Respiratory Pharmacology
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Respiratory Pharmacology
There are several categories of respiratory drugs, each specific to a drug's purpose and mode of action. The following is a list of key pharmaceuticals in the prevention and treatment of respiratory-related ailments. Adrenergic (Sympathomimetic) Bronchodilators Ultra Short-Acting *Epinephrine *Racemic epinephrine *Isoetharine Short-Acting *Metaproterenol *Albuterol *Pirbuterol *Levalbuterol Long-Acting *Salmeterol *Formoterol * Arformoterol Anticholinergic (Parasympatholytic) Bronchodilators *Ipratropium bromide *Tiotropium bromide Xanthines * Theophylline * Oxtriphylline *Aminophylline *Dyphylline Mucus-controlling agents * Acetylcysteine (10%,20%) * Dornase alfa * Hypertonic saline (3-10%) Surfactants *Beractant * Calfactant *Poractant alfa Corticosteroids * Beclomethasone (dipropionate) *Triamcinolone acetonide * Flunisolide (hemihydrate) * Fluticasone (propionate) * Budesonide *Mometasone furoate Nonsteroidal Antiasthma agents Cromolyn-like ag ...
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Adrenergic Bronchodilator
Beta2-adrenergic agonists, also known as adrenergic β2 receptor agonists, are a class of drugs that act on the β2 adrenergic receptor. Like other β adrenergic agonists, they cause smooth muscle relaxation. β2 adrenergic agonists' effects on smooth muscle cause dilation of bronchial passages, vasodilation in muscle and liver, relaxation of uterine muscle, and release of insulin. They are primarily used to treat asthma and other pulmonary disorders, such as Chronic obstructive pulmonary disease (COPD). Mechanism of action Activation of β adrenergic receptors leads to relaxation of smooth muscle in the lung, and dilation and opening of the airways. β adrenergic receptors are coupled to a stimulatory G protein of adenylyl cyclase. This enzyme produces the second messenger cyclic adenosine monophosphate (cAMP). In the lung, cAMP decreases calcium concentrations within cells and activates protein kinase A. Both of these changes inactivate myosin light-chain ki ...
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Aminophylline
Aminophylline is a compound of the bronchodilator theophylline with ethylenediamine in 2:1 ratio. The ethylenediamine improves solubility, and the aminophylline is usually found as a dihydrate. Aminophylline is less potent and shorter-acting than theophylline. Its most common use is in the treatment of airway obstruction from asthma or COPD. Aminophylline is a nonselective adenosine receptor antagonist and phosphodiesterase inhibitor. Medical uses Intravenous aminophylline can be used for acute exacerbation of symptoms and reversible airway obstruction in asthma and other chronic lung disease such as COPD, emphysema and chronic bronchitis. It is used as an adjunct to inhaled beta-2 selective agonists and systemically administered corticosteroids. Aminophylline is used to reverse regadenoson, dipyridamole or adenosine based infusions during nuclear cardiology stress testing. Aminophylline has also been reported to be effective in preventing slow heart rates during complex cardiov ...
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Cromoglicic Acid
Cromoglicic acid (INN)—also referred to as cromolyn (USAN), cromoglycate (former BAN), or cromoglicate—is traditionally described as a mast cell stabilizer, and is commonly marketed as the sodium salt sodium cromoglicate or cromolyn sodium. This drug prevents the release of inflammatory chemicals such as histamine from mast cells. Cromoglicic acid has been the non- corticosteroid treatment of choice in the treatment of asthma, for which it has largely been replaced by leukotriene receptor antagonists because of their convenience (and perceived safety). Cromoglicic acid requires administration four times daily, and does not provide additive benefit in combination with inhaled corticosteroids. History Cromolyn sodium was discovered in 1965 by Roger Altounyan, a pharmacologist who had asthma. It is considered a breakthrough drug in management of asthma, as the patients can be freed from steroids in many cases; however, it is mainly effective as a prophylaxis for allergic and ...
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Mometasone Furoate
Mometasone, also known as mometasone y 3 s, is a glucocorticoid, steroid medication used to treat certain skin conditions, hay fever, and asthma. Specifically it is used to prevent rather than treat asthma attacks. It can be applied to the skin, inhaled, or used in the nose. Mometasone furoate, not mometasone, is used in medical products. Common side effects when used for asthma includes asthma and Candidiasis, thrush. It is therefore recommended to rinse the mouth after use. Long term use may increase the risk for glaucoma and cataracts. Common side effects when used in the nose includes upper respiratory tract infections and nose bleeds. Common side effects when applied on the skin include acne, skin atrophy, and itchiness. It works by decreasing inflammation. Mometasone furoate was patented in 1981 and came into medical use in 1987. It is on the WHO Model List of Essential Medicines, World Health Organization's List of Essential Medicines. It is available as a generic medic ...
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Budesonide
Budesonide, sold under the brand name Pulmicort among others, is a medication of the corticosteroid type. It is available as an inhaler, nebulization solution, pill, nasal spray, and rectal forms. The inhaled form is used in the long-term management of asthma and chronic obstructive pulmonary disease (COPD). The nasal spray is used for allergic rhinitis and nasal polyps. The pills in a delayed release form and rectal forms may be used for inflammatory bowel disease including Crohn's disease, ulcerative colitis, and microscopic colitis. Common side effects with the inhaled form include respiratory infections, cough, and headaches. Common side effects with the pills include feeling tired, vomiting, and joint pains. Serious side effects include an increased risk of infection, loss of bone strength, and cataracts. Long-term use of the pill form may cause adrenal insufficiency. Stopping the pills suddenly following long-term use may therefore be dangerous. The inhaled form is genera ...
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Fluticasone
Fluticasone is a manufactured glucocorticoid used to treat nasal symptoms. Both the esters, fluticasone propionate (a brand name for which is Flovent) and fluticasone furoate, are also used as topical anti-inflammatories and inhaled corticosteroids, and are used much more commonly in comparison. It is on the World Health Organization's List of Essential Medicines. In 2020, it was the 23rd most commonly prescribed medication in the United States, with more than 24million prescriptions, although it is also sold over the counter. See also * Fluticasone furoate ** Fluticasone furoate/vilanterol * Fluticasone propionate ** Fluticasone/salmeterol Fluticasone/salmeterol, sold under the brand name Advair among others, is a fixed-dose combination medication containing fluticasone propionate and salmeterol. It is used in the management of asthma and chronic obstructive pulmonary disease (C ... References External links * Antiasthmatic drugs Diketones Diols Dr ...
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Flunisolide
Flunisolide (marketed as AeroBid among others) is a corticosteroid often prescribed as treatment for allergic rhinitis. Intranasal corticosteroids are the most effective medication for controlling symptoms. The principal mechanism of action of flunisolide is to activate glucocorticoid receptors, meaning it has an anti-inflammatory action. The effects of topical corticosteroids is not immediate and requires regular use and at least a few days to start experiencing noticeable symptom relief. As-needed use has been shown to be not as effective as regular recommended use. Flunisolide should not be used in the presence of nasal infection. It should not be continued if there is no relief of symptoms after regular use over two to three weeks. It was patented in 1958 and approved for medical use in 1978. It is on the World Health Organization's List of Essential Medicines. Side effects Temporary nose and throat dryness, irritation, bleeding or unpleasant taste or smell may occur. ...
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Triamcinolone
Triamcinolone is a glucocorticoid used to treat certain skin diseases, allergies, and rheumatic disorders among others. It is also used to prevent worsening of asthma and COPD. It can be taken in various ways including by mouth, injection into a muscle, and inhalation. Common side effects with long-term use include osteoporosis, cataracts, thrush, and muscle weakness. Serious side effects may include psychosis, increased risk of infections, adrenal suppression, and bronchospasm. Use in pregnancy is generally safe. It works by decreasing inflammation and immune system activity. Triamcinolone was patented in 1956 and came into medical use in 1958. It is available as a generic medication. In 2020, it was the 106th most commonly prescribed medication in the United States, with more than 6million prescriptions. Medical uses Triamcinolone is used to treat a number of different medical conditions, such as eczema, alopecia areata, lichen sclerosus, psoriasis, arthritis, allergie ...
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Beclometasone Dipropionate
Beclomethasone, also known as beclomethasone dipropionate, and sold under the brand name Qvar among others, is a corticosteroid, steroid medication. It is available as an inhaler, cream, pills, and nasal spray. The inhaled form is used in the long-term management of asthma. The cream may be used for dermatitis and psoriasis. The pills have been used to treat ulcerative colitis. The nasal spray is used to treat allergic rhinitis and nasal polyps. Common side effects with the inhaled form include Respiratory tract infection, respiratory infections, headaches, and throat inflammation. Serious side effects include an increased risk of infection, cataracts, Cushing's syndrome, and anaphylaxis, severe allergic reactions. Long-term use of the pill form may cause adrenal insufficiency. The pills may also cause mood or personality changes. The inhaled form is generally regarded as safe in pregnancy. Beclometasone is mainly a glucocorticoid. Beclomethasone dipropionate was first patented ...
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Corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are involved in a wide range of physiological processes, including stress response, immune response, and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior. Some common naturally occurring steroid hormones are cortisol (), corticosterone (), cortisone () and aldosterone (). (Note that cortisone and aldosterone are isomers.) The main corticosteroids produced by the adrenal cortex are cortisol and aldosterone. Classes * Glucocorticoids such as cortisol affect carbohydrate, fat, and protein metabolism, and have anti-inflammatory, immunosuppressive, anti-proliferative, and vasoconstrictive effects. Anti-inflammatory effects are mediated by blocking the action of inflammatory medi ...
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Pulmonary Surfactant
Pulmonary surfactant is a surface-active complex of phospholipids and proteins formed by type II alveolar cells. The proteins and lipids that make up the surfactant have both hydrophilic and hydrophobic In chemistry, hydrophobicity is the physical property of a molecule that is seemingly repelled from a mass of water (known as a hydrophobe). In contrast, hydrophiles are attracted to water. Hydrophobic molecules tend to be nonpolar and, t ... regions. By adsorption, adsorbing to the air-water Interface (chemistry), interface of pulmonary alveolus, alveoli, with hydrophilic head groups in the water and the hydrophobic tails facing towards the air, the main lipid component of surfactant, dipalmitoylphosphatidylcholine (DPPC), reduces surface tension. As a medication, Pulmonary surfactant (medication), pulmonary surfactant is on the WHO Model List of Essential Medicines, the most important medications needed in a basic health system. Function * To increase pulmonary com ...
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Saline (medicine)
Saline (also known as saline solution) is a mixture of sodium chloride (salt) and water. It has a number of uses in medicine including cleaning wounds, removal and storage of contact lenses, and help with dry eyes. By injection into a vein it is used to treat dehydration such as that from gastroenteritis and diabetic ketoacidosis. Large amounts may result in fluid overload, swelling, acidosis, and high blood sodium. In those with long-standing low blood sodium, excessive use may result in osmotic demyelination syndrome. Saline is in the crystalloid family of medications. It is most commonly used as a sterile 9 g of salt per litre (0.9%) solution, known as normal saline. Higher and lower concentrations may also occasionally be used. Saline is acidic, with a pH of 5.5 (due mainly to dissolved carbon dioxide). The medical use of saline began around 1831. It is on the World Health Organization's List of Essential Medicines. In 2020, sodium was the 274th most commonly p ...
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