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2010-05-03 10:47:37

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  1. Drug Therapy for COPD
    More effective in “relieving” respiratory symptoms than curing underlying disorders that cause the symptoms
  2. Two major drug groups used to treat respiratory symptoms:
    • Bronchodilators
    • Anti-inflammatory agents
  3. Bronchodilators
    • Beta-adrenergic agonists
    • Most frequently prescribed drugs for pulmonary disorders
  4. Beta Agonists:
    • Activate SNS=relaxes bronchial smooth muscle=bronchodilation
    • DOC in treatment of bronchoconstriction
  5. Beta-Adrenergic Agonists
    • Act on either beta-1 receptors (located primarily in the heart)
    • Think…one heart…beta-1
  6. Beta 2 receptors are located where?
    • on smooth muscle of the lung
    • uterus
    • other organs
  7. Beta 1 works on
  8. Beta-2 works on
    lungs…you have 2 lungs
  9. Beta agonists that activate both beta 1 and beta 2 receptors are called
    “non-selective” agents
  10. What is an examples of non-selective Beta Agonist?
    • Isoproterenol
    • Epinephrine
  11. What was the 1st beta agonist used for bronchospasms. “non-selective”
  12. Why is Isoproterenol not used much today?
    numerous side effects
  13. A catecholamine with alpha and beta receptor properties used for COPD?
  14. Uses of epinephrine in COPD patients?
    • Given for immediate bronchodilation effects to increase patency of airway
    • EMERGENCY DRUG - shock
  15. Selective Beta agonists
    • Albuterol, aka Proventil or Ventolin
    • Can get some beta 1 effects if used in excess
  16. Beta adrenergic agonists
    Selective beta 2 agonists have largely replaced the older non- selective agonists that were often alpha, beta 1 and beta 2
  17. What does the Beta Adrenergic agonists do?
    Prevents unwanted cardiac effects
  18. Beta 2 adrenergic agonists - Classified by duration of action
    • Short acting agents have rapid onset of action
    • Usually within several minutes
    • Effective in terminating and acute asthma “episode”
    • “Rescue agents”
    • Typically lasts 2-6 hours in duration
    • Used “prn”
    • DOC for acute symptoms
  19. What are Short Acting Beta Agonists (SABA’s)?
    • SABA’S…rapid onset…30 sec-1 minute
    • short-term relief of acute reversible airway problems
  20. Examples of SABA’s?
    • Albuterol
    • Proventil
    • Ventolin
    • Alupent (Metaproterenol)
  21. How is (albuterol) Proventil & Ventolin administered?
    Available in po, MDI, DPI
  22. What is MOA of Albuterol, proventil, & Ventolin?
    Promotes bronchodilation
  23. How is Alupent (Metaproterenol) administered?
    Nebulizer, MDI, po
  24. Bronchodilators
    • Relax smooth muscle of the bronchi, promoting bronchodilation
    • Reduces airway resistance
  25. Beta-adrenergic agonists bronchodilators
    Most frequently prescribed drugs for pulmonary disorders
  26. Beta Agonists:
    • Activate SNS=relaxes bronchial smooth muscle=bronchodilation
    • DOC in treatment of bronchoconstriction
  27. Bronchodilators - Sympathomimetics
    Epinephrine (adrenaline)
  28. Action of epinephrine
    • Increases cAMP in lung tissue causing bronchodilation
    • Restores circulation and increases airway patency
    • First line of defense in acute asthma attack or anaphylaxis, given subQ
  29. Side effects of epinephrine
    • Palpitations
    • Dizziness
    • Nervousness
    • Tremors
    • Tachycardia
    • Dysrhythmias
    • hypertension