Bronchodilators and Antiasthma Drugs:
Within the past few years a number of new drugs have been introduced to treat respiratory disorders, such as
bronchial asthma and disorders that produce chronic airway obstruction. bronchodilators, drugs that have been around for a long time but are still effective in specific instances, and the newer antiasthma drugs that have proven to be highly effective in the prophylaxis (prevention) of breathing difficulty.
Asthma is a reversible obstructive disease of the lower airway. With asthma there is increasing airway
obstruction caused by bronchospasm and bronchoconstriction, inflammation and edema of the lining of the bronchioles,and the production of thick mucus that can plug the airway .
There are three types of asthma:
1. Extrinsic (also referred to as allergic asthma and caused in response to an allergen such as pollen, dust, and animal dander)
2. Intrinsic asthma (also called nonallergic asthma and caused by chronic or recurrent respiratory infections, emotional upset, and exercise)
3. Mixed asthma (caused by both intrinsic and extrinsic factors)
Extrinsic or allergic asthma causes the IgE inflammatory response. With exposure, the IgE antibodies
are produced and attach to mast cells in the lung. Reexposure to the antigen causes them to bind to the IgE
antibody, releasing histamine and other mast cell products. The release of these products causes bronchospasm, mucous membrane swelling, and excessive mucous production. Gas exchange is impaired,
causing carbon dioxide to be trapped in the alveoli so that oxygen is unable to enter.identifies the
asthmatic pathway from both intrinsic and extrinsic stimulus.
Other disorders of the lower respiratory tract include emphysema (lung disorder in which the terminal bronchioles or alveoli become enlarged and plugged with mucus) and chronic bronchitis (chronic
inflammation and possibly infection of the bronchi).
Chronic obstructive pulmonary disease (COPD) is the name given collectively to emphysema and chronic
bronchitis because the obstruction to the airflow is present most of the time. Asthma that is persistent and
present for most of the time may also be referred to as COPD.
BRONCHODILATORS
A bronchodilator is a drug used to relieve bronchospasm associated with respiratory disorders, such as
bronchial asthma, chronic bronchitis, and emphysema.These conditions are progressive disorders characterized by a decrease in the inspiratory and expiratory capacity of the lung. Collectively, they are often referred to as COPD.
The patient with COPD experiences dyspnea (difficulty breathing) with physical exertion, has difficulty inhaling
and exhaling, and may exhibit a chronic cough.The two major types of bronchodilators are the sympathomimetics and the xanthine derivatives. The anti-cholinergic drug ipratropium bromide (Atrovent) is
used for bronchospasm associated with COPD, chronic bronchitis, and emphysema.
Bronchodilators: Sympathomimetic
Examples of sympathomimetic bronchodilators include albuterol (Ventolin), epinephrine (Adrenalin), salmeterol (Serevent), and terbutaline (Brethine). Many of the sympathomimetics used as bronchodilators have the subclassification of beta-2 (2) receptor agonists (eg,albuterol, salmeterol, and terbutaline). Additional information concerning the various sympathomimetic
ACTIONS
When bronchospasm occurs, there is a decrease in the lumen (or inside diameter) of the bronchi, which
decreases the amount of air taken into the lungs with each breath. A decrease in the amount of air taken into
the lungs results in respiratory distress. Use of a bronchodilating drug opens the bronchi and allows more air
to enter the lungs, which in turn, completely or partially relieves respiratory distress.
USES
Sympathomimetics (drugs that mimic the sympathetic nervous system) are used primarily to treat reversible airway obstruction caused by bronchospasm associated with acute and chronic bronchial asthma,exercise induced bronchospasm, bronchitis, emphysema, bronchiectasis (abnormal condition of the bronchial tree), or other obstructive pulmonary diseases.
ADVERSE REACTIONS
Administration of a sympathomimetic bronchodilator may result in restlessness, anxiety, increase in blood
pressure, palpitations, cardiac arrhythmias, and insomnia. When these drugs are used by inhalation, excessive
use (eg, over the recommended times) may result in paradoxical bronchospasm.
CONTRAINDICATIONS, PRECAUTIONS,
AND INTERACTIONS
The sympathomimetic bronchodilators are contraindicated in patients with known hypersensitivity to the
drug, cardiac arrhythmias associated with tachycardia, organic brain damage, cerebral arteriosclerosis, and narrow angle glaucoma. Salmeterol is contraindicated during acute bronchospasm. The sympathomimetics are used cautiously in patients with hypertension, cardiac dysfunction, hyperthyroidism, glaucoma, diabetes, prostatic hypertrophy, or a history of seizures. The sympathomimetic drugs are used cautiously during pregnancy (all are Pregnancy Category C, except terbutaline, which is Pregnancy Category B), and lactation.
When the sympathomimetics are used concurrently with other sympathomimetic drugs , additive adrenergic effects can occur. When used with the monoamine oxidase inhibitors, the patient is at increased risk for a hypertensive crisis.
When the sympathomimetics are administered with a adrenergic blocker, the drugs may inhibit the cardiac,
bronchodilating, and vasodilating effects of the sympathomimetic. When a blocker such as propranolol is
administered with a sympathomimetic such as epinephrine, an initial hypertensive episode may occur followed
by bradycardia. Concurrent use of the sympathomimetics with oxytocic drugs may result in severe hypotension. When the sympathomimetics are administered with theophylline there is an increased risk for cardiotoxicity. When epinephrine is administered with insulin or oral hypoglycemic drugs, the patient may require an increased dose of the hypoglycemic drug.
Bronchodilators: Xanthine Derivatives
Examples of the xanthine derivatives (drugs that stimulate the central nervous system [CNS] resulting in
bronchodilation, also called methylxanthines) are theophylline and aminophylline.
ACTIONS
The xanthine derivatives, although a different class of drugs, also have bronchodilating activity by means of their direct relaxation of the smooth muscles of the bronchi.
USES
The xanthine derivatives are used for symptomatic relief or prevention of bronchial asthma and reversible
bronchospasm associated with chronic bronchitis and emphysema.
ADVERSE REACTIONS
Adverse reactions associated with administration of the xanthine derivatives include nausea, vomiting, restlessness, nervousness, tachycardia, tremors, headache, palpitations, increased respirations, fever, hyperglycemia,and electrocardiographic changes.
CONTRAINDICATIONS, PRECAUTIONS,
AND INTERACTIONS
The xanthine derivatives are contraindicated in those with known hypersensitivity, peptic ulcers, seizure disorders (unless well controlled with appropriate anticonvulsant medication), serious uncontrolled rrhythmias,
and hyperthyroidism.
The xanthine derivatives are used cautiously in patients older than 60 years, those with cardiac disease,
hypoxemia, hypertension, congestive heart failure, or liver disease. Aminophylline, dyphylline, oxtriphylline,
and theophylline are Pregnancy Category C drugs and are used cautiously during pregnancy and lactation.
When xanthine bronchodilators are administered with sympathomimetic drugs, additive
CNS and cardiovascular effects may occur. If a patient eats large amounts of charcoal-broiled foods while taking the xanthines, a decrease in the therapeutic effect of the xanthines may occur. Certain foods contain xan
thine (eg, coffee, colas, or chocolate) and may increase the risk of cardiac and CNS adverse reactions.Cigarettes, nicotine gum and patches, barbiturates,phenytoin, loop diuretics, isoniazid, and rifampin may decrease the effectiveness of the xanthines. There is an increased risk of xanthine toxicity when the drugs are administered with influenza vaccination, oral contraceptives, glucocorticoids, -adrenergic blockers, cimetidine, macrolides, thyroid hormones, or allopurinol.
Within the past few years a number of new drugs have been introduced to treat respiratory disorders, such as
bronchial asthma and disorders that produce chronic airway obstruction. bronchodilators, drugs that have been around for a long time but are still effective in specific instances, and the newer antiasthma drugs that have proven to be highly effective in the prophylaxis (prevention) of breathing difficulty.
Asthma is a reversible obstructive disease of the lower airway. With asthma there is increasing airway
obstruction caused by bronchospasm and bronchoconstriction, inflammation and edema of the lining of the bronchioles,and the production of thick mucus that can plug the airway .
There are three types of asthma:
1. Extrinsic (also referred to as allergic asthma and caused in response to an allergen such as pollen, dust, and animal dander)
2. Intrinsic asthma (also called nonallergic asthma and caused by chronic or recurrent respiratory infections, emotional upset, and exercise)
3. Mixed asthma (caused by both intrinsic and extrinsic factors)
Extrinsic or allergic asthma causes the IgE inflammatory response. With exposure, the IgE antibodies
are produced and attach to mast cells in the lung. Reexposure to the antigen causes them to bind to the IgE
antibody, releasing histamine and other mast cell products. The release of these products causes bronchospasm, mucous membrane swelling, and excessive mucous production. Gas exchange is impaired,
causing carbon dioxide to be trapped in the alveoli so that oxygen is unable to enter.identifies the
asthmatic pathway from both intrinsic and extrinsic stimulus.
Other disorders of the lower respiratory tract include emphysema (lung disorder in which the terminal bronchioles or alveoli become enlarged and plugged with mucus) and chronic bronchitis (chronic
inflammation and possibly infection of the bronchi).
Chronic obstructive pulmonary disease (COPD) is the name given collectively to emphysema and chronic
bronchitis because the obstruction to the airflow is present most of the time. Asthma that is persistent and
present for most of the time may also be referred to as COPD.
BRONCHODILATORS
A bronchodilator is a drug used to relieve bronchospasm associated with respiratory disorders, such as
bronchial asthma, chronic bronchitis, and emphysema.These conditions are progressive disorders characterized by a decrease in the inspiratory and expiratory capacity of the lung. Collectively, they are often referred to as COPD.
The patient with COPD experiences dyspnea (difficulty breathing) with physical exertion, has difficulty inhaling
and exhaling, and may exhibit a chronic cough.The two major types of bronchodilators are the sympathomimetics and the xanthine derivatives. The anti-cholinergic drug ipratropium bromide (Atrovent) is
used for bronchospasm associated with COPD, chronic bronchitis, and emphysema.
Bronchodilators: Sympathomimetic
Examples of sympathomimetic bronchodilators include albuterol (Ventolin), epinephrine (Adrenalin), salmeterol (Serevent), and terbutaline (Brethine). Many of the sympathomimetics used as bronchodilators have the subclassification of beta-2 (2) receptor agonists (eg,albuterol, salmeterol, and terbutaline). Additional information concerning the various sympathomimetic
ACTIONS
When bronchospasm occurs, there is a decrease in the lumen (or inside diameter) of the bronchi, which
decreases the amount of air taken into the lungs with each breath. A decrease in the amount of air taken into
the lungs results in respiratory distress. Use of a bronchodilating drug opens the bronchi and allows more air
to enter the lungs, which in turn, completely or partially relieves respiratory distress.
USES
Sympathomimetics (drugs that mimic the sympathetic nervous system) are used primarily to treat reversible airway obstruction caused by bronchospasm associated with acute and chronic bronchial asthma,exercise induced bronchospasm, bronchitis, emphysema, bronchiectasis (abnormal condition of the bronchial tree), or other obstructive pulmonary diseases.
ADVERSE REACTIONS
Administration of a sympathomimetic bronchodilator may result in restlessness, anxiety, increase in blood
pressure, palpitations, cardiac arrhythmias, and insomnia. When these drugs are used by inhalation, excessive
use (eg, over the recommended times) may result in paradoxical bronchospasm.
CONTRAINDICATIONS, PRECAUTIONS,
AND INTERACTIONS
The sympathomimetic bronchodilators are contraindicated in patients with known hypersensitivity to the
drug, cardiac arrhythmias associated with tachycardia, organic brain damage, cerebral arteriosclerosis, and narrow angle glaucoma. Salmeterol is contraindicated during acute bronchospasm. The sympathomimetics are used cautiously in patients with hypertension, cardiac dysfunction, hyperthyroidism, glaucoma, diabetes, prostatic hypertrophy, or a history of seizures. The sympathomimetic drugs are used cautiously during pregnancy (all are Pregnancy Category C, except terbutaline, which is Pregnancy Category B), and lactation.
When the sympathomimetics are used concurrently with other sympathomimetic drugs , additive adrenergic effects can occur. When used with the monoamine oxidase inhibitors, the patient is at increased risk for a hypertensive crisis.
When the sympathomimetics are administered with a adrenergic blocker, the drugs may inhibit the cardiac,
bronchodilating, and vasodilating effects of the sympathomimetic. When a blocker such as propranolol is
administered with a sympathomimetic such as epinephrine, an initial hypertensive episode may occur followed
by bradycardia. Concurrent use of the sympathomimetics with oxytocic drugs may result in severe hypotension. When the sympathomimetics are administered with theophylline there is an increased risk for cardiotoxicity. When epinephrine is administered with insulin or oral hypoglycemic drugs, the patient may require an increased dose of the hypoglycemic drug.
Bronchodilators: Xanthine Derivatives
Examples of the xanthine derivatives (drugs that stimulate the central nervous system [CNS] resulting in
bronchodilation, also called methylxanthines) are theophylline and aminophylline.
ACTIONS
The xanthine derivatives, although a different class of drugs, also have bronchodilating activity by means of their direct relaxation of the smooth muscles of the bronchi.
USES
The xanthine derivatives are used for symptomatic relief or prevention of bronchial asthma and reversible
bronchospasm associated with chronic bronchitis and emphysema.
ADVERSE REACTIONS
Adverse reactions associated with administration of the xanthine derivatives include nausea, vomiting, restlessness, nervousness, tachycardia, tremors, headache, palpitations, increased respirations, fever, hyperglycemia,and electrocardiographic changes.
CONTRAINDICATIONS, PRECAUTIONS,
AND INTERACTIONS
The xanthine derivatives are contraindicated in those with known hypersensitivity, peptic ulcers, seizure disorders (unless well controlled with appropriate anticonvulsant medication), serious uncontrolled rrhythmias,
and hyperthyroidism.
The xanthine derivatives are used cautiously in patients older than 60 years, those with cardiac disease,
hypoxemia, hypertension, congestive heart failure, or liver disease. Aminophylline, dyphylline, oxtriphylline,
and theophylline are Pregnancy Category C drugs and are used cautiously during pregnancy and lactation.
When xanthine bronchodilators are administered with sympathomimetic drugs, additive
CNS and cardiovascular effects may occur. If a patient eats large amounts of charcoal-broiled foods while taking the xanthines, a decrease in the therapeutic effect of the xanthines may occur. Certain foods contain xan
thine (eg, coffee, colas, or chocolate) and may increase the risk of cardiac and CNS adverse reactions.Cigarettes, nicotine gum and patches, barbiturates,phenytoin, loop diuretics, isoniazid, and rifampin may decrease the effectiveness of the xanthines. There is an increased risk of xanthine toxicity when the drugs are administered with influenza vaccination, oral contraceptives, glucocorticoids, -adrenergic blockers, cimetidine, macrolides, thyroid hormones, or allopurinol.
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Ditulis oleh:
Unknown - Monday 20 December 2010
