CHAPTER 3, PHARMACOTHERAPEUTICS, RESPIRATORY SYSTEM

RESPIRATORY SYSTEM

PREPARED BY MR. ABHIJIT DAS

ASTHMA

Definition:
Asthma is a chronic lung condition where narrow airways make breathing difficult, often triggered by allergens, irritants, or exercise. It can be life-threatening in severe cases.

Etiopathogenesis:

1.    Genetics: Family history can increase asthma risk.

2.    Environmental triggers: Allergens like dust, pollen, smoke, or pollution can trigger symptoms.

3.    Immune response: Overreaction of the immune system causes airway swelling and narrowing.

Clinical Manifestations:

  • Wheezing: High-pitched whistling sound while breathing.
  • Shortness of breath: Difficulty breathing, worsens with activity.
  • Chest tightness: Pressure or tight feeling in the chest.
  • Cough: Persistent, especially at night or in the morning.
  • Rapid breathing: Faster than normal, also known as tachypnea.
  • Fatigue and anxiety: Due to breathing difficulty.

Non-Pharmacological Management:

1.    Avoid triggers: Identify and avoid allergens or irritants.

2.    Clean environment: Reduce indoor dust and allergens.

3.    Healthy weight: Regular exercise and diet management.

4.    Breathing exercises: Diaphragmatic breathing, yoga, and relaxation techniques.

5.    Stress management: Use meditation, deep breathing, or gentle exercise.

Pharmacological Management:

1.    Inhaled bronchodilators: Relax airway muscles for quick relief.

2.    Inhaled corticosteroids: Reduce inflammation for ongoing asthma control.

3.    Combination inhalers: Blend bronchodilators and steroids.

4.    Leukotriene modifiers: Block inflammation-causing chemicals.

5.    Immunomodulators: Adjust immune response to reduce symptoms.

 

COPD (CHRONIC OBSTRUCTIVE PULMONARY DISEASE)

Definition:
COPD is a long-term lung disease causing persistent breathing difficulty due to limited airflow, usually from chronic bronchitis and emphysema. It's often linked to exposure to harmful particles or gases.

Etiopathogenesis:

1.    Chronic inflammation: Irritation from harmful particles leads to inflammation, mucus buildup, and narrowed airways.

2.    Alveolar damage: Exposure can damage air sacs, leading to emphysema and poor gas exchange.

3.    Genetics: Genetic factors may increase COPD risk.

4.    Other factors: Infections, malnutrition, and comorbidities like heart disease can worsen COPD.

Clinical Manifestations:

  • Shortness of breath: Worsens with activity.
  • Chronic cough: Often produces mucus.
  • Wheezing: Whistling sound while breathing.
  • Chest tightness: Pressure in the chest.
  • Fatigue: Low energy, especially during activity.
  • Weight loss: Due to poor appetite.
  • Frequent infections: Increased risk for pneumonia and bronchitis.

Non-Pharmacological Management:

1.    Quit smoking: Essential to slow COPD progression.

2.    Pulmonary rehab: Exercise and education to improve breathing.

3.    Healthy diet: Supports energy and prevents malnutrition.

4.    Oxygen therapy: Helps improve oxygen levels.

5.    Breathing techniques: Pursed-lip and diaphragmatic breathing ease breathing.

6.    Avoid triggers: Reduce exposure to irritants and infections.

Pharmacological Management:

1.    Bronchodilators: Relax airway muscles to ease breathing.

2.    Corticosteroids: Reduce inflammation in airways.

3.    Combination therapy: Bronchodilators with steroids for added relief.

4.    Phosphodiesterase-4 inhibitors: Reduce inflammation in severe COPD.

5.    Antibiotics: For infections or exacerbations.

6.    Oxygen therapy: For severe cases to aid breathing.

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