Pharmacology and Lower Respiratory Drugs

Overview

• Introduction to pharmacology courses and app for studying.
• Two teams of drugs for lower respiratory issues:
  • BAM Team: Bronchodilators
  • SLAM Team: Anti-inflammatory agents

BAM Team: Bronchodilators

B for Beta-2 Agonists

• Commonly end in -butol (e.g., Albuterol, Levalbuterol)
• Used for brutal asthma attacks
• Key Facts:
  • First drug used during severe asthma attacks.
  • Fastest acting bronchodilator.
  • Only rescue inhaler for acute asthma attacks (use before steroid inhalers).
  • Common exam point: Used before steroid inhalers.
  • Salmeterol is a slower-acting beta-2 agonist (not a rescue inhaler).

Mechanism of Action

• Activates beta-2 in lungs: Bronchodilation, increased airflow.
• Activates beta-1 in heart: Increased heart rate.
• Side Effects:
  • Tachycardia, palpitations.
  • Tremors.
  • Insomnia (avoid taking at bedtime).

Patient Education

• Avoid beta blockers ending in -lol (e.g., Atenolol) and NSAIDs like Naproxen.
• During severe asthma attacks:
  • Instruct: 2-4 puffs every 20 minutes x3.
  • Notify HCP if ineffective after 3 doses.
  • Efficacy: Reduced respiratory rate, O2 saturation ≥ 90%.

Administration Tips

• Shake inhaler before use.
• Inhale albuterol first, then steroid inhalers.
• Clean mouthpiece 1-2 times/week.

A for Anticholinergics

Examples

• End in -tropium (e.g., Ipratropium, Tiotropium)
• Usage:
  • Moderate to severe asthma and COPD.
  • Longer-acting bronchodilator.
  • Reduces secretions.

Mechanism of Action

• Blocks secretions: "Can't see, pee, spit, or poop."
• Anti-cholinergic effect.

Side Effects and Patient Teaching

• Dry mouth and hoarseness.
• Use gum, candy, and fluids for dry mouth.
• Important: Do not swallow tiotropium capsules; inhale them.

Key Test Tips

• Order of medication during asthma attacks: AIM (Albuterol, Ipratropium, Methyprednisolone).
• No swallowing of tiotropium capsules.
• Clean steroid inhalers after each use.

Conclusion

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