DRUGS ACTING ON THE RESPIRATORY SYSTEM

 DRUGS ACTING ON RESPIRATORY SYSTEM

PREPARED BY MR. ABHIJIT DAS


BRONCHODILATORS

DEFINITION
Bronchodilators are medications that help open up and widen the airways in the lungs, making it easier to breathe.

CLASSIFICATION

1.     Selective Beta-2 Agonists: Target specific airway receptors, relaxing muscles for better breathing. Example: salbutamol, terbutaline.

2.     Non-Selective Beta Agonists: Activate various receptors, aiding airflow but might affect heart. Example: adrenaline, ephedrine.

3.     Methylxanthines: Relax airway muscles mildly. Example: theophylline.

4.     Anticholinergics: Block airway constriction signals. Example: ipratropium bromide.

SALBUTAMOL

MOA

Salbutamol binds to bronchial smooth muscle's beta-2 receptor, activating adenylyl cyclase. This enzyme converts ATP to cAMP, triggering relaxation of the muscle and causing bronchodilation.


ADVERSE EFFECTS

  • Increased heart rate
  • Tremors
  • Nervousness
  • Headache
  • Insomnia

THERAPEUTICAL USES

1.     Asthma: Salbutamol is commonly used to relieve and prevent asthma symptoms, helping to open airways and improve breathing.

2.     Chronic Obstructive Pulmonary Disease (COPD): It's used to manage COPD symptoms by relaxing airway muscles, making breathing easier.

3.     Bronchospasm: Salbutamol is also used to treat acute bronchospasms, such as those triggered by exercise or allergies, to quickly relieve breathing difficulties.

 

ANTI TUSSIVE AGENTS

DEFINITION
Antitussive agents are medications that help alleviate or suppress coughing, providing relief from excessive or irritating coughing episodes.

CLASSIFICATION

1.     Opioid Antitussives: These contain opioids and include medications like codeine and hydrocodone.

2.     Non-Opioid Antitussives: These do not contain opioids and include medications like dextromethorphan and benzonatate.

CODEINE

MOA
Codeine binds to the mu receptors in the cough center of the brain's medulla. By doing so, it deactivates the motor signals responsible for triggering coughing.


ADVERSE EFFECTS

1.     Sedation

2.     Respiratory depression

3.     Constipation

4.     Nausea and vomiting

5.     Addiction

6.     Tolerance

7.     Withdrawal effects

THERAPEUTICAL USES

1.     Cough Suppression: Codeine is used to alleviate persistent and bothersome coughing.

2.     Respiratory Conditions: It can be prescribed for cough associated with respiratory infections or conditions like bronchitis.

3.     Post-Operative Cough: Codeine might be given to control coughing after certain surgical procedures.

 

MUCOLYTIC AGENTS

DEFINITION

Mucolytic agents are medicines that help thin and loosen mucus in the lungs and airways, making it easier to cough up and clear.

SOME COMMON CLASSES OF MUCOLYTIC AGENTS

1.     ACETYLCYSTEINE:

MOA

This medication breaks down mucus by disrupting its structure (By breaking down disulfide bonds in the mucoproteins), making it easier to cough up and clear from the respiratory tract. It's often used in conditions like chronic obstructive pulmonary disease (COPD) and cystic fibrosis.

NOTE: Mucoproteins are major components of mucus, contributing to its thick and sticky nature.


2.     Guaifenesin: Guaifenesin works by increasing the hydration of mucus, making it less viscous and easier to expel. It's commonly found in over-the-counter cough and cold medications.

3.     Erdosteine: This mucolytic agent not only reduces the viscosity of mucus but also has antioxidant properties that can help protect the respiratory tract. It's used to manage conditions like chronic bronchitis.

 

EXPECTORANTS

DEFINITION

An expectorant is a medication that helps loosen and expel mucus from the respiratory tract, facilitating easier coughing and clearing of the airways.

CLASSIFICATION WITH MOA

1.     Guaifenesin:

·         Example: Mucinex (contains guaifenesin)

·         MOA: Guaifenesin increases the volume and reduces the viscosity of respiratory secretions, making it easier to cough up and clear mucus.

2.     Ammonium Salts:

·         Example: Ammonium Chloride

·         MOA: Ammonium chloride irritates the respiratory tract lining, stimulating secretory glands to produce more mucus, which can then be cleared more easily.

3.     Iodides:

·         Example: Potassium Iodide

·         MOA: Potassium iodide acts as an irritant, causing increased production of respiratory secretions and helping to loosen and clear mucus.


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