[os 213] Lec 03 Drugs Acting On The Respiratory System (1)-1

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OS 213: Human Disease and Treatment 3 (Circulation and Respiration) LEC 03: Drugs Acting on the Respirator Sstem • O!"ecti#es • • • • • • Undestand t!e pharmacologic basis o" dugs used in COPD and ASTHMA Management o" ot!e causes o" cough, congestion and mucus problems TO ACH$%&% O'T$A TH%RA'*  Di#eentiate Relievers vs controllers  $G!A "##$% Undestand t!ea%& o" C'(D )ocus: TR%AT%+T O, +O+ $+,%CT$O-S R%S'$RATOR* CO+D$T$O+S • • $. /RO+CHOS'AST$C CO+D$T$O+S COO COO+ + DR-0 DR-0S S 0$&% 0$&%+ + ,OR ,OR ASTH ASTHA A A+D A+D CO'D /ronchodilators 1. 4ad 4adre rene nerg rgic ic agon agonis ists ts SA/A5 A/A Antic Anticho holi line nerg rgic ic agent agents s SAA5 AA eth ethl l6a 6ant nthi hine ne (theophlline) * Short acting (aminophlline theophlline) ong Acting (Do6o7lline) • 2. • 3. • Antiinammator Drugs  Antimediator Drugs 1. Corticosteroids +!en s&ste s&stemic mical all& l& gien, gien, !ig! dose- eliees n!aled, lo/-dose- contolles 2. eu8otriene inhi!itors s% 3. Cromones * e s% t!ose /it! alleg& & disease modi'(ing • AD6 AD6 o" "e7 "e7ue uent nt use use o" elie eliee es s incl nclude ude !&%o8 !&%o8ale alemia mia and a!&t a!&t!mi !mia, a, /!ic! /!ic! ma& esult esult to deat!. 6eliees must e used to inteene and eese t!ese c!anges. " not used eal&, moe %otent dugs must e used to eese c!anges. *Asthma is !OT a  progressive disease, unli)e COPD+ ' given proper  manage managemen ment, t, it ma( revert revert to normal normal++ n betee beteen n attac)s, pulmonar( 'unctions are normal+% 9ist 9istol olog ogic ic $4ai $4ai/ /a& a& emo emode deli ling ng5 5,, ai/ ai/a& a& occlusion due to: mucous %lugs $ell& lungs o mucosal and sumucosal edema o o smoot! muscle !&%eto%!& o t!ic8ening o" asement memane o !&%eto%!& o" sumucous glands ,unctional hper hper reac reacti ti#e #e air9 air9a as $dug: o $dug: Anti Anti inam coticosteoids coticosteoids #aria #aria!l !le e air9 air9a a o!st o!stru ruct ctio ion n $dug: o ;onc!odilatos • • ASTHMA, COPD *ORMAL *ORM AL AIR+A AIR+AS S (ABN PULM N!RMAL PULM! FXN FXN =>S/S) (Pul"onar#COUGH/COLD $o"eo%ta%i% ) $o"eo%ta%i%) disorders THERAPEUTICS GOAL: Relief, Restoration, Cure!" Dru# R$: %asi& ' Clini&al P(ar) Non-Drug Rx, Alternatie Rx /. CHRO+$C O/STR-CT$&% '-O+AR*  '-O+AR*  D$S%AS% • 0el7orming mucins ae %oduced & golet cells and mucous cells • n !ealt!, t!ese cells ae "ound in lage ai/a&s, s%ase in small ai/a&s 0o!let cells cells increa increase se in num!er num!er5 mucous mucous cells cells • 0o!let increase in sie • (atients usuall& com%lain o" c!onic s%utum %oduction •End esult: impaired mucociliar clearance  $teminal and es%iato& onc!ioles ae not cleaed & coug! o ncreased mucus secretions Ta!le 1. Comparison o7 asthma and CO'D Similarit  Di;eren ce A. AST ASTHA HA • • A %ulm %ulmon ona a& & diso disod de e asso associ ciat ated ed /it! /it! an inammator inammator  response response to a ai aiet et& & o" "act "acto os s $triggers * e.g. antigens, stess and execise execise o contro controll trigge triggers rs  contr control ol respons response e  avoid asthmatic attac)  Stre Stress ss  increases increases glucocort glucocorticoi icoids ds but  o still induces asthma c!aa !aac ctei tei ed & inc inceas eased %ul %ulmona mona& & inammati inammation on "ollo/ed "ollo/ed & onc!ial onc!ial !&%e- !&%e-eacti eactiit& it& and and een eentu tual all& l&,, dec decea ease sed d lung lung "unc "uncti tion on due due to $due to on onc! c!ia iall musc muscle le air9a air9a  narro9 narro9ing ing $due conges esti tion on and and edem edema a  $4ai/a& cont conta act ctio ion n,, cong emodeling5 /!ic! can e eesile STR-CT-RA A+D ,-+CT$O+A CHA+0%S $+ ASTHA • C!anges ae cumulatie and ae n ot MAIN DIFFERE NCE Asthma CO'D ;ot! ae c!aacteied & ai/a& nao/ing seconda& to c!onic inammation ineate  >eated d coectl&,  ?ou  ?ou can nee go ac8 ac8 to can can go ac8 ac8 to aseline nomal nomal $'%RA+%+T A+D (R%&%RS$/%) 'RO0R%SS$&%) C. $-+O'ATHO0%+%S$S O, ASTHA A+D CO'D