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Antitussives
- -suppress cough
- -some act within CNS
- -some act peripherally (dexitromethorphan)
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Expectorants
-renders cough more productive by stimulating the flow of respiratory tract secretions (gulafinesin)
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Mucolytics
-reacts directly with mucous to make it more watery (mucomyst)
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Neubulizers
small machines used to convert a drug solution into a mist for inhalation
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DPI
- (dry-powder inhalers)
- -used to deliver drugs in the form of a dry, micromized powder directly to the lungs
- -no propellant is employed
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MDI
- (metored dose inhalers)
- -small, hand-held, pressurized devices that deliver a measured dose of drug with each actuation
- -usually 1-2 puffs
- -make sure to each not to put lips on device but rather a distance of 1-2 inches from mouth
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spacers
- -available to use with MDI devices
- -attach directly to the device
- -serve to increase delivery of drug to the lungs and decrease deposition of drug on the orophrayngeal mucosa
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two types of antihistamines
H1 antagonists and H2 antagonists
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H1 antagonist
- -bind selectively to H1-histaminic receptors thereby blocking actinos of histamine at these sites
- -do not block H2 receptors
- -do not block release of histamine from mast cells or basophils
- -side effects: sedation, anticholinergic effects, nonsedative CNS effects, GI effects
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H2 antagonists
- -produce selective blockade of H2 receptors
- -do not block H1 receptors (no use in treating allergies)
- -widely used for Peptic Ulcer Disease
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1st generation (highly sedating)
- -alkylamines
- -ethanolamines
- -phenothiazines
- -piperazines
- -piperidines
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2nd generation (not highly sedating)
- -cross blood-brain barrier poorly (much less sedative effect)
- -azelastine (Astelin)
- -cetirizine (Zyrtec)
- -levocetirizine (Xyzal)
- -fexofenadine (Allegra, Allegra ODT)
- -lordatadine (Alavert, Claritin, Tavist ND)
- -desloratadine (Clarinex, Clarinex RediTabs
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asthma
- -common, chronic disorder that occus in children and adults
- -chronic inflammatory disorder of the airways
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two main treatments for asthma
- -these drugs help relieve the symptoms of asthma by opening up the airway
- -anti-inflammatory drugs and bronchodilators
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anti-inflammatory drugs include:
glucocorticoids, leukotriene modifiers, cromolyn and nedocromil, omalizumab
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glucocorticoids
- -budesonide and fluticasone
- -most effective antiasthma drugs available
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inhalation use of glucocorticoids
- -first line therapy for asthma
- -patients with moderate to severe asthma should use drug daily
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oral use of glucocorticoids
- -reserved for patients with severe asthma
- -only prescribed when symptoms cannot be controlled with safer medications (inhaled glucocorticoids, inhaled beta2-agonists)
- -duration of use should be as brief as possible because of risk of toxicity is increased with prolonged use
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adverse effects of inhaled glucocorticoids
- -largely devoid of serious toxicity, even when used in high doses
- -most serious concerns are adrenal suppression and bone loss
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