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RESPIRATORY DRUGS
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RESPIRATORY SYSTEM
RESPONSIBLE FOR MEDIATING GAS EXCHANG
BETWEEN THE EXTERNAL ENVIRONMENT AND
BLOODSTREAM
THE UPPER RESPIRATORY TRACT CONDUCTS
THE LOWER RESPIRATORY PASSAGES AND
ULTIMATELY TO THE LUNGS
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RESPIRATORY SYSTEM
HUMIDIFIES AND CONDITIONS INSPIRED AIR AND
TO PROTECT THE LUNGS FROM HARMFUL SUBSTA
GAS EXCHANGE TAKES PLACE BETWEEN THE ALV
AND THE PULMONARY CIRCULATION FUNCTION: MAINTAINING PROPER AIRFLOW THRO
THE RESPIRATORY PASSAGES
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RESPIRATORY DRUGS
FIRST GROUP
INCLUDES DRUGS THAT TREAT ACUTE AND
RELATIVELY MINOR PROBLEMS
EX. NASAL CONGESTION, COUGHING, ANDSEASONAL ALLERGIES
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RESPIRATORY DRUGS
SECOND GROUP
THE SECOND CATEGORY INCLUDES DRUG
TREAT MORE CHRONIC AND SERIOUS AIRW
OBSTRUCTIONS, EX. BRONCHIAL ASTHMA
CHRONIC BRONCHITIS, AND EMPHYSEMA
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RESPIRATORY THERAPY
PHYSICAL THERAPISTS AND OCCUPATIOTHERAPISTS WILL FREQUENTLY TREAT PATWITH BOTH ACUTE AND CHRONIC RESPIRA
CONDITIONS
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DRUGS USED TO TREAT AND CONT
RESPIRATORY TRACT IRRITATION A
SECRETIONS
TREAT SYMPTOMATIC COUGHING AND IRRITA
RESULTING FROM COMMON COLD, SEASONA
ALLERGIES, AND UPPER RESPIRATORY TRACT
INFECTIONS
MANY OF THESE DRUGS ARE FOUND IN OVE
COUNTER PREPARATIONS
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DRUGS USED TO TREAT AND CONT
RESPIRATORY TRACT IRRITATION A
SECRETIONS
SEVERAL DIFFERENT AGENTS ARE COMBINED IN THE SAME
COMMERCIAL PREPARATION
EX. A DECONGESTANT, AN ANTITUSSIVE, AND AN EXPECTORBE COMBINED AND IDENTIFIED BY A SPECIFIC TRADE NAME.
AGENTS WITHIN A SPECIFIC CATEGORY MAY HAVE PROPERTOVERLAP INTO OTHER DRUG CATEGORIES
CERTAIN ANTIHISTAMINES MAY ALSO HAVE ANTITUSSIVE PR
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ANTITUSSIVES
USED TO SUPPRESS COUGHING ASSOCIATED W
COMMON COLD AND FLU SYMPTOMS
USUALLY RECOMMENDED FOR SHORT-TERM USE
RELIEVING SYMPTOMATIC COUGHING
THE EXTENSIVE USE OF ANTITUSSIVES HAS BEE
QUESTIONED IN OUR SOCIETY
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ANTITUSSIVES
COUGHING IS A DEFENSE MECHANISM THAT HE
EXPEL MUCUS AND FOREIGN MATERIAL FROM T
UPPER RESPIRATORY TRACT
ANTITUSSIVES MAY REDUCE THE ABILITY OF CO
ANTITUSSIVES MAY BE HELPFUL IN TREATING AN
ANNOYING DRY COUGH
USE OF THESE DRUGS TO TREAT AN ACTIVE AND
PRODUCTIVE COUGH MAY NOT BE USTIFIED
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ANTITUSSIVES
THERE IS ALSO CONCERN THAT MANY ANTITUSS
ARE NOT REALLY EFFECTIVE IN TREATING COUG
OVER-THE-COUNTER PRODUCTS MAY NOT CONT
ADEQUATE AMOUNT OF THE ACTIVE MEDICATIOMAY BE NO MORE EFFECTIVE THAN PLACEBO IN
TREATING COUGH
DOSES THAT ARE EFFECTIVE IN TREATING COUG
ALSO PRODUCE SERIOUS SIDE EFFECTS
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ANTITUSSIVES
MECHANISM UNDER THE COUGH REFLEX CONTI
BE STUDIED SO THAT SAFER AND MORE EFFECT
ANTITUSSIVES CAN BE DEVELOPED
CODEINE AND SIMILAR OPIATE DERIVATIVES SUPTHE COUGH REFLEX BY A CENTRAL INHIBITORY
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ANTITUSSIVES
NONOPIOID ANTITUSSIVES INHIBIT THE IRRITANT EFF
OF HISTAMINE ON THE RESPIRATORY MUCOSA OR BY
LOCAL ANESTHETIC ACTION ON THE RESPIRATORY
EPITHELIUM
THE PRIMARY ADVERSE EFFECT ASSOCIATED WITH M
ANTITUSSIVES IS SEDATION, DI!!INESS AND
GASTROINTESTINAL UPSETMAY ALSO OCCUR
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COMMON ANTITUSSIVE AGENTS
GENERIC TRADE NAME
MOA
NAME
BEN!ONATATE TESSALON LOCA
ANESTHETIC EFFECT ON RESPIRATORY
CODEINE MANY TRADE NAMES INCOUGH REFLEX BY DIRECT EFFECT ON BRAINSTEM COU
CENTER
DEXTROMETHORPHAN MANY TRADE NAMES I
COUGH REFLEX "SIMILAR TO CODEINE# BUT IS NON- NARC
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COMMON ANTITUSSIVE AGENTS
GENERIC TRADE NAME
MOA
NAME DIPHENHYDRAMINE BENADRYLANTIHISTAMINE
HYDROCODONE DONATUSSIN, HYDROPANE SIMCODEINE TUSSIGON
HYDROMORPHONE ILAUDID SIMCODEINE
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DECONGESTANTS
CONGESTION AND MUCOUS DISCHARGE FROM T
UPPER RESPIRATORY TRACT ARE FAMILIAR SYMP
ALLERGIES, COMMON COLD, AND VARIOUS
RESPIRATORY INFECTIONS OFTEN PRODUCE A RNOSE AND A STUFFY HEAD SENSATION
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DECONGESTANTS
DECONGESTANTS USED TO TREAT THESE SYMPTOMS A
USUALLY ALPHA-$%ADRENERGIC AGONISTS
THESE AGENTS BIND TO ALPHA-$ RECEPTORS LOCATE
THE BLOOD VESSELS OF THE NASAL MUCOSA AND STI
VASOCONSTRICTION
EFFECTIVELY DRY UP THE MUCOSAL VASCULATURE
DECREASING LOCAL CONGESTION IN THE NASAL PASS
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DECONGESTANTS
AGENTS TAKEN SYSTEMICALLY OR APPLIED LOCA
THE NASAL MUCOSA VIA AEROSOL SPRAYS
OCCASIONAL USE OF THESE DRUGS CAN HELP T
SYMPTOMS RELATED TO NASAL CONGESTION
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DECONGESTANTS
MIMIC THE EFFECTS OF INCREASED SYMPATHET
NERVOUS SYSTEM ACTIVITY AND CAN CAUSE SE
CARDIOVASCULAR AND CENTRAL NERVOUS SYS
"CNS# EXCITATION EXCESSIVE USE OR ABUSE SHOULD BE AVOIDED
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DECONGESTANTS
PRIMARY ADVERSE EFFECTS ASSOCIATED ARE
HEADACHE, DI!!INESS, NERVOUSNESS, NAUSEA
INCREASED BLOOD PRESSURE, PALPITATIONS
THESE EFFECTS BECOME MORE APPARENT AT HDOSES AND DURING PROLONGED OR EXCESSIV
USE
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COMMON DECONGESTANTS
GENERIC NAME TRADE NAME
DOSAGE FORMS
EPHEDRINE RYNATUSS
OXYMETAZOLINE AFRIN, DRISTANNASAL SPRAY
$&-HR NASAL SPRAY
PHENYLEPHRINE NEO-SYNEPHRINENASAL SPRAY
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COMMON DECONGESTANTS
GENERIC NAME TRADE NAME
DOSAGE FORMS
PSEUDOEPHEDRINE DIMETAPPORAL
DECONGESTANT, SUDAFED
XYLOMETAZOLINE OTRIVIN SPRAY
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ANTIHISTAMINES
USED FOR SEDATION' TREATMENT OF PARKINSO
TREATMENT OF THE RESPIRATORY ALLERGIC RE
TO SEASONAL ALLERGIES "HAY FEVER, AND SO
AND OTHER ALLERGENS ARE ENDOGENOUS CHEMICALS THAT REGULATE
GASTRIC SECRETION, CNS NEURAL MODULATIO
HYPERSENSITIVITY
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ANTIHISTAMINES
EXERT ITS EFFECTS THROUGH ( PRIMARY RECEP
SUBTYPES:
H$, H&, H), AND H(
SPECIFICALLY BLOCK THE H$SUBTYPE OF HISTARECEPTORS
THE EFFECTS OF HISTAMINE DURING ALLERGIC
REACTIONS, RESPIRATORY INFECTIONS ARE MED
THROUGH THE H$ RECEPTOR LOCATED ON VASC
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ANTIHISTAMINES
DRUGS THAT SELECTIVELY BLOCK THE H& RECE
"REFERRED TO AS H& ANTAGONISTS# MAY HELP
CONTROL GASTRIC SECRETION IN CONDITIONS
AS PEPTIC ULCER
THE H) RECEPTOR IS INVOLVED IN THE LOCAL
REGULATION OF HISTAMINE RELEASE FROM CNS
TERMINALS
H( RECEPTOR HAS BEEN IDENTIFIED ON BLOOD
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ANTIHISTAMINES
THE CLINICAL AND PHARMACOLOGIC SIGNIFICANCE
AND H( RECEPTORS REMAINS TO BE DETERMINED
IT DECREASES NASAL CONGESTION BY BLOCKING TH
EFFECTS OF HISTAMINE ON THE UPPER RESPIRATORY
TISSUES, MUCOSAL IRRITATION AND DISCHARGE "RH
SINUSITIS#, AND CONUNCTIVITIS CAUSED BY INHALE
ALLERGENS
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ANTIHISTAMINES
DECREASE THE COUGHING AND SNEE!ING
ASSOCIATED WITH THE COMMON COLD
ANTIHISTAMINES MAY BE USED AS AN ADUNCT
PATIENTS WITH ASTHMA TO HELP CONTROL RHIAND SINUSITIS BUT DO NOT REVERSE BRONCHO
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ANTIHISTAMINE SIDE EFFECTS
PRIMARY ADVERSE EFFECTS ARE SEDATION, FAT
DI!!INESS, BLURRED VISION, AND INCOORDINA
GASTROINTESTINAL DISTRESS "NAUSEA, VOMIT
CERTAIN SIDE EFFECTS ARE RELATED DIRECTLY EACH DRUG*S ABILITY TO CROSS THE BLOOD-BR
BARRIER
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ANTIHISTAMINE SIDE EFFECTS
FIRST-GENERATION ANTIHISTAMINES READILY
THE BLOOD-BRAIN BARRIER AND ENTER THE BR
CAUSING AS SEDATION AND PSYCHOMOTOR SLO
NEWER SECOND-GENERATION ANTIHISTAMINENOT EASILY CROSS THE BLOOD BRAIN BARRIER,
HENCE, SEDATION AND OTHER CNS SIDE EFFEC
REDUCED SUBSTANTIALLY
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ANTIHISTAMINE SIDE EFFECTS
NEWER AGENTS, ALSO KNOWN AS NONSEDATING
ANTIHISTAMINES, INCLUDE CETIRI!INE "!YRTEC#, LOR
"CLARITIN#, DESLORATIDINE "CLARINEX#, AND FEXOF
"ALLEGRA
NEWER ANTIHISTAMINES ARE MORE SELECTIVE FOR T
RECEPTOR SUBTYPE AND PRODUCE FEWER SIDE EFF
RELATED TO OTHER HISTAMINE RECEPTORS
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ANTIHISTAMINE SIDE EFFECTS
ASTEMI!OLE AND TERFENADINE MAY BE CARDIOTOXIC, A
PROBLEMS SUCH AS SEVERE VENTRICULAR ARRHYTHMIA
"TORSADES DE POINTES#
NON-SEDATING AGENTS HAVE BECOME THE AGENTS OF
FOR MANY PEOPLE BECAUSE THEY DECREASE HISTAMINERELATED SYMPTOMS WITHOUT PRODUCING EXCESSIVE S
AND OTHER NEUROPSYCHIATRIC EFFECTS
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ANTIHISTAMINES GENERIC NAME TRADE NAME SEDAPOTENTIAL
A!ATADINE OPTIMINE
BROMPHENIRAMINE BROMPHEN,DIMETAPP
CARBINOXAMINE RONDEC LOW T
MODERATE
CETIRI!INE !YRTEC V
LOW
CHLORPHENIRAMINE CHLOR-TRIMETON
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ANTIHISTAMINES GENERIC NAME TRADE NAME SEDAPOTENTIAL
CLEMASTINE TAVIST L
CYPROHEPTADINE PERIACTIN MO
DESLORATIDINE CLARINEX, AERIUS V
LOW
DEXCHLORPHENIRAMINE POLARAMINE L
DIMENHYDRINATE DRAMAMINE
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ANTIHISTAMINES GENERIC NAME TRADE NAME SEDAPOTENTIAL
DIPHENHYDRAMINE BENADRYL
DOXYLAMINE UNISOM HIGSLEEP-AID
FEXOFENADINE ALLEGRA VLOW HYDROXY!INE ATARAX
MODERATE LORATADINE CLAVERY LOW
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ANTIHISTAMINES GENERIC NAME TRADE NAME SEDAPOTENTIAL
PNINDAMIN NOLAHIST L
PYRILAMINE CODIMALMODERATE
TRIPELENNAMINE PB!
MODERATE
TRIPROLIDINE ACTIFED
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MUCOLYTICS AND EXPECTORANTS
MUCOLYTIC DRUGS ATTEMPT TO DECREASE THE VISCOS
RESPIRATORY SECRETIONS
EXPECTORANT DRUGS FACILITATE THE PRODUCTION AN
EECTION OF MUCUS
THESE DRUGS ARE USED TO PREVENT THE ACCUMULAT
THICK VISCOUS SECRETIONS THAT CAN CLOG RESPIRAT
PASSAGES AND LEAD TO PULMONARY PROBLEMS
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MUCOLYTICS AND EXPECTORANTS
EXPECTORANTS AND MUCOLYTICS ARE USED IN ACUTE
DISORDERS RANGING FROM THE COMMON COLD TO
PNEUMONIA, AS WELL AS IN CHRONIC DISORDERS SUC
EMPHYSEMA AND CHRONIC BRONCHITIS
THESE DRUGS ARE OFTEN USED IN COMBINATION WITHAGENTS "ANTITUSSIVES, DECONGESTANTS, BRONCHOD
SOME STUDIES HAVE DOCUMENTED THAT THESE DRUG
IMPROVE THE ABILITY TO EXPEL MUCUS AND INCREASE
PULMONARY FUNCTION
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MUCOLYTIC
THE PRIMARY MUCOLYTIC DRUG CURRENTLY IN USE IS ACETYL
THIS DRUG IS THOUGHT TO WORK BY SPLITTING THE DISULF
BONDS OF RESPIRATORY MUCOPROTEINS FORMING A LESS VI
SECRETION
ACETYLCYSTEINE ALSO HAS ANTIOXIDANT EFFECTS, AND SOMACETYLCYSTEINE*S BENEFITS MAY BE DUE TO ITS ABILITY TO
DECREASE FREE-RADICAL DAMAGE IN THE RESPIRATORY TISS
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MUCOLYTIC
ACETYLCYSTEINE IS USUALLY ADMINISTERED DIR
TO THE RESPIRATORY MUCOSA BY INHALATION O
INTRATRACHEAL INSTILLATION "THROUGH A
TRACHEOSTOMY#
THE PRIMARY ADVERSE EFFECTS ASSOCIATED W
THIS DRUG INCLUDE NAUSEA, VOMITING,
INFLAMMATION OF THE ORAL MUCOSA "STOMAT
AND RHINORRHEA
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EXPECTORANT
BUT GUAIFENESIN IS THE ONLY DRUG CURRENTL
ACKNOWLEDGED BY THE FDA TO HAVE EVIDENC
THERAPEUTIC EFFECTS
THIS DRUG IS ADMINISTERED TO INCREASE THEPRODUCTION OF RESPIRATORY SECRETIONS
ENCOURAGING EECTION OF PHLEGM AND SPUT
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EXPECTORANT
GUAIFENESIN, WHICH IS USUALLY ADMINISTERED ORALLY IN
FORM OF SYRUP OR ELIXIR OFTEN COMBINED WITH OTHER A
OVER-THE-COUNTER PREPARATIONS
EXACT MECHANISM OF ACTION IS NOT FULLY UNDERSTOOD
PRIMARY ADVERSE EFFECT ASSOCIATED WITH GUAIFENESIN GASTROINTESTINAL UPSET, WHICH IS EXACERBATED IF EXCE
DOSES ARE TAKEN OR IF THIS DRUG IS TAKEN ON AN EMPTY
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TAPOSNAPO+++
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