Pharmacology Chapter 37

COPD - asthma (persistent) emphysema chronic bronchitis bronchial asthma - - recurrent and reversible SOB - narrow lungs airway - airflow is obstructed (Sxs: wheezing, difficulty breathing) 4 categories of asthma - 1) intrinsic 2) extrinsic 3) exercise induced 4) drug induced intrinsic - occurring in patients with no Hx of allergies extrinsic - occurring in patients exposed to a known allergen emphysema - effective respiration is impaired chronic bronchitis - -continuous inflammation and low-grade infection of the bronchi. - excessive secretion of mucus - beware of prolonged exposure to bronchial irritants such as cig smoke 3 classes of bronchodilators - beta-adrenergic agonists anticholinergics xanthine bronchodilators: beta-adrenergic agonists ACTION - Only SABA are used during acute phase of asthmatic attacks -quickly reduce airway constriction and restore normal airflow short-acting beta agonist (SABA) inhalers - albuterol (Ventolin) levalbuterol (Xopenex) pirbuterol (Maxair) terbutaline (Brethine) metaproterenol (Alupent) long-acting beta agonist (LABA) inhalers NOT used during acute phase of asthmatic attacks - arformoterol (Brovana) formoterol (Foradil, Perforomist) salmeterol (Serevent) bronchodilators: beta-adrenergic agonists 3 types - 1) nonselective adrenergics 2) nonselective beta-adrenergics 3) selective beta2 drugs nonselective adrenergics - stimulate alpha, beta 1 (cardiac), and beta 2 (respiratory) receptors nonselective beta-adrenergics - stimulate both beta 1, and beta 2 receptors nonselective beta-adrenergics DRUG - metaproterenol selective beta2 - stimulate ONLY beta2 receptors selective beta2 drugs - albuterol beta-adrenergic agonists - dilation of the airways beta-adrenergic agonists: indications - bronchospasm r/t asthma, bronchitis, and other pulmonary diseases. - used in Tx and prevention of acute attacks - used in hypotension and shock beta-adrenergic agonists: contraindications - - known drug allergy - uncontrolled HTN - cardiac dysrhythmias - high risk of stroke (because of the vasoconstrictive drug action) beta-adrenergic agonists: alpha and beta (epinephrine) adverse effects - insomnia, restlessness, anorexia, vascular headache, hyperglycemia, tremor, cardiac stimulation beta-adrenergic agonists: beta 1 and beta 2 (metaproterenol) adverse effects - cardiac stimulation tremor