PNUR 1104 Pharmacology

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PNUR 1104Pharmacology

• Respiratory and Gastrointestinal Medications

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Objectives

• Discuss bronchodilating and asthmatic drugs.
• Identify the purpose and uses of anti-histamine
  drugs.
• Discuss the use of nasal decongestants,
  antitussives, mucolytics, and cold remedies.
• Discuss peptic ulcer disease drugs.

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Objectives

• Identify the purpose and use of cathartics and
  laxatives.
• Discuss anti-diarrheal drugs.
• Discuss anti-emetic drugs and their uses.

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Bronchodilators Antiasthmatic drugs

• Purpose
• Used in the treatment of respiratory disorders
  characterized by bronchoconstriction or
  bronchospasm, inflammation, mucosal edema, and
  excessive mucous production (asthma, bronchitis,
  emphysema).

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BronchodilatorsAdrenergics

• Action stimulate beta 2 adrenergic receptors in
  the smooth muscle to cause bronchodilation
• Examples Proventil, Alupent, Serevent, Brethine
• Uses Prevent treat bronchoconstriction

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Adrenergics

• Contraindications Cardiac tachyarrithmias
  severe CAD, HTN, Hyperthyroidism, Diabetes,
  seizure disorder.
• Side Effects Tachycardia, palpitations,
  restlessness, nervousness, insomnia, agitation,
  chest pain and tremor.

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Anticholinergics

• Action bronchodilation
• Examples Atrovent, Combivent
• Uses primarily for chronic disorders
• Contraindications narrow angle glaucoma
  prostatic hypertrophy
• Side effects dry mouth, blurred vision, H/A,
  nervousness, nausea (nasal epitaxis, dryness,
  irritation)

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Xanthines

• Action Bronchodilation
• Examples aminophylline, theophylline (Theo-Dur).
• Uses prevent treat bronchoconstriction.
• Contraindications acute gastritis, PUD, CV
  disorders.
• Side effects N/V, convulsions, anxiety,
  tachycardia.

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Anti-inflammatory antiasthmaticsCorticosteroids

• Action suppress inflammation
• Examples Pulmacort, Flovent Azmacort,
  Solu-Cortef
• Uses acute chronic asthma
• Contraindications PUD, HTN, CHF, inflammatory
  bowel disease, thromboembolic disorders.
• Side effects Hoarseness, cough, H/A, fungal
  infections

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Leukotriene Inhibitors

• Action inhibit bronchoconstriction and
  inflammation.
• Examples Singulair, Accolate
• Uses prophylaxis chronic asthma treatment
• Side effects H/A, infection, nausea, pain ,
  elevated liver enzymes, liver dysfunction.

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Mast Cell Stabilizers

• Action stabilize mast cells, prevent release of
  bronchoconstrictive inflammatory substances.
• Examples Nasalcrom
• Uses prophylaxis of asthma attacks.
• Contraindications impaired hepatic and renal
  function.
• Side effects arrythmias, hypotension, chest
  pain, restlessness, dizziness, etc.

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Antihistamines

• Purpose to block the effect of histamines in
  allergic reactions.
• Action prevent histamine action
• Examples Chlor-Trimeton, Tavist, Benadryl,
  Zyrtec.
• Uses Allergic rhinitis, N/V, motion sickness,
  sleep.
• Contraindications Prostatic hypertrophy
• Side effects Sedation, Dry mouth, throat
  nose, (give most with food).

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Nasal Decongestants, Antitussives, Mucolytics and
Cold Remedies

• Purpose
• to treat signs and symptoms of respiratory
  disorders with nasal congestion, cough, and
  increased secretions.

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Nasal Decongestants

• Action relieve nasal congestion by constricting
  arterioles, reducing blood flow to nasal mucosa.
• Examples Afrin, Neo-synephrine, Sudafed.
• Uses relieve rhinitis
• Contraindications Severe HTN or CAD, glaucoma,
  MAO antidepressants
• Sides effects tachycardia, arrythmias, anxiety,
  HTN, nervousness, palpitations, anorexia.

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Antitussives

• Action suppress cough.
• Examples codeine, Benlyn DM
• Uses dry, hacking, nonproductive cough.
• Sides effects N/V, Constipation, dizziness,
  confusion, hypotension.

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Expectorant

• Action liquefy respiratory secretions to allow
  for easier removal.
• Examples Robitussin
• Uses respiratory disorders with thick
  secretions.
• Sides effects Dizziness, H/A, N/V, diarrhea,
  stomach pain

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Mucolytics

• Action Liquefy mucus in the respiratory tract -
  administered by inhalation.
• Examples Mucomyst
• Uses respiratory disorders in which secretions
  are too thick or difficult to remove.
• Sides effects bronchial/tracheal irritation,
  N/V, bronchoconstriction, chest tightness,
  stomatitis, drowsiness.

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Peptic Ulcer Disease Medications

• Purpose To treat acid peptic disorders

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Antacids

• Action neutralize gastric acids
• Examples Maalox, Mylanta
• Uses heartburn, indigestion, GERD
• Contraindications Renal failure, CHF, HTN
• Sides effects diarrhea, constipation,
  hypermagnesemia

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Histamine

• Action inhibit secretion decrease amount
  acidity of gastric juices.
• Examples Tagamet, Pepcid
• Uses prevention and treatment of PUD,
  esophagitis, GI bleeding
• Sides effects Diarrhea, H/A, Mental confusion,
  dizziness, skin rashes

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Proton Pump Inhibitors

• Action Prevent release of gastric acid
• Examples Prevacid, Prilosec
• Uses PUD, GERD
• Contraindications Use cautiously in liver
  disease, elderly, children,, pregnancy
  lactation.
• Sides effects H/A, Diarrhea, abdominal pain, N/V.

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Laxatives and Cathartics

• Purpose
• Used to promote bowel elimination.
• Actions
• Bulk forming laxatives
• Surfactant laxatives
• Saline cathartics
• Irritant or stimulant cathartics
• Lubricant laxatives

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Laxatives and Cathartics

• Examples Metamucil, Perdiem, Colace, Surfak,
  Colyte, MOM, Dulcolax, Doxidan, Ex-lax, mineral
  oil
• Uses relief of constipation
• Contraindications undiagnosed abdominal pain,
  intestinal obstruction fecal impaction.
• Side efefects diarrhea, abdominal cramping,
  hyponatremia, hypokalemia, dehydration.

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Anti-Diarrheals

• Purpose used to treat diarrhea, either to
  relieve symptoms (nonspecific therapy) or the
  underlying cause (specific therapy).
• Action
• Opiate opiate derivatives
• Antibacterials
• Miscellaneous

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Anti-Diarrheals

• Examples Lomotil, Imodium, neomycin, Septra,
  Pepto-Bismol
• Uses prevent treat diarrhea
• Contraindications some children lt 2
• Sides effects Constipation, drug dependence

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Anti-Emetics

• Purpose
• Used to prevent or treat nausea vomiting.
• Action
• Phenothiazines
• Antihistamines
• Prokinetic agents
• Miscellaneous

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Anti-Emetics

• Examples Thorazine, Phenergan, Dramamine,
  Antivert, Bonine, Reglan
• Uses to prevent treat nausea vomiting
• Contraindications routine use, mask diagnosis or
  toxicity
• Sides effects Excessive sedation, hypotension,
  extrapyramidal reactions, anticholinergic effects.

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Questions?