The Respiratory System and Drug Therapy Pharmacological Sciences Standard 5 Research the basic chemical properties, physical properties, dosages, and indications of legend for selected over-the-counter (OTC) drugs and herbal and dietary supplements. Illustrate findings in an oral, visual, or digital presentation, citing information obtained from print and online medical sites such as the U.S. National Library of Medicine databases. Section 1: The Respiratory System Identify the basic structure and function of the respiratory system. We will do this by Answering 3 questions related to the anatomy and physiology of the lungs. Objective upper region and lower regions Upper Respiratory Tract: nasal passages, sinuses, and the throat area Epiglottis and larynx (voice box) are in the upper throat Lower Respiratory Tract: bronchi, bronchioles, lungs, and alveoli Regions of the Respiratory Tract ` The Respiratory System When a person breathes, air is pulled into and pushed out of the lungs In the lungs, small air sacs (alveoli) fill with air and allow for gas exchange with the blood Alveolis large surface area and number of blood vessels allow oxygen to move into the blood and carbon dioxide (a by-product of cellular function) to leave the blood This process is called the gas-exchange process The Process of Breathing Involves two actions Oxygen is picked up in the lungs and is carried by red blood cells to all the cells of the body Carbon dioxide is brought back to the lungs to be expelled during exhalation Serves two functions Provides oxygen to body cells to supply energy and to fuel cellular respiration Helps maintain acid/base balance in blood; keeps blood pH within safe limits The Gas-Exchange Process Gas Exchange Process Plicker time! Review Lets learn about medication to treat problems of the Respiratory System! Section 2: Drug Therapy Research the basic chemical properties, physical properties, dosages, and indications of legend for selected prescription, over-the-counter (OTC) drugs and herbal and dietary supplements. Illustrate findings in an oral, visual, or digital presentation, citing information obtained from print and online medical sites such as the U.S. National Library of Medicine databases. Standard 5 The student will analyze two medications to treat asthma with consideration given to A. patient history & assessment B. route of administration C. dose Objective Over 22 million people in the U.S are diagnosed with Asthma The primary goals of treatment Reduce acute and chronic symptoms Prevent exacerbations Minimize hospitalizations or visits to the ER Asthma Inflammatory disorder of the airways Chronic (not curable) condition 3 THINGS!! bronchioles constrict, mucus increases, and lung tissue swells Symptoms: coughing, wheezing, breathlessness, and chest tightness Common triggers: smoke, dust, exercise, pet dander, cold weather, cockroaches Asthma A lung with asthma overreacts to produce excess mucus and swelling The combination of excess mucus and bronchoconstriction makes airflow difficult Asthmatic Lung Allergic Asthma Most common type Symptoms are triggered by an allergic reaction Inhaling an allergen (dust, pet dander etc.) Non Allergic Asthma Symptoms are triggered by something other than an allergen (stress, exercise, cold air) Patients typically complain of pain or burning in their chest during exercise, and often cough frequently after exercise. BOTH REQUIRE MEDICATION TO REVERSE SYMPTOMS Types of Asthma Short-term drug therapy Rescue inhalers for quick relief during an asthma attack Short-acting beta agonists (inhaled) Long-term drug therapy Inhaled corticosteroids as anti-inflammatory agents Drugs for Asthma Type of Bronchodilator (It dilates the Bronchioles!) Works by relaxing the smooth muscle in the airways to increase airflow to the lungs. Helps for immediate relief of acute symptoms. (remember during an asthma attack - bronchioles constrict, mucus increases, and lung tissue swells) Example: ProAir HFA Inhaler (albuterol) Given 30 minutes prior to exercise or at the onset of symptoms Short Acting Beta Agonists Inhaler - Long Acting medication used for long term management of moderate to severe asthma (typically used for allergy induced asthma) Oral given for short term therapy only (oral steroids) Both work by decreasing inflammation and mucous production in the lungs. Example: Prednisone Corticosteroids Chronic and progressive disease that is not reversible; airflow is limited by an abnormal inflammatory response Two sets of symptoms: chronic bronchitis and emphysema Chronic bronchitis: a persistent cough producing sputum for 3 + months for at least 2 consecutive years Emphysema: fast, labored breathing that results from damaged or destroyed alveolar walls Impaired walls reduce lung surface area COPD Drug therapy Relieves symptoms Improves quality of life Allows increased patient activity Drugs for COPD Indication: first-line treatment for bronchoconstriction Mechanism of Action: inhibit ACh (neurotransmitter that causes smooth muscles in the lungs to constrict) Routes: all are inhalation; ipratropium is also intranasal Side Effects (common): dry mouth, nervousness, dizziness, headache, cough, nausea, nasal dryness, upper RTI Cautions: contraindicated in patients with glaucoma, urination problems, or soy or peanut allergies Cautions: ipratropium inhalers need primed before first use; tiotropium capsules are inhaled (not swallowed) Drugs for COPD: Anticholinergics Indications: COPD; also severe asthma Mechanism of Action: stimulate beta-2 receptors in lungs and produce smooth muscle relaxation in bronchioles administered less often than short-acting beta agonists Route: all are inhalation Side Effects (common): dizziness, heartburn, nausea, tremors Side Effects (severe): increased BP, heart palpitations Caution: do not use with digoxin or beta blockers Caution: shake MDIs before each use Drugs for COPD: Long-Acting Beta Agonists Pneumonia- A lower RTI caused by bacterial, viral, or fungal pathogens Two types of pneumonia: CAP and nosocomial CAP: acquired from exposure outside of an inpatient facility Nosocomial pneumonia: acquired while hospitalized or living in a long-term care facility Severe and difficult to treat because it is usually caused by more virulent pathogens Pneumonia and TB An infectious disease caused by a mycobacterium that infects the lungs Incidence is on the rise due to drug-resistant strains and more prevalent immunodeficiency conditions Annual PPD skin test for TB exposure required for healthcare workers in inpatient or long-term care settings For PPD skin test, an injection is placed just under the skin, then checked 4872 hours later for inflammation and swelling TB For positive PPD test, chest x-ray and other tests are done to determine if drug therapy is needed Not everyone exposed to TB develops the full disease with active organisms Symptoms (active disease): night sweats, weight loss, coughing blood, chest pain, fatigue Universal Precautions: put on gown, mask, and gloves before entering the room of a patient with TB Remove these items on exiting to protect against transmission TB Normal vs Positive CXR with TB With treatment A two-step treatment process is usually followed, because determining the disease type takes time First process: an antibiotic covering a broad range of pathogens is started Second process (narrowing treatment): lab tests and cultures are taken to determine the bacteria or fungus Technicians may retrieve these results Once the pathogen is found, drug therapy may change Bronchodilators and corticosteroids may be administered to assist labored breathing Drugs for Pneumonia Drugs for TB are often specialized; not dispensed regularly Reemergence of TB due to the high rate of nonadherence to drug therapy Course of therapy for TB is 6 months or longer Many unpleasant side effects of TB therapy Doses are not always taken on an empty stomach or on a consistent basis Incomplete therapy promotes the emergence of drug- resistant TB Drugs for TB A genetic disease that affects exocrine glands Thick, sticky mucus is produced in the lungs, GI system, and pancreas; this mucus causes many problems Sweat glands and reproductive organs also affected Treatment needed for nutrition, pancreas, and respiratory complications Most hospitalizations and deaths due to pulmonary problems Most patients die before early to middle adulthood Cystic Fibrosis Specialized drugs; not dispensed regularly in all settings Respiratory therapy includes percussion (non-drug treatment), mucolytics, and antibiotics Percussion is a tapping, pounding movement performed on the back and chest Breaks up and helps expectorate mucus from lungs Nebulizer therapy with bronchodilators, hypertonic saline, acetylcysteine accompanies use of percussion Antibiotics and antifungal drugs are used to combat the bacteria and fungus in respiratory mucus secretions Drugs for CF Special vitamins and pancreatic enzyme supplements are used to help prevent ductal obstructions Improve growth and life expectancy for children with CF Fat-soluble vitamins are poorly absorbed Supplements containing vitamins A, D, E, and K are often prescribed Supplements for CF