药理学英文PHARMACOLOGY9Respiratory Drugs

Drug List
Asthma Agents Bronchodilators
• albuterol (Proventil, Proventil HFA, Ventolin, Ventolin HFA)
• epinephrine (EpiPen) • formoterol (Foradil) • ipratropium (Atrovent) • ipratropium-albuterol (Combivent) • isoetharine (Beta-2)
treatment for it. **This is a medical emergency.**
Stepwise Approach to Asthma Therapy
Step 1. Short-acting oral or inhaled beta-2 agonist (less than once a week); no daily medications
• Causes self-sustaining inflammation
Asthmatic Response
Peak Flow Meter
• Assesses severity of disease and aids in determining course of therapy
• Measures maximum flow rate in forced expiratory maneuvers
• Be aware of the reemergence of tuberculosis and of treatment for this disease
Learning Objectives
• Understand how the antitussives, expectorants, decongestants, and antihistamines differ, and be able to describe their uses
each puff
Devices Used in Asthma Therapy
• Metered Dose Inhaler (MDI)
– Contains medication and compressed air – Delivers a specific amount of medication with
Goals of Asthma Care
• Sleep well every night • Be able to go to work or school every day • Be free from wheezing all day • Have good control of coughing • Be able to continue with activities and
Drug List
Asthma Agents Bronchodilators
• isoproterenol (Isuprel) • levalbuterol (Xopenex) • metaproterenol (Alupent) • pirbuterol (Maxair) • salmeterol (Serevent) • terbutaline (Brethine) • tiotropium (Spiriva)
• Intermittent attacks are precipitated by specific triggering events
• Causes a decrease in the amount of oxygen and carbon dioxide exchanged
Asthma Classes
Step 4. Short-acting oral or inhaled beta-2 agonist; daily medications; inhaled corticosteroid, long-acting bronchodilator, long-acting beta-2 agonist, and oral corticosteroids long term
• Allergic
– Present in 35%-55% of patients
Asthma Classes
• Allergic
– Present in 35%-55% of patients
• Exercise Induced
Asthma Classes
• Allergic
– Present in 35%-55% of patients
• Know why some drugs are prescribed for their side effects
• Outline smoking cessation plans and supportive therapy
Asthma
• Inflammatory disease that affects the airways causing a reversible airway obstruction
Chapter 9
Respiratory Drugs
Chapter 9 Topics
• Asthma • Emphysema • Other Lung Diseases • Cough and Cold • Smoking Cessation
Learning Objectives
• Differentiate the pulmonary diseases • Learn the pathophysiology and treatment of
• Exercise Induced
• Nonallergic
Upper and Lower Respiratory Tracts
Exchange of Oxygen and Carbon Dioxide
Asthma
• Asthmatic lung is more sensitive to lower doses of allergens
• Asthma has shown to have genetic predisposition
Asthma Characteristics
1. Reversible small airway obstruction 2. Progressive airway inflammation 3. Increased airway responsiveness to stimuli These characteristics translate into:
Stepwise Approach to Asthma Therapy
Step 3. Short-acting oral or inhaled beta-2 agonist; daily medications (e.g., inhaled corticosteroid and long-acting bronchodilator)
each puff
• Spacer
– Used with MDIs to help get medication into the lungs instead of depositing on the back of the throat
Devices Used in Asthma Therapy
Stepwise Approach to Asthma
Therapy
Step 3. Short-acting oral or inhaled beta-2 agonist; daily medications (e.g., inhaled corticosteroid and long-acting bronchodilator)
• Very effective
• Must be cleaned and taken care of to reduce risk of contamination
Devicesse Inhaler (MDI)
– Contains medication and compressed air – Delivers a specific amount of medication with
1. Wheezing 2. Dyspnea 3. Acute and Chronic Cough
Asthma Attack – 1st Response
• Triggered by an antigen-antibody reaction • Causes degranulation of mast cells:
albuterol before exercise gives protection for 2 hours
Devices Used in Asthma Therapy
Nebulizer
• Uses a stream of air that flows through liquid medication to make a fine mist to be inhaled
Stepwise Approach to Asthma Therapy
Step 1. Short-acting oral or inhaled beta-2 agonist (less than once a week); no daily medications
Step 2. Short-acting oral or inhaled beta-2 agonist (not to exceed three to four times in one day); daily medications (e.g., inhaled corticosteroids)
Asthma Drug Therapy
• Treatment should start at the most appropriate step • Start with an aggressive initial approach • Rescue corticosteroids may be used at any time • Treatment should be reviewed every 3-6 months • For exercise-induced asthma, using terbutaline or
exercise • Tolerate medicines well
Asthma Therapy
• Know the triggers and try to avoid them • Accurately use a Peak Flow Meter regularly • Be aware of status asthmaticus and the
• Dry powder inhalers
– Starting to replace MDIs – The patient turns the dial and a capsule full of
powder is punctured – The patient then inhales the powder
asthma • Define the goals of asthma treatment • Discuss the pathophysiology and treatment
of emphysema and chronic bronchitis
Learning Objectives
• Describe other diseases related to the lungs
histamine released • Results in bronchospasm and mucus
production that plugs the small airways
Asthma Attack – 2nd Response
• Bronchoconstriction with delayed, sustained reactions