Transcript PO 003.01 - Part 30 - Respiratory System Drugs

Respiratory System Drugs
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EO 003.01 Part 30
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Overview of Lesson
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Nasal Preparations
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Drugs for Obstructive Airway Disease
- Adrenergic inhalants
- Other drugs for obstructive airway
disease.
-Other systemic drugs for obstructive
airway disease.
Cough and Cold Preparations
-Expectorants
-Other cold combination products
Antihistamines
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What I need to know as a pharmacy technician
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In this lecture we will cover the drugs listed
in the ANA Formulary which are classified
according to the ATC system under
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(R) Respiratory System Drugs
For each of these medications/classes
students must obtain an understanding of:
(1) Mechanism of Action
(2) Indications (Uses)
(3) Efficacy
(4) Side Effects
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Nasal Preparations
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Naphazoline
Mechanism of Action
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Causes the blood vessels within
the nasal mucosa to constrict.
This decreases symptoms of
runny nose and post nasal drip
which can irritate the throat.
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Naphazoline : Indication (Uses)
‫مورد استعمال‬
•
It is used to ease allergy
symptoms.
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Naphazoline : Side Effects
‫عوارض جانبی‬
•
•
•
•
Nervous and excitable
Dry mouth.
Nose irritation
Bad taste in your mouth.
This most often goes back
to normal
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Naphazoline : Important Points
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•
How to properly use a nasal
spray will be covered in
more detail in EO 003.03.
This medication is meant
for short term use only, for
3-5 days.
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Important Points
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•
If you think there has been
an overdose, call your
poison control center or get
medical care right away. Be
ready to tell or show what
was taken, how much, and
when it happened.
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Drugs For Obstructive Airway
Diseases
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Review of Obstructive Airway Disease
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(1) Asthma
(2) Chronic Obstructive
Pulmonary Disease (COPD)
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Asthma
Inflammatory disease of the
airways characterized by
recurring symptoms, reversible
airflow obstruction, and
bronchospasm.
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Common symptoms include
wheezing, coughing, chest
tightness, and shortness of
breath.
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Chronic Obstructive Pulmonary Disease (COPD)
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Often caused by smoking.
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Damage occurs to the
airways and they are
often blocked by mucous.
The alveoli (air sacs)
within the lungs also
become damaged.
Patients often have a
bothersome cough and are
short of breath.
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Adrenergic Inhalants : Salbutamol
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Salbutamol
Mechanism of Action
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Relaxes bronchial smooth
muscles = airway dilation
(opening) allowing easier
passage of air through the
lungs.
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Salbutamol: Indication (Uses)
‫مورد استعمال‬
•
•
This drug is used to stop
exercise-induced breathing
problems
It is used to open the
airways in lung diseases
where spasm may cause
breathing problems
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Salbutamol: Side Effects
‫عوارض جانبی‬
•
•
•
Chest pain or pressure.
A fast heartbeat.
Very nervous and excitable.
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Salbutamol: Important Points
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Can be administered using
an inhaler or a nebulizer.
How to properly use an
inhaler /nebulizer will be
covered in more detail in
EO 003.03.
If you have severe
breathing issues, do not run
out of this drug.
If you are not able to get
the breathing attack under
control. Get help right
away.
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Inhaled Steroids : Beclomethasone
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Inhaled Steroids: Mechanism of Action
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Decreases inflammation within the
airways allowing for easier passage
of air into the lungs.
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Inhaled Steroids
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Indication
It is used to treat asthma.
Can also be used to treat chronic
obstructive pulmonary disease
(COPD).
Side Effects
• Odd taste in the mouth.
• Can cause thrush infections.
• May cause slight irritation of the
airways.
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Inhaled Steroids: Important Points
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• Do not use this drug to treat an
asthma attack – this is NOT a quick
acting drug and will not help you
when an attack occurs.
• This is a maintenance
medication that is meant to be taken
every day.
• It may take 2-4 weeks to see the
full benefit of this medication
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Inhaled Steroids: Important Points
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• If you have been taking this drug
for many weeks, talk with your
doctor before stopping. You may
want to slowly stop this drug.
• Rinse your mouth out with water
after using. This will help to avoid
getting a thrush infection in your
mouth.
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Anti-cholinergic Agent : Ipratropium Bromide
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Ipratropium Bromide
Mechanism of Action
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Causes bronchodilation (opening of
the airways).
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Ipratropium Bromide : Indication (Uses)
‫مورد استعمال‬
It is used to open the airways in
lung diseases such as chronic
obstructive pulmonary disease
(COPD), where spasm may cause
breathing problems
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Ipratropium Bromide: Side Effects
‫عوارض جانبی‬
•
•
•
•
•
Headache.
Throat irritation.
Nose stuffiness.
Cough.
Dry mouth
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Ipratropium Bromide : Important Points
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•Can be administered using an
inhaler or a nebulizer.
•How to properly use an inhaler
/nebulizer will be covered in more
detail in EO 003.03.
•If you have severe breathing
issues, do not run out of this drug.
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Other Systemic Drugs For Obstructive
Airway Diseases
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Aminophylline and Theophylline
Mechanism of Action
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Both belong to a class of drugs
called phosphodiesterase
inhibitors.
These medications cause
bronchodilation which opens
the airways allowing increased
air flow within the lungs.
Also increases mucous
secretions.
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Aminophylline and Theophylline : Indication (Uses)
‫مورد استعمال‬
•
•
•
It is used to treat breathing
problems such as asthma
and chronic obstructive
pulmonary disease.
Generally used in more
severe cases.
Aminophylline can also be
used as a mucolytic or
expectorant in severe
respiratory infections.
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Aminophylline and Theophylline : Side Effects
‫عوارض جانبی‬
•
•
•
Dizziness or passing out
Nervous and excitable
Upset stomach or throwing
up
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Important Points
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This medication is
administered intravenously,
using a nebulizer and orally.
If taken orally it should be
taken with food to reduce
stomach upset.
Works fairly quickly,
should feel some benefit
shortly after taking this
medication.
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Montelukast
Mechanism of Action
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Helps to reduce airway
inflammation and relaxes
smooth muscle.
Also helps to decrease the
immune response associated
with allergic rhinitis.
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Montelukast : Indication (Uses)
‫مورد استعمال‬
•
•
•
It is used to ease allergy
symptoms
This drug is used to stop
exercise-induced breathing
problems
It is used to treat asthma.
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Montelukast : Side Effects
‫عوارض جانبی‬
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Cough.
Loose stools (diarrhea).
Headache.
Upset stomach or throwing
up.
Sore throat.
Belly pain.
Stuffy nose.
Runny nose.
Feeling tired or weak.
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Important Points
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Can take approximately a
week to feel benefit from
this medication.
Very important that this
medication is taken every
day.
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Cough And Cold Preparations
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Expectorants, Excl. Combinations With Cough
Suppressants
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Ambroxol
Mechanism of Action
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Is a mucolytic agent.
A mucolytic agent means that it
helps to loosen and release
mucous from the airways.
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Ambroxol : Indication (Uses)
‫مورد استعمال‬
Treatment of acute and chronic
respiratory tract disorders
associated with viscid mucus.
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Ambroxl : Side Effects and Important Points
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Side Effects
May cause some minor GI
upset.
Important Points
• Not to be used during
pregnancy.
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Other Cold Combination Preparations
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Paracetamol + Pseudoephedrine+Chlorphenaramine
Mechanism of Action
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Paracetamol – reduces pain,
fever and headache.
Pseudoephedrine – is a nasal
decongestant that relieves
congestion.
Chlorphenaramine – is an
antihistamine that reduces
runny nose and post nasal
drip.
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Paracetamol + Pseudoephedrine + Chlorphenaramine
Indications, Side Effects and Important Points
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Indication
To help relieve symptoms
associated with the common
cold.
Side Effects
• May cause drowsiness
(chlorphenaramine)
• Can also keep patients
awake (psuedoephedrine).
Important Points
• Should be avoided in patient
with uncontrolled hypertension.
• If symptoms do not improve
within 5-7 days patients should
see a doctor as they may
require additional treatment.
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Antihistamines For Systemic Use
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Dimenhydrinate
Mechanism of Action
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Competes with histamine
for H1-receptor sites on effector
cells in the gastrointestinal tract,
blood vessels, and respiratory tract;
blocks chemoreceptor trigger zone,
diminishes vestibular stimulation,
and depresses labyrinthine function
through its central anticholinergic
activity
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Dimenhydrinate : Indication (Uses)
‫مورد استعمال‬
• It is used to help motion sickness
• It is used to treat upset stomach
and throwing up.
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Dimenhydrinate : Side Effects
‫عوارض جانبی‬
• Dizziness
• Feeling sleepy
• Dry mouth
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Dimenhydrinate : Important Points
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• Patients should avoid driving and doing
other tasks or actions that call for you to
be alert until you see how this drug
affects you.
• To lower the chance of feeling dizzy or
passing out, patients should rise slowly
over a few minutes when sitting or lying
down. Be careful climbing stairs.
• Avoid other sedating medications,
alcohol etc while taking this medication.
• Side effects tend to be more
problematic in the elderly.
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Sedating Anti-histamines: Diphenhydramine
Mechanism of Action
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Blocks the effect of histamine on
cells in the gastrointestinal tract,
blood vessels, and respiratory tract.
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Diphenhydramine: Indication (Uses)
‫مورد استعمال‬
•It is used to stop coughing
•It is used to ease allergy signs
•It is used to ease cold signs
•It is used to help motion sickness
•It is used to treat hives
•It is used to treat itching
•It is used to treat swelling of the
face, lips, tongue, or throat
•It is used to treat sleep problems
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Diphenhydramine: Side Effects
‫مورد استعمال‬
•Feeling sleepy.
•Dizziness.
•Dry mouth.
•Thickening of mucus in nose or
throat.
•Feeling nervous and excitable.
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Important Points
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•Patients should avoid driving and doing
other tasks or actions that call for you to
be alert until you see how this drug
affects you
•To lower the chance of feeling dizzy or
passing out, patients should rise slowly
over a few minutes when sitting or lying
down. Be careful climbing stairs
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Important Points
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•Do not use with other products that
have diphenhydramine.
•Avoid beer, wine, mixed drinks, or
other drugs and natural products
that slow your actions
•Patients 65 or older, use this drug
with care. They could have more
side effects.
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Non-Sedating Anti-histamines
Mechanism of Action
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Long-acting antihistamine with
selective histamine blocking
properties.
Because these medications are
selective, they tend to be less
sedating.
Include:
Loratadine
Chlorphenaramine
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Non-Sedating Anti-histamines: Indication (Uses)
‫مورد استعمال‬
•It is used to treat symptoms of
seasonal allergies.
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Non-Sedating Anti-histamines : Side Effects
‫عوارض جانبی‬
Generally very well tolerated,
minor side effects include:
•Headache
•Dizziness
•Dry mouth
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Non-Sedating Anti-histamines : Important Points
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• This medication needs to be taken
regularly every day in order to work
properly.
• Should start to see some benefit
after a day or two and full benefit
after a week.
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Questions?
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In-class Assignment
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This assignment will consist of 5 questions
which are to be completed individually.
Once complete the instructor will review the
answers with the class.
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1. Match the following drugs with their indication
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A)Salbutamol
B)Inhaled steroid
C)Non-sedating antihistamine
D)Dimenhydrinate
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1)Nausea and vomiting
2)Seasonal allergies
3)Asthma and COPD
4)Acute breathing attacks
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1. Answer: Match the following drugs with their indication
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A)Salbutamol (4) acute breathing
attack
B)Inhaled steroid (3) asthma and
COPD
C)Non-sedating antihistamine (2)
seasonal allergies
D)Dimenhydrinate (1) nausea and
vomiting
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2. Which of the following is a nasal preparation on the
ANA formulary that is used to treat allergies?
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A)Salbutamol
B)Naphazoline
C)Beclomethasone
D)Ipratropium bromide
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2. Answer: Which of the following is a nasal preparation
on the ANA formulary that is used to treat allergies?
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A)Salbutamol
B)Naphazoline
C)Beclomethasone
D)Ipratropium bromide
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3. Which of the following is true regarding inhaled
steroids?
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A)They act immediately
B)They can be used to treat
breathing attacks
C)You should rinse your mouth out
with water after using.
D)They are taken orally.
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3. Answer: Which of the following is true regarding
inhaled steroids?
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A)They act immediately
B)They can be used to treat
breathing attacks
C)You should rinse your mouth out
with water after using.
D)They are taken orally.
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4. True or False? Montelukast can be used to treat asthma
as well as allergic rhinitis?
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4. True or False? Montelukast can be used to treat asthma
as well as allergic rhinitis?
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Answer: True
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5. Which of the following best describes a mucolytic agent?
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A)It helps to loosen and release
mucous from the airways.
B)It increases the production of
mucous in the respiratory tract.
C)It kills the cells that produce
mucous.
D)It prevents the production of
mucous.
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5. Answer: Which of the following best describes a
mucolytic agent?
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A)It helps to loosen and release
mucous from the airways.
B)It increases the production of
mucous in the respiratory tract.
C)It kills the cells that produce
mucous.
D)It prevents the production of
mucous.
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