ANTIASTHMATIC DRUGS

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ANTIASTHMATIC DRUGS:

Composed By: KHALID,M#44,M.M.C. ANTIASTHMATIC DRUGS PRESENTED BY: DR. SHAMIMA NASREEN LECTURER DEPT. OF PHARMACOLOGY M.M.C.

PowerPoint Presentation:

Composed By: KHALID,M#44,M.M.C. 1.Short time relievers: Bronchodilators 2.Long time controllers: Preventors/Steroids of inflammation *1. Bronchodilators (dilates airway): β 2 agonists (drug of choice). Methyl xanthine derivatives/PD inhibitors. Antimuscarinic drugs. Antihistamines. *2. Preventors (Interrupt bronchial inflammation): Corticosteroid. Cromolyn like compounds (Intal). Kitotifen (Tofen –tab/syp).

Drug discussions:

Composed By: KHALID,M#44,M.M.C. Drug discussions Β 2 agonists Salbutamol Terbutaline Isoprenaline Ephidrine Adrenaline Salmeterol These are the drugs of choice because adrenoceptors in the bronchi are mainly of β 2 types & their stimulation cause bronchial muscle to relax. Preparations: Salbutamol Tab (2-4mg) TDS/QDS. Salbutamol Syrup (for children)-1 teaspoonful=5ml=2mg. Salbutamol inhaler- 100µg/puff. 2 puff 3-8 times/daily. Terbutaline-5mg tab TDS/QDS daily.

PowerPoint Presentation:

Composed By: KHALID,M#44,M.M.C. USES: In- Acute asthma-short acting β 2 agonists. Emphysema. Threatened abortions as tocolytics. Salmeterol: Long acting , 12 hourly , not suitable for acute attack. Used in chronic asthma & prophylactically. Adverse effects of β 2 agonists: Anxiety Headache Tremor Palpitation Tachycardia.

PowerPoint Presentation:

Composed By: KHALID,M#44,M.M.C. Less selective β 2 adrenoceptors agonists: Adrenaline inhaler/injection (S/C or IM: 0.3-0.5ml used in emergency cases). Mechanism of salbutamol Salbutamol ↓ Stimulate β 2-receptors in bronchus ↓ Stimulation of adenylate cyclase ↓ ↑ cAMP production & β 2 receptors activation also causes reduction of intracellular calcium. ↓ Bronchodilatation.

PowerPoint Presentation:

Composed By: KHALID,M#44,M.M.C. Mechanism of salbutamol (Contd..) Salbutamol acts on β 2 –receptors on mast cells ↓ Increase cAMP production ↓ Stabilizes mast cell membrane ↓ No histamine release ↓ No bronchoconstrictioin. 3. Salbutamol increases mucociliary action of lung.

Methyl Xanthine derivatives/ Phosphodiesterase inhibitors:

Composed By: KHALID,M#44,M.M.C. Methyl Xanthine derivatives/ Phosphodiesterase inhibitors Theophylline (300 mg) Theobromine Caffeine. Aminophylline (200mg) ½ + 0+ ½ Dose: 5mg/kg with 20ml of saline over 20 minutes. or, Suppositories- 350mg 1-2 times daily. Methyl Xanthine: is a xanthine derivatives. Xanthine is a nitrogenous compound present in muscle, tissue, liver, spleen, pancreas & other organs & in urine. It is formed by metabolism of neucleoproteins. M/A: Blocks bronchoconstrictor action of adenosine by competitive inhibition of adenosine receptor.So, bronchodilatation occurs.

Indications of Aminophyllines:

Composed By: KHALID,M#44,M.M.C. Indications of Aminophyllines Severe bronchial asthma. Chronic asthma. Treatment of chronic obstructive pulmonary diseases. Emergency treatment of left ventricular failure. Migraine. Ordinary headache (Caffeine + Aspirin.)

Adverse effects of Aminophylline:

Composed By: KHALID,M#44,M.M.C. Adverse effects of Aminophylline Nausea Vomiting Headache Nervousness Insomnia Convulsion Arrythmia Severe tachycardia Tremor *Notes: It is a weak diuretic. It also decreases secretion from mast cells & other sources of mediators of inflammation.

Anticholinergic/Antimuscarinic Bronchodilators:

Composed By: KHALID,M#44,M.M.C. Anticholinergic/Antimuscarinic Bronchodilators Ipratropium bromide Atropine *M/A: These drugs inhibit Ach mediated bronchoconstriction. *Nebulizer: 1ml ipratropium bromide + 1ml salbutamol liquid + 2ml normal saline. These formulation is given for 10 mins. Then 10 mins rest is given & again given for 10 mins.

Antihistamines:

Composed By: KHALID,M#44,M.M.C. Antihistamines Kitotifen (Tab Tofen) Terfenadine. M/A: Inhibits histamine release & cause bronchodilatation. **Differences between salbutamol & Aminophyllines.

PowerPoint Presentation:

Composed By: KHALID,M#44,M.M.C. THANKS TO YOU ALL