, IV, Nasal MDI), Hexadrol (Oral, IM, IV), Dexasone (Oral) • Beclomethasone: Beclovent, Vanceril (Oral MDI & DPI); Beconase, Vancenase (Nasal MDI) • Flunisolide: Bronalide, AeroBid (Oral • Fluticasone: Flovent (Oral MDI), Flonase • Action: stabilizes mast cells, preventing – Nasalcrom: nasal solution for prophylaxis of – Opticrom: seasonal allergic conjunctivitis – No role in treatment of acute bronchospasm – Prophylaxis of asthma (esp. allergic); 6 to 12 – Prevention of cold air and exercise-induced • Throat irritation: dryness, hoarseness, coughing • Action: blocks production of inflammatory • Action: inhibits formation of leukotrienes • Action: competitive, reversible antagonist • Action: competitive, reversible antagonist of the • Action: ruptures disulfide bonds of glycoproteins • Effectiveness: best when given by direct instillation, especially via bronchoscope. • Adverse effects: bronchospasm, “rotten egg” odor • Precautions: administer with a bronchodilator • Action: hygroscopic agent - absorbs water & • Bacteriostatic: not suitable for sputum induction for sputum induction intended for C & S • Action: weakens saccharide side chains of • Effective against infected sputum in cystic

Source: http://www.crcresources.com/files/respiratory_therapy_drugs.pdf