Pulmonary/Asthma Drugs

Pulmonary/Asthma Drugs + Pulmonary Disease Chronic Obstructive Pulmonary Disease (COPD) [Long-term difficulty breathing] Asthma [Short term difficulty in breathing due to various mitigating factors] ● Dec ability to ventilate & exchange gas at alveoli ● Results in compromised daily activities Inappropriate outflow of air due to inc airway resistance ● Bronchoconstriction of SM ● Commonly due to Structural or Infection Also due to alveoli destruction, low CV Fitness, & low muscular fitness Results in low POs & high PCO2, ventilatory muscle fatigue & failure Usually see Depression & Anxiety w/ daily activities, if disease severe enough + Pulmonary Function Asthmatic Reactions ● Allergic agents in young asthmatics ● Non allergic agents in older asthmatics Cause 2 responses ● Bronchiolar SM spasms = dec airflow ● Increases mucous release = dec airflow Inspiration is adequate, but outflow is compromises due to smaller diameter + Asthma Numbers 7.7% of adults (+17yrs) are asthmatics 8.4% of children are asthmatics 65% adults & 60% children have persistent asthma Avg annual medical cost is $1,000 in 2014 Mortality was 3,564 in 2017 Common in boys & women Common in Africans & Hispanics + Factors Activating SM Histamine - in response to allergies / agents ● Causes bronchoconstriction Cholinergic stimulation - neurotransmitter ● Causes bronchoconstriction B2-adrenergic stimulation - catecholamines ● Causes bronchodilation + Drug Assistance Inhalers vs. oral ingestion + Ipratropium (Atrovent) - Anticholinergic + Albuterol (Proventil) - Short-Acting B2-Agonists + Salmeterol (Serevent) - Long-Acting B2-Agonists + Budesonide & Formoterol (Symbicort) - Combination Long-Acting Corticosteroid & B2- Agonist + Theophylline (Theo-24) - Theophyllines + Immune Function Antibiotics ● ● ● ● Amoxicillin Cephalexin (Keflex) Penicillin (Penicillin V Potassium) Tetracycline CNS Stimulants +CNS Stimulants Commonly used for controlling ADHD or weight loss In the last 10 yrs research shows use high for mental function Of all users for brain activity: ● 62% have tried Ritalin ● 44% tried Provigil ● 15% used beta-blockers (Inderal) Early research - Nature April 10, 2008 Research (double blind) showed expert chess player improved play w/ Ritalin, Provigil, caffeine ● European Neuropsychopharmacology +Methylphenidate (Ritalin, Concerta) +Amphetamine (Adderall) +Modafinil (Provigil) +Diethylpropion (Tenuate) +Phendimetrazine (Bontril) Antianxiety and Antidepressant Drugs +Anxiety - feeling of apprehension that may or may not be based on reality Faintness, breathing problems, nausea, rapid or irregular heartbeat, butterflies in the stomach, irritability, uneasiness, jumpiness, stomachache Excessive anxiety can make daily life impossible People may have generalized anxiety disorder (GAD) or more specific anxiety disorders such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and phobias +Antianxiety drugs (or anxiolytics) and antidepressants can treat these disorders Benzodiazepines - diazepam (Valium) and alprazolam (Xanax) Work in a short time w/ few side-effects Addictive = used for brief periods of time Take longer to get an action +Alprazolam (Xanax) +Buspirone (BuSpar) - Nonbenzodiazepines +Antidepressants Feelings of intense sadness, helplessness, and impaired daily functioning Symptoms occur every day for 2 weeks or more 3 general types of antidepressants ● Tricyclic Antidepressants (TCAs) ● Monoamine Oxidase Inhibitors (MAOIs) ● Selective Serotonin Reuptake Inhibitors (SSRIs) +Imipramine (Tofranil) +Phenelzine (Nardil) +Sertraline (Zoloft) Immune Function - Antibiotics +Antibiotics Discovered by Alexander Fleming Typically produced by microorganisms (molds) Specific in killing cells of pathogenic bacteria Bacteria have a hard outer cell wall, without it the bacteria will get too big and die. Antibiotics damage the cell wall development. They are of great clinical importance, but their use is currently being challenged by the evolution of resistance Strong bacteria survive antibiotics and pass along immunity against antibiotics to offspring = stronger bacteria We now use “super-antibiotics”But aren’t as effective as they should be +Amoxicillin (Amoxil) +Cephalexin (Keflex) +Azithromycin (Zithromax) +Clindamycin (Cleocin) +Triclosan (chloro-dichlorophenoxy phenol) Insulin and Glucose Lowering Drugs +Diabetes Controlling Drugs Became available around 1950 Several currently available Type I Diabetes Type II Diabetes ● Used to be prescribed Diet and Exercise Both forms of disease caused increase in blood glucose levels ● Can lead to life-threatening situations +Type I Diabetes Receive Insulin Many forms ● Injection ● Pump New ● Closed loop pump system ● Genetic engineering with pancreatic stem cells +Type II Diabetes 8 main oral meds for Type II Diabetics ● Drugs used when Exercise/Diet doesn’t work +Biguanides - metformin (Glucophage) +Sulfonylureas - glimepiride (Amaryl) +Meglitinides - repaglinide (Prandin) +Alpha-Glucosidase Inhibitors - acarbose (Precose) +DPP-4 Inhibitors - sitagliptin (Januvia) +SGLT2 Inhibitors - dapagliflozin (Farxiga) +Thiazolidinediones - rosiglitazone (Avandia) +Glucagon-like Peptide-1 Receptor Agonists (GLP-1 Agonists) - semaglutide (Ozempic) Musculoskeletal System Drugs +Musculoskeletal Disorders Many clinical disorders in this group Only going to cover drugs for the following: ● Osteoporosis ● Osteoarthritis ● Skeletal Muscle Relaxants +Osteoporosis 44 mil Americans have low bone density 10 mil+ people have osteoporosis 25% of women and 5% of men +65 yrs 1 in 2 Caucasian women will suffer a fracture due to osteoporosis in her lifetime 20% of those suffering a hip fracture will die within the 1st yrs following the facture Only 33% of hip fracture patients regain prefracture level of function +Alendronate (Fosamax) +Osteoarthritis Over 59 mil Americans have osteoarthritis By age 40 yrs, 90% have some degree of OA No certain way to avoid OA Most often occurs in hands, joints of lower back, hips and knees. 4-5x more prevalent obese vs. normal weight Overweight/obese individuals that lose 11 lbs dec risk of OA by 50% Commonly treated w/ NSAIDs +Celecoxib (Celebrex) +Meloxicam (Mobic) +Needs for Muscle Relaxants Alleviate symptoms of muscle spasm and pain 2 different groups: ● Neuromuscular Blockers - Interfere w/ NM endplate and has no CNS action ● Spasmolytics - Centrally acting relaxants ● Typically only the spasmolytics are referred to as the muscle relaxants +Carisoprodol (Soma) +Cyclobenzaprine (Flexeril) +Diazepam (Valium)