Scribd
Upload
20 views33 pages

Respiratory System

Pharmacology

Uploaded by

mojzob345
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
20 views33 pages

Respiratory System

Pharmacology

Uploaded by

mojzob345
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 33

‫ﺑﺴﻢ ﷲ اﻟﺮﺣﻤﻦ اﻟﺮﺣﯿﻢ‬

Alzaiem Alazhari University AAU


Faculty of Radiological Sciences& Medical Imaging
SEM.5
Lecture 6

Ejlal Abdallah Abdallah Abdallah


B. Pharm., M. Pharm., Pharmacology
[email protected]
Department of Pharmacology
Respiratory system
Regulation of airway muscle, blood vessels
and glands
 Autonomic Innervation:

 Parasympathetic innervation:

 M3 bronchoconstriction and mucus secretion.


 Sympathetic innervation
• β2 relax bronchial smooth muscle.
Pulmonary Disease and its Treatment
• Common symptoms of pulmonary disease include:

• Shortness of breath, wheeze, chest pain and cough with or


without sputum production or haemoptysis (blood in the
sputum).

• The two important diseases of the airways:

• Asthma.

• COPD.
Bronchial Asthma

• Asthma is defined as recurrent reversible airway obstruction,


with attacks of wheeze, shortness of breath and, often,
nocturnal cough.

• Severe attacks (also known as status asthmaticus) cause


hypoxaemia and are life-threatening.
Drugs Used to Treat and Prevent Asthma

• Antiasthmatic drugs include:

• 1.Bronchodilators (reverse the bronchospasm of the


immediate phase).

• 2.Anti-inflammatory agents (inhibit or prevent the


inflammatory components of both phases).
Bronchodilators

• They include:

1. β2-adrenoceptor agonists (The main drugs used as


bronchodilators).

2. Methylxanthines(Theophylline).

3. Cysteinyl leukotriene receptor antagonists.

4. Muscarinic receptor antagonists:Ipratropium.


1. Short-acting agents
• E.g. salbutamol and terbutaline.

• Given by inhalation.

• They act immediately, peaking within 30 min and the duration

of action is 3–5 h.

• Clinical uses: They are usually used on an ‘as needed’ basis to

control symptoms.
2. Longer-acting agents
• E.g. Salmeterol and Formoterol.

• Given by inhalation.

• Duration of action is 8–12 h.

• Clinical uses: They are not used ‘as needed’ but are given

regularly, twice daily, as adjunctive therapy in patients whose

asthma is inadequately controlled by glucocorticoids.


Unwanted effects

• The unwanted effects of β2-adrenoceptor agonists result from


systemic absorption, the commonest adverse effect is tremor.

• Other unwanted effects include: tachycardia and cardiac


dysrhythmia.
Anti-inflammatory Agents

• Glucocorticoids:

• are the main drugs used for their anti-inflammatory action in


asthma.

• They are not bronchodilators, but prevent the progression of


chronic asthma and are effective in acute severe asthma.
• The main compounds used are beclometasone, budesonide,

fluticasone, mometasone and ciclesonide.

• These are given by inhalation with a metered-dose or dry-

powder inhaler.

• There are now several inhaler formulations where inhaled

corticosteroids are combined together with long-acting β2-

adrenoceptor agonists.
• Oral glucocorticoids are reserved for patients with the

severest disease.
Severe Acute Asthma (Status Asthmaticus)
• Severe acute asthma is a medical emergency requiring
hospitalisation.

• Treatment includes:

• Oxygen (in high concentration).

• Inhalation of nebulised salbutamol with ipratropium.

• Intravenous hydrocortisone followed by a course of oral


prednisolone.
Additional measures

• Occasionally used include:

• Intravenous salbutamol or aminophylline.

• Intravenous magnesium (considered to have bronchodilator


effects).

• Antibiotics (if bacterial infection is present).

• Monitoring.
Allergic Emergencies

Anaphylaxis and angio-oedema are emergencies involving

acute airways obstruction.

Aadrenaline (epinephrine) is potentially life-saving.

It is administered intramuscularly (or occasionally

intravenously, as in anaphylaxis occurring in association with

general anaesthesia).
Patients at risk of acute anaphylaxis, for example, from food

or insect sting allergy.

 Oxygen, an antihistamine such as chlorphenamine and

hydrocortisone are also indicated.


Anaphylactic shock

 Systemic changes in anaphylaxis resemble those produced


following an injection of histamine.

 The antigen reacts with a specific class of antibody,


reaginic: antibodies (IgE), bound to the mast cell surface.
Interaction of antigen with these antibodies increases the
cell membrane permeability.
 Thus, anaphylaxis in man is associated with an explosive
degranulation of the mast cells and massive release of
histamine.

Many drugs, sera, chemicals are capable of causing allergic


and/or anaphylactic reactions.
Treatment of anaphylactic shock

Anaphylaxis is medical emergency and needs immediate


treatment.

• 1. Administration of adrenaline: produces a dramatic


reversal of hypotension, bronchospasm and laryngeal edema
and is life-saving in this condition.
• 2. Administration of fluids: hypotension associated with
anaphylactic shock should be corrected by immediate
administration of large quantities of fluids (normal saline and
colloids) intravenously. If necessary, norepinephrine can be
infused intravenously.
• 3.Corticosteroids: corticosteroids are routinely administered
in the treatment of anaphylactic shock. Hydrocortisoneis
given intravenously, followed latter by oral predrisolone.

• 4. Antihistamine drugs: the antihistaminic drugs are not very


useful as they are unable to counter the hypotension and
bronchospasm characteristic of anaphylactic shock.
• This may be attributed to involvement of substances other
than histamine in the genesis of anaphylactic shock.

• Other supportive measures include administration of oxygen


and artificial respiration if necessary.
Assignment

Angio-oedema is the intermittent occurrence of focal


swelling of the skin or intra-abdominal organs caused by
plasma leakage from capillaries.

It can be caused by drugs, especially angiotensin-converting


enzyme inhibitors
break
Bronchial Asthma
• Asthma affects about 8% of the population.
• It is an inflammatory condition in which there is recurrent
reversible airways obstruction in response to irritant stimuli
that are too weak to affect non-asthmatic subjects.
• Reversibility of airways obstruction in asthma contrasts with
COPD, where the obstruction is either not reversible or at
best incompletely reversible by bronchodilators.
Chronic Obstructive Pulmonary Disease
(COPD)
• is a major global health problem,current projections suggest
that it will be the third commonest cause of death within 3
years.
• Is a term for two respiratory illnesses chronic bronchitis and/or
emphysema, in technical terms, COPD is a slowly progressive
disease that is characterized by a decrease in the ability of the
lungs to maintain the body’s oxygen supply and remove carbon
dioxide.
Cause of COPD

• Cigarette, Pipe, cigar and other types of tobacco smoking.


Passive exposure to cigarette smoking, occupational dusts and
chemicals.

• Air pollution and Genetic factors (less than 5% of cases).


Cigarette smoking is the leading cause of COPD and has been
implicated in 80% to 90% of cases.
Principles of treatment

Stopping smoking slows the progress of COPD.

Patients should be immunised against influenza and

Pneumococcus, because superimposed infections with these

organisms are potentially lethal.

No medications have been found to cure the disease or

reverse the loss of lung infection caused by smoking.


Inhaled steroids do not influence the progressive decline in

lung function in patients with COPD, but do improve the

quality of life, probably as a result of a modest reduction in

hospital admissions.

Long-acting bronchodilators give modest benefit, but do not

deal with the underlying inflammation.


No currently licensed treatments reduce the progression of

COPD or suppress the inflammation in small airways and

lung parenchyma.
Have a nice day

You might also like