Drugs affecting the Respiratory System

4 phases of Respiratory System

1. Breathing
2. External Respiration
3. Internal Respiration
4. Cellular Respiration
Divided into 2:
 Upper respiratory system
 Lower respiratory system
Nose > pharynx > larynx > trachea > bronchus > bronchioles > lungs
Bronchodilators
 Works directly to the lungs and heart of patient
 Activates B2 (lungs) B1 (heart)
 Dilate lungs and heart so that patient can breathe normally

 BETA II- ADRENERGIC AGONIST

 Used to treat symptoms associated with asthma and chronic obstructive pulmonary disease (COPD)
 Short-acting beta2-adrenergic agonists include:
o Albuterol (systemic, inhalation)
o Levalbuterol (inhalation)
o Metaproterenol (inhalation)
o Pirbuterol (inhalation)
o Terbutaline (systemic)
 Long-acting beta2-adrenergic agonists include:
o Formoterol (inhalation)
o Salmeterol (inhalation)
 ANTIHISTAMINE
 are drugs which Great allergic rhinitis and other allergies. Typically, people take antihistamines as
inexpensive, generic, Over-the-counter drug then provide relief from nasal congestion, sneezing or hives
caused by pollen, dust mite, or animal allergy with fewer side effects.
 Decrease the nasal itching and tickling that causes sneezing.
 Drug of choice: rhinitis caused by the common cold
 First generation antihistamine: Diphenhydramine
 Side effects:
o Drowsiness
o dry mouth and other Anti-cholinergic symptoms (dehydrating) NI: Give medicine before bedtime
 Second Generation antihistamine “non-sedating antihistamine”:
o Cetirizine
o Fexofenadine
o Loratadine
 CORTICOSTEROIDS
 noninflammatory drugs
 examples:
o beclomethasone dipropionate
o budesonide
o flunisolide
o fluticasone
o triamcinolone acetonide
 Oral corticosteroids include:
o Prednisolone
 o Prednisone
 IV corticosteroid include:
o hydrocortisone sodium succinate
o methylprednisolone sodium succinate
 LEUKOTRIENE MODIFIERS
 are used for the prevention and long-term control of mild asthma
 Leukotriene receptor antagonists include:
o Montelukast
o Zafirlukast
 Leukotriene formation inhibitors include
o Zileuton
 METHYLXANTHINES
 also called xanthines
 “lline” drugs
 Used to treat respiratory disorders
 Theophylline is the most Commonly prescribed oral methylxanthines.
 Aminophylline is preferred when an IV methylxanthines is required
 MUCOLYTIC
 act directly on mucus, breaking down sticky, thick secretions so that they’re more easily eliminated.
 Drug: Acetylcysteine
 NASAL AND SYSTEMIC DECONGESTANTS
 nasal congestion results from dilation of nasal blood vessels cause by infection, inflammation or allergy.
Nasal decongestants stimulate the alpha-adrenergic receptors, producing vascular contraction of the
capillaries within the nasal mucosa.
1. SYMPATHOMIMETIC DRUGS
 systemic decongestants stimulate the sympathetic nervous system to reduce swelling of the
respiratory tract’s vascular network. Systemic decongestants include:
o ephedrine
o phenylephrine
o pseudoephedrine
2. TOPICAL DECONGESTANTS
 They provide immediate relief from nasal congestion
 Examples:
o ephedrine, epinephrine, and phenyleprine (sympathomimeticasmines)
o naphazoline and tetrahydrozoline (imidazoline derivatives of sympathomimetic amines)
 ANTITUSSIVE
 Act on the cough-control center in the medulla to suppress the cough reflex
o Benzonatate
o Codeine
o Dextromethorphan
o hydrocodone bitartrate
 EXPECTORANTS
 Loosen bronchial secretions so that they can be eliminated by coughing
 The most common expectorant include:
o guaifenesin

Summary of Respiratory Drugs

 BRONCHIOLES ANTI-INFLAMMATORY
AGENT
B-BETA 2 drugs S-STEROID
 “terol” drugs  “sone” drugs
 acts directly on heart and lungs  cause smooth muscles to relax. Slow acting.
Act directly on adrenal gland
A-ANTICHOLINERGIC AGENT L-LEUKOTRINE
 “pium” drugs  “Lukast” drugs
 decrease mucus production  decrease the inflammation
M-METHYLXANTHINES DRUG M-MAST CELLS STABILIZER
 “phylline” drugs  “cromolyn”
 Increase HR and opens up the lungs  open the blood vessel and decrease the
accumulation of blood thus decrease swelling

BRONCHIOLES (BRONCHODILATORS)
1. B- B2 AGONIST
 treatment for asthma
 AIM (step for acute asthma attack)
 “Albuterol”
 Ipratropium
 Methyl-prednisolone (solu medrol)
 MONITOR 3 T:
 Tachycardia (Palpitation)
 Tremors
 Toss and turning at night (don’t give at nighttime)
 NURSING INTERVENTIONS:
• advice to shake medicines before using (spray)
• advice to inhale drugs and hold for 3 seconds
• Cleaning: 1-2 times per week with warm water
2. A- ANTICHOLINERGIC AGENTS
 “Ipratropium”
 treatment for moderate to sever asthma and COPD
o SIDE EFFECT (“CANT PEE WITH THEM”):
• dehydrates the patient (dries out the body)
• dry mouth (NI: Offer gum or candy)
• hoarseness (NI: Offer gum or candy)
 Administered through inhalation (never to be swallowed)
3. M- METHYLXANTHINE
 “Theophylline”
 increases heart rate- advice to decrease intake of caffeinated drug
 Key points to remember (3T’s)
• Toxicity- level of theophylline is more than 20 mcg/ml
• Tonic clonic seizure- Priority (provide seizure free environment)
• Tachycardia and dysrhythmias- changes of heart activity
 should not be administered with Beta Blockers
 NURSING INTERVENTIONS:
• Take the medication in morning
• avoid caffeinated drinks
• stop before cardiac stress test
ANTI-INFLAMMATORY DRUGS
1. S-STEROID
 “Beclomethasone”- act to decrease swelling
 4S
• Swelling and inflammation (respiratory system)
• slow onset- not a drug for acute asthma attack
• sugar level will rise- less fatty food, sweets, and caffeinated beverages
• sores in the mouth- oral hygiene (use spacers)
 Rinse mouth after use
 Clean (inhaler): daily with water
2. L-LEUKOTRIENE MODIFIERS
 “Montelukast”- prevention for asthma attack
 3L
• Luke like to sing (opens airway)
• Long term management
• Long onset (1-2 week to reach therapeutic range)
3. M-MAST CELL STABILIZER (cromolyn)
 act directly on your blood vessel
 block massive inflammation
 decrease swelling
 Key points:
• prevents activity induced asthma
• take medication 15mins before exertion
• use 10-15mins before physical activity