pharmacology

drugs for Disorders of the
Respiratory System
PREFERRED DRUGS USED TO TREAT ASTHMA
A. Pathophysiology of asthma
B. Goals of therapy

C. ?2-Adrenergic agonists
Short-acting ?2 agonists
Long-term control
Corticosteroids
Actions on lung: Inhaled corticosteroids (ICS) do not directly affect the airway smooth
muscle. Instead, ICS therapy directly targets underlying airway
inflammation by decreasing the inflammatory cascade (eosinophils,
macrophages, and T lymphocytes), reversing mucosal
edema, decreasing the permeability of capillaries, and inhibiting
the release of leukotrienes. After several months of regular use,
ICS reduce the hyperresponsiveness of the airway smooth muscle
to a variety of bronchoconstrictor stimuli, such as allergens, irritants,
cold air, and exercise

Routes of administration

a. Inhalation: The development of ICS has markedly reduced the
need for systemic corticosteroid treatment to achieve asthma
control. However, as with all inhaled medications, appropriate
inhalation technique is critical to the success of therapy (see
section on Inhaler Technique).
b. Oral/systemic
Adverse effects
ALTERNATIVE DRUGS USED TO TREAT ASTHMA
A. Leukotriene modifiers
Leukotrienes (LT) B4 and the cysteinyl leukotrienes, LTC4, LTD4,
and LTE4, are products of the 5-lipoxygenase pathway of arachidonic
acid metabolism and part of the inflammatory cascade.
5-Lipoxygenase is found in cells of myeloid origin, such as mast
cells, basophils, eosinophils, and neutrophils
1. Pharmacokinetics:
2. Adverse effects

B. Cromolyn
C. Cholinergic antagonists
D. Theophylline
E. Omalizumab

DRUGS USED TO TREAT CHRONIC OBSTRUCTIVE
PULMONARY DISEASE

A. Bronchodilators
B. Corticosteroids
C. Other agents
Roflumilast

INHALER TECHNIQUE
A. Metered-dose inhalers and dry powder inhalers
B. Spacers

DRUGS USED TO TREAT ALLERGIC RHINITIS
A. Antihistamines (H1-receptor blockers)
B. Corticosteroids
C. ?-Adrenergic agonists
D. Other agents
Intranasal cromolyn