Drug therapy in respiratory diseases

DRUG THERAPHY IN RESPIRATORY DISEASES

Drug Therapy in Respiratory Diseases

  • Purpose: To maintain Normal Ventilation, Reflexes and Secretion
  • Pre-requist: An accurate diagnosis
  • Choice: Perform Surgery -DH.
    • - Medicate if, Bacterial Pneumonia.
    • - Do nothing, if viral infections.

Medical Treatment

Must Consider

  • What is medically possible
  • Benefits of Treatment
  • Potential risk to the patient
  • Pathophysiology of Respiratory Tract Inflammations

Mucokinetic Therapy

  • Mucokineses achieved by:
    • Thinning Viscous Secretions
    • Improving ciliary activity
    • Improving air way mechanics
    • Water most valable Agents
      • Mist (steam)
      • Vapor (aerosols) Mouth
        • Caution - Bronchospasm with (a) & (b).
    • Agents - water, Saline. 2% Propylene glycol 2 ml
    • Acetylcysteine - Breaks mucoprotein mol. 2 to 5 ml, 10% Sol for nebulization
    • Sod. Bicarb 2.5% for nebulization natural proteases, Adhesiveness Resp. secretion by osmotic effect
    • thanol - Surface tension of Resp. T.
    • Eucalyptus, menthol and camphor - ?

Oral Mucokinetic Agents (Expectorants)

Reflex stimulation of vagal efferents to Bronchial gland through gastric mucosa.

  • ral W.K. Salt sol. - Ammonium bicarbonate
  • Amm. chloride, KI, Sodium bicarbonates NaCL
  • Volatile oil
  • Phenolic Compounds - Creosol, G. Guaiacolate.

Aerosol Therapy

  • uspension of a liquid as fine particles dispersed in a gas. Idea particle size 2-4 u
  • A plastic bag tapped to the neck and a nubulizer attached at one cut corner

BRONCHOSPASM THERAPY

  • A. Sympathomimetic dilators (long acting)
    • B 2 stimulator preferred
    • Ephedrine: Mod B 2 , slight B 1 &
    • Metaproterenol: B 2 , B 1 &
    • Salbutamol: specific B 2
  • Phosphodiesterase inhibitors - Xanthines
    • Preserve AMO. Intercellular messenger eg., Theophylline and aminophylline
    • Relax brochial M. Cardiac output

Antitussive Therapy

  • Depress cough than totally supress.
    • Act peripherally - irritation, block receptors e.g. Benzons
    • Act Centrally
  • Narcotic antitussives - codeine, hydrocodone
  • Non-narcotics - Benzonatate, dextromethorphan

Decongestant Therapy

  • When specific etio. lacking
  • Antihistamines - chlorpheniramine
  • Alpha adrenergic sympathomimetics
  • Cause vasoconstriction. Rebound congestion?
  • e.g. Phenylephrine, phenylpropanolamine

Antimicrobial Therapy

  • Esp. large mole AB (Gents - Erythro.) have better blood - bronchial penetration then small mole AB - (Penicilline, Cephalosp)
  • Topical Antibiotic - not effective in tracheobronchial tree
Last modified: Tuesday, 5 June 2012, 12:04 PM