Transcript Drugs For Treating Asthma

Drugs For Treating Asthma
Chapter 9
Sympathomimetic Agents
• Noninfectious respiratory diseases are divided
into two groups
– Asthma is characterized by reversible airway
obstruction
– Chronic obstructive pulmonary disease (COPD) is
characterized by irreversible airway obstruction
• COPD is further divided into emphysema and chronic
bronchitis
Sympathomimetic Agents - Continued
• Beta-Adrenergic Agonists
– Nonselective adrenergic agonist drugs stimulate beta receptors
in the lungs and heart and alpha receptors in the heart
– Epinephrine and isoproterenol are nonselective adrenergic
agonists
– Today, short- and long-acting β2-agonists are used to treat
asthma and COPD
– Β2-Agonists stimulate receptors in the lungs.
– Stimulation of these receptors produces bronchodilation
– Adverse effects include nervousness, tachycardia, and insomnia
Respiratory Drugs
• Beta-Adrenergic Agonists
– Short-Acting β2-Agonists
• These drugs are used to treat acute asthma attacks.
• They are usually administered via metered dose
inhalers
• They are available in tablet and liquid dose forms.
• Short-acting β2-agonists are often used as prophylaxis
prior to exercise or another known precipitating event
Long-Acting β2-Agonists
• These agonists have a delayed onset of action
and a longer duration of action
• Onset of action is within 10-20 minutes and
the duration of action of 12 hours.
• These drugs are used as maintenance therapy
in the treatment of asthma and COPD
Metered Dose Inhalers (MDI)
• These devices deliver the medication directly to
the bronchioles
• The total dose is kept low and side effects should
be minimal
• The inhaled dose can be accurately measured
• Onset of action is rapid and predictable
• They are compact, portable, and sterile
• They can be difficult to use
• Spacers are available which makes the inhaler
easier to use
• Adverse effects with MDI use include dry mouth
Corticosteroids
• Steroids reduce the inflammation associated
with airway obstruction
– They also inhibit the release of inflammatory
substances
– Steroids are available as MDIs and oral and liquid
dose forms
– The MDI has become the most common dose
form used in treating asthma and COPD
Corticosteroids - Continued
• Corticosteroids significantly improve
pulmonary function with a decrease in
wheezing, tightness, and cough
– These drugs are not used for acute attacks.
– Chronic oral prednisone use is reserved for
patients with severe asthma
– Adverse effects are dependent upon dose form,
frequency of intake, total dose, and any
preexisting conditions
Corticosteroids - Continued
• Prolonged systemic use can lead to adrenal
suppression, poor wound healing, and
immunosuppression
– MDI use can lead to oral candidiasis.
– Patients using inhaled steroids should be
instructed to brush, floss, rinse, and spit, after
each use
Leukotriene-Pathway Inhibitors
• These drugs work by either preventing the
synthesis of leukotrienes or by blocking
leukotriene receptors
– Leukotriene release produces
bronchoconstriction, increased mucus secretion,
mucosal edema, and increased bronchial
hyperreactivity
– These drugs are used to treat asthma and allergic
rhinitis
– Adverse reactions include irritation of the stomach
mucosa, headache, and altered liver function tests
Cromolyn
• Cromolyn inhibits mast cell degranulation.
– It is used for the prophylaxis of asthma
– It can be used in patients with chronic asthma or
taken before exercise-induced asthma
– Adverse effects include cough, dry mouth, nausea,
and headache
– It is available as a nebulizer or in a spinhaler dose
form
Methylxanthines
• Theophylline is the main drug in this category
– It is a bronchodilator with a narrow therapeutic
window
– It is used to treat severe asthma and the
bronchospasm associated with COPD
– Side effects include CNS stimulation, cardiac
stimulation, and GI upset
Anticholinergic Drugs
• Ipratropium bromide is an inhaled
anticholinergic drug that is used to treat
asthma and COPD
– Its anticholinergic effects produce a
bronchodilating effect in the lungs
– Side effects include dry mouth. The patient should
rinse after each inhaler use to minimize dry mouth
Role of the Athletic Trainer
• Educate the patient in regards to:
– The type of medication they are taking
– Specific effects in regard to athletic performance
• Understand proper inhalation technique
• Take action to adjust specific drug through
consultation if necessary
• Keep medication readily available
• Monitor the patient during exercise
• Know the medications the athletes are using