Unit 7_Pharm

Views:
 
Category: Education
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

Respiratory, GI, Endocrine:

Respiratory, GI, Endocrine

Respiratory Medications:

Respiratory Medications Coughing, Irritation, Secretions Anti- Tussives Opiate drugs suppress cough reflex in CNS ( Codeine ) Others inhibit irritation effects of histamine ( Diphenhydramine ) Some act as local anesthetic ( Benzonatate )

Respiratory Medications:

Respiratory Medications Coughing, Irritation, Secretions Anti- Tussives Side effects of antitussive drugs: Reduce ability to expel mucus and foreign material from upper respiratory tract Sedation Dizziness

Respiratory Medications:

Respiratory Medications Coughing, Irritation, Secretions 2. Decongestants These are administered either orally ( Ephedrine ) or as nasal spray ( Phenylephrine ). These are alpha 1-adrenergic agonists that bind alpha-1 receptors in nasal blood vessels. Action : Vasoconstriction, which dries up mucosa of nasal region

Respiratory Medications:

Respiratory Medications Coughing, Irritation, Secretions 2. Decongestants Side effects of decongestants Headache Dizziness Nervousness Nausea Increased blood pressure Palpitations Rebound congestion

Respiratory Medications:

Respiratory Medications Coughing, Irritation, Secretions 3. Antihistamines Action: Blocks H-1 receptors Treat respiratory allergic response decrease in nasal congestion decrease in conjunctivitis d ecrease coughing and sneezing d oes not block airway constriction of asthma

Respiratory Medications:

Respiratory Medications Coughing, Irritation, Secretions 3. Antihistamines Side effects Sedation Fatigue Dizziness Blurred vision Incoordination GI distress   First generation antihistamines affect CNS but new non-sedating drugs have less CNS effect but may produce CV changes.

Respiratory Medications:

Respiratory Medications Coughing, Irritation, Secretions 4. Mucolytics and Expectorants Mucolytics and expectorants are used for acute respiratory disorders (cold, pneumonia) and chronic disorders, such as emphysema and chronic bronchitis.   Mucolytics (inhalation or intratracheal administration)   Action: Decrease viscosity of secretions Acetylcysteine most commonly used Splits bonds of mucoproteins producing a less viscous secretion

Respiratory Medications:

Respiratory Medications Coughing, Irritation, Secretions 4. Mucolytics Nausea, vomiting Inflammation of oral mucosa Rhinorrhea

Respiratory Medications:

Respiratory Medications Coughing, Irritation, Secretions 4. Mucolytics and Expectorants Expectorants (oral administration) Action: Stimulate the production and removal of mucus Guaifenesin is commonly used Increases production of secretion, which stimulates the removal of phlegm and sputum Mechanism of action unclear Side effects Nausea and vomiting

Respiratory Medications:

Respiratory Medications Asthma & COPD Obstructive PD COPD= chronic bronchitis/ emphysema Similar symptoms airway inflammation Bronchial constriction Increased secretions

Respiratory Medications:

Respiratory Medications Treatment of Asthma & COPD Bronchodilators A. Beta 2 agonists- Salbutamol ( albuterol ), EPI, Iso B. Xanthine Derivatives - Theophylline ( areolate ) May inhibit Phosphodiesterase ? Inhalation or Oral - Side effects: - GI - confusion, irritability - arrhythmias, seizures

Respiratory Medications:

Respiratory Medications Treatment of Asthma & COPD Bronchodilators C. Anticholinergics - Ipratroprium ( Atrovent ) - Block M receptors (like atropine) - inhaled 3-4x/day - Side effects: - less with inhaled drug

Respiratory Medications:

Respiratory Medications Treatment of Asthma & COPD Bronchodilators D. Leukotriene Antagonists- Monteleukast ( Singulair ) -oral administration Side effects : GI Weakness Suicidal behavior, agressiveness

Respiratory Medications:

Respiratory Medications Treatment of Asthma & COPD Anti-inflammatory medications Glucocorticoids - Cortisone ( Cortone ) -mostly inhalant Side effects: - fewer with inhaled medication

GI Medications: Drugs to control gastric acidity:

GI Medications: Drugs to control gastric acidity Antacids - neutralize acid - base + Al, Mg, Ca++ CaCO 3 + 2HCL CaCl 2 + H 2 O + CO 2 Many OTC Side Effects: - constipation or diarrhea - can affect absorption of other drugs

GI Medications: Drugs to control gastric acidity:

GI Medications: Drugs to control gastric acidity 2 . Proton Pump Inhibitors - inhibit H+/K+ ATPase pump - Lansoprazole ( Prevacid ) - few side effects- may cause hyperplasia? 3. H2 Antagonists - Famotidine ( Pepcid ) - side effects- well tolerated - headache, dizziness All can cause acid rebound after prolonged use

GI Medications: Drugs to control gastric acidity:

GI Medications: Drugs to control gastric acidity 4. Anticholinergics you know the side effects! 5. Metoclopramide ( Reglan ) - DA antagonist - may also enhance Ach to increase GI motility - keeps stuff moving forward (GERD) - Side Effects: - restless - drowsiness - fatigue - tremor/ rigidity - tardive dyskinesia

GI Medications: Drugs to treat diarrhea:

GI Medications: Drugs to treat diarrhea Opiates - decrease GI motility - increase reabsorption of Na/H20? - help with pain from cramping Adsorbents (Kaolin, pectin= Kaopectate , Donnagel - binders 3. Bismuth Salicylate ( PeptoBismal ) - increase fluid absorption - decrease HCL secretion

GI Medications: Laxatives and Cathartics::

GI Medications: Laxatives and Cathartics: Laxatives and cathartics - promote bowel evacuation - slow vs fast - overused Types: A. Bulk forming Methylcellulose(Citrucel ) - absorb water, swell B. Stimulants (Castor oil) - increase water in GI C. Hyperosmotics (MgSo4-Epsom salts) - attract water D. Lubricants and stool softeners (Fleet meneral Oil) - increase water in fecal mass Side Effects: - cramping - laxative dependence

GI Medications: Emetics and Antiemetics::

GI Medications: Emetics and Antiemetics: Emetics - induce vomiting - Syrup of Ipecac - irritant on GI, stimulate medullary emetic center 2. Antiemetics - decrease nausea and vomiting - anticholinergics (Scopolamine) - antihistamines ( Meclazine ) - antidopaminergics - antacids and adsorbants soothe gastric mucosa

Endocrine Medications:

Endocrine Medications 1. Treatment of excessive endocrine function Drugs used to inhibit the synthesis of a hormone, employing negative feedback mechanism Drugs can also be used to block hormone receptors   2. Hormone replacement - Thyroid hormone, estrogen, etc 3. Using beneficial hormonal effects Drugs can exaggerate a beneficial response, as when glucocorticoids are used to treat inflammation Concentration raised above normal physiological levels   3. Altering endocrine function Bringing about a desired alteration in endocrine response, as when oral contraceptives are used to inhibit ovulation   4. Use in non-endocrine disease Preventing excessive epinephrine production may help control angina

Adrenal Hormone Disorders:

Adrenal Hormone Disorders Adrenal Cortex Disorders Hypercortisolism and Cushing’s Hyperaldosteronism Adrenal Cortical Insufficiency

Adrenal Hormone Disorders:

Adrenal Hormone Disorders Adrenal Cortex Disorders Hypercortisolism and Cushing’s

Adrenal Hormone Disorders:

Adrenal Hormone Disorders Hypercortisolism and Cushing’s

Tx of Hypercortisolism (Cushings):

Tx of Hypercortisolism ( Cushings ) Surgery Radiation Stop taking cortisol medications ketoconazole ( Nizoral )- antifungal, mitotane ( Lysodren)-antineoplastic , and metyrapone ( Metopirone ) All supress synthesis or release of cortisol

Adrenal Hormone Disorders:

Adrenal Hormone Disorders B. Hyperaldosteronism Primary: adenoma (Conn’s) Secondary: high renin Clinical: - Hypernatremia - Hypokalemia - Hypertension

Tx of Conn’s Disease:

Tx of Conn’s Disease Surgical removal of tumor Aldosterone angatonists ( spironolactone ) Antihypertensives such as AII blockers

Adrenal Hormone Disorders:

Adrenal Hormone Disorders C. Adrenocortical Insufficiency 1. Acute - withdrawal of steroid therapy - hemorrhagic infarct of adrenal - meningococcal meningitis 2. Chronic (Addison’s) - Mainly autoimmune disorder

Tx of Addison’s Disease:

Tx of Addison’s Disease Hormone Replacement Therapy oral corticosteroid Corticosteroid injections Androgen replacement therapy Increased salt intake

Adrenal Hormone Disorders:

Adrenal Hormone Disorders 2. Adrenal Medulla Disorders Pheochromacytoma Epinephrine secreting tumor Severe, abrupt hypertension Tachycardia Palpitations Headache Tremor Tx - remove tumor, anti- hypertensives

authorStream Live Help