1. Drugs Affecting the Respiratory System

2. Antihistamines,Decongestants,Antitussives,andExpectorants

3. COUGH with presence of secretion in bronchi bronchi PRODUCTIVE Sputum with significant viscous-elastic properties: muco- and proteolytic drugs - muco- and proteolytic drugs Sputum with significant adhesive properties: drugs which stimulate production of surfactant - drugs which stimulate production of surfactant Decreasing of speed of mucociliar transport with unchanged properties of sputum: drugs which stimulate ciliar function - drugs which stimulate ciliar function Significant disorders of bronchial permeability, morphological changes of bronchi (atrophy of mucous membrane, bronchial stenosis), excessive production of mucus: alkali inhalations - alkali inhalations Signs of allergic reaction with increased histamine activity: antihistamine drugs - antihistamine drugsNONPRODUCTIVE Cataral inflammation (usually viral), reflector and central cough: anticough drugs - anticough drugs Signs of allergic reaction: antihistamine drugs - antihistamine drugs Bronchospasm: broncholytics - broncholytics dry REHYDRANTS IN ALL CASES

4. Upper and Lower Respiratory Tracts

5. Decongestants

6. Nasal Congestion Excessive nasal secretions Excessive nasal secretions Inflamed and swollen nasal mucosa Inflamed and swollen nasal mucosa Primary causes: Primary causes: –Allergies –Upper respiratory infections (common cold)

7. Decongestants Two main types are used: Adrenergics (largest group) Adrenergics (largest group) Corticosteroids Corticosteroids Two dosage forms: Oral Oral Inhaled/topically applied to the nasal membranes Inhaled/topically applied to the nasal membranes

8. Cough Physiology Respiratory secretions and foreign objects are naturally removed by the cough reflex cough reflex –Induces coughing and expectoration –Initiated by irritation of sensory receptors in the respiratory tract

9. Antitussives Drugs used to stop or reduce coughing Opioid and nonopioid (narcotic and non-narcotic) Opioid and nonopioid (narcotic and non-narcotic) Used only for NONPRODUCTIVE coughs!

10. Antitussives: Mechanism of Action Opioid Suppress the cough reflex by direct action on the cough center in the medulla. Suppress the cough reflex by direct action on the cough center in the medulla. Examples:codeine (Robitussin A-C, Dimetane-DC) hydrocodone

11. Beta-adrenomimetics Salbutamol, Ventolin, Berotek, Asthmopent

12. Antitussives: Mechanism of Action Nonopioid Suppress the cough reflex by numbing the stretch receptors in the respiratory tract and preventing the cough reflex from being stimulated. Suppress the cough reflex by numbing the stretch receptors in the respiratory tract and preventing the cough reflex from being stimulated. Examples:benzonatate (Tessalon) dextromethorphan (Vicks Formula 44, Robitussin-DM)

13. Antitussives: Therapeutic Uses Used to stop the cough reflex when the cough is nonproductive and/or harmful Used to stop the cough reflex when the cough is nonproductive and/or harmful

14. Oxeladin citrate, Tussuprex

15. Glaucin hydrochloride (glauvent) + ephedrine + Sage oil

16. Libexin

17. Drugs of medical plants Althea officinalis ThermopsisViola

18. Drugs of medical plants Ledum palustrae Origanum vulgaris

19. Crystal tripsin (Trуpsinum crystallisatum) Ampoules - 0,005 g and 0,01 g Ampoules - 0,005 g and 0,01 g

20. Acetylcystein (Acetylcysteinum) Forms of production: tablets - 0,1, 0,2 and 0,6, 20 % solution for inhalation in ampoules – Forms of production: tablets - 0,1, 0,2 and 0,6, 20 % solution for inhalation in ampoules – 5 and 10 ml; 10 % solution for injection in ampoules - 2 ml and 5 % solution in ampoules – 10ml.

21. Bromhexin (Bromhexinum)

22. Mucaltin (Mucaltinum)

23. Antitussives: Side Effects Benzonatate Dizziness, headache, sedation Dizziness, headache, sedationDextromethorphan Dizziness, drowsiness, nausea Dizziness, drowsiness, nauseaOpioids Sedation, nausea, vomiting, lightheadedness, constipation Sedation, nausea, vomiting, lightheadedness, constipation

24. Bronchodilators and Other Respiratory Agents

25. Asthmatic Response

26. Exchange of Oxygen and Carbon Dioxide

27. Methylxanthines Theophyllin (of prolonged action)

28. M-cholinoblockers Atropine sulfate, Solutan, Ipratropii bromidum (Atrovent)

29. Inhibitors of mast cells degranulation Cromolyn, Ketotifen and Nedocromil antagonize antigen- induced (IgE-mediated) mast cell degranulation Cromolyn, Ketotifen and Nedocromil antagonize antigen- induced (IgE-mediated) mast cell degranulation they prevent the release of histamine and slow-reacting substance of anaphylaxis (SRS-A) - mediators of type I allergic reactions they prevent the release of histamine and slow-reacting substance of anaphylaxis (SRS-A) - mediators of type I allergic reactions their beneficial effects in the treatment of asthma are largely prophylactic their beneficial effects in the treatment of asthma are largely prophylactic

30. Ketotifen Tilade (sodium nedocromil)

31. Devices Used in Asthma Therapy Uses a stream of air that flows through liquid medication to make a fine mist to be inhaled Uses a stream of air that flows through liquid medication to make a fine mist to be inhaled Very effective Very effective Must be cleaned and taken care of to reduce risk of contamination Must be cleaned and taken care of to reduce risk of contamination Nebulizer

32. Cellular Makeup of an Alveolus and Capillary Supply

33. Mast Cell Stabilizers: Side Effects CoughingTaste changes Sore throatDizziness RhinitisHeadache Bronchospasm

34. Morphine hydrochloride (Morphini hydrochloridum)

35. GANGLIONBLOCKERS Hygronium, Pentamin

36. Vasodilators Nitroglycerin (Nitroglycerinum) Nitromint

37. Diuretics Furosemid (Lazix), Mannit

38. Modified Bobrov’s apparatus (Alcohol 55-90 % for inhalation with oxygen – to reduce the foam in alveoli)

39. Dimedrol, Suprastin, Prednisolone