Drugs And Cough And Bronchial Asthma Important Notes
1. Drugs used in bronchial asthma
- Bronchodilators
- Sympathomimetics
- Selective β2 agonists
- Short-acting – salbutamol, Terbutaline
- Longer acting – salmeterol
- Non-selective agents – adrenaline, aminophylline
- Methylxanthines – Heophylline, aminophylline
- Anticholinergics – ipratropium bromide, atropine
- Sympathomimetics
- Anti-inflammatory
- Systemic – glucocorticoids, hydrocortisone, prednisolone
- Inhalational – beclomethasone, triamcinolone
- Mast cell stabilizer – disodium cromoglycate
- Leukotriene receptor antagonists – Montelukast
- Anti – IgE antibody – Omalizumab
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2. Drugs causing bronchospasm
- ACE inhibitors
- Aspirin and other NSAIDs
- Beta-blockers
- Cholinergic drugs
- Bulk-forming laxatives
- Quinine
- Morphine
3. Ipratropium bromide
- It is an anticholinergic drug
- Produces slower response
- Used for regular prophylactic use
4. Mechanism of adrenergic as a bronchodilator
- Stimulation of β2 receptor
- Increased cAMP formation in bronchi muscle cells
- Relaxation of bronchi
5. Salbutamol
- It is β2 receptor agonist
- Safer than adrenaline and isoprenaline in the treatment of asthma
- Uses
- In acute exacerbation of asthma
- COPD
- For short-term relief of bronchoconstrictor
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Question 1. Mention two drugs used to suppress dry cough
Answer:
Drugs Used To Suppress Dry Cough:
1. Pharyngeal demulcents
- Lozenges
- Cough drops
- Glycerine
2. Expectorants
- Bronchial secretion enhancers
- Sodium or potassium citrate
- Potassium iodide
- Balsum of tolu
- Mucolytic
- Bromhexine
- Acetylcysteine
3. Antitussives
- Opioids
- Codeine
- Pholcodine
- Non Opioids
- Noscapine
- Dextromethorphan
- Antihistamines
- Chlorpheniramine
- Diphenhydramine
- Promethazine
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4. Adjuvant Antitussives
- Bronchodilators- Salbutamol, terbutalin
Question 2. Noscapine
Answer:
- Noscapine is a natural opium alkaloid
- It is a potent Antitussive
- It is highly effective and safe
- It may cause bronchoconstriction due to the release of histamine
- It acts by inhibiting the cough center In the medulla
Noscapine Use:
- Cough suppressant
Noscapine Adverse Effects:
- Nausea
- Headache
Noscapine Dose:
- 15-30 mg 6 hourly
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Question 3. Disodium cromoglycate
Answer:
- Disodium cromoglycate is a synthetic derivative
- It belongs to a group of antiasthmatic drugs
- It is administered as an aerosol through metered dose inhaler
Disodium cromoglycate Mechanism of Action:
- Inhibits degranulation of mast cells
- Inhibits the release of inflammatory mediators
- Inhibits the release of cytokines
- Depresses neuronal reflexes
Disodium cromoglycate Adverse Effects:
- Throat irritation
- Cough
- Rarely bronchospasm and allergic reactions
Disodium cromoglycate Uses:
1. Prophylactic in bronchial asthma
- It is used for longer periods in mild to moderate asthma
- 2 puffs, 3-4 times daily
2. Allergic rhinitis
- Used as a nasal spray to produce symptomatic improvement
3. Allergic conjunctivitis
- Used as eyedrops
- 1-2 drops, 3-4 times daily
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Question 4. Salbutamol
Answer:
- Salbutamol is a sympathomimetic drug
- It is fast acting bronchodilator
- The onset of action-1-5 min
- Duration of action- short
Salbutamol Actions:
- Bronchodilator
- Relaxation of the pregnant uterus
- Dilatation of blood vessels supplying the skeletal muscles
- Promote peptic glycogenolysis and uptake of potassium
Salbutamol Uses:
- In bronchial asthma- 100-200 meg every 6 hours through metered dose inhaler
- To delay premature labor
- In hyperkalemia
Salbutamol Adverse Effects:
- Tachycardia, palpitation
- Muscle tremors
- Tolerance
- Restlessness, nervousness
- Throat irritation
- Ankle edema
- Hyperglycaemia, hypokalaemia
Question 5. Pharmacotherapy of status asthmatics
Answer:
Treatment of status asthmaticus is as follows:
Question 6. Mention three groups of drugs used in bronchial asthma with an example.
Answer:
Drugs Used in Bronchial Asthma:
Question 7. Write the rationale for using any one drug for asthma.
Answer:
The Rationale of Using Sympathomimetic Drugs in Bronchial Asthma:
- Sympathomimetic drugs like adrenaline have the following mechanism
- It has a rapid onset and a short duration of action
- Hence it is used in acute asthmatic attacks as an aerosol
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Drugs And Cough And Bronchial Asthma Short Question And Answers
Question 1. Aminophylline
Answer:
- Aminophylline is one of the methylxanthines
Aminophylline Mechanism of Action:
- Enhances cAMP levels
- Causes bronchodilatation
- Inhibits the release of inflammatory mediators
Aminophylline Actions:
- CNS stimulant
- CVS stimulant
- Relaxes smooth muscles
- Mild diuretic
- Enhances secretion of acid and pepsin in the stomach
- Inhibits the release of inflammatory mediators
Aminophylline Uses:
- Bronchial asthma and COPD
- Apnea in the premature infant
Aminophylline Adverse Effects:
- Dyspepsia, vomiting, nervousness, tremor, delirium, hypotension, arrhythmia, and convulsions
Question 2. Nasal decongestants.
Answer:
- Nasal decongestants stimulate the alpha receptors and cause vasoconstriction in the nasal mucous membrane and relieve nasal congestion
Drugs Used As Nasal Decongestants:
- Naphazoline
- Pseudoephedrine
- Phenylephrine
- Imidazole
Nasal decongestants Use:
- Allergic rhinitis
- Common cold
- Sinusitis
Nasal decongestants Adverse Effects:
- Atrophic rhinitis
- Anosmia
- Local irritation
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Question 3. The rationale for using Salbutamol in bronchial asthma
Answer:
- Salbutamol is used in asthma to reduce cardiac side effects
- Inhaled Salbutamol produces bronchodilatation within 5 min
- Its action lasts for 2-4 hours
- It is the most effective, convenient, and relatively safe
- Hence it is used to terminate the attacks of asthma.
Question 4. Beclomethasone
Answer:
- Beclomethasone is long acting glucocorticoid
Beclomethasone Mechanism of Action:
- Suppresses inflammatory response to antigen-antibody reaction
- Reduces mucosal edema and hyper irritability
Beclomethasone Uses:
- Prophylactic use to prevent acute attacks of asthma
- Prevent bronchial hypersensitivity
- Controls the symptoms
Beclomethasone Available As:
- Nasal spray- For allergic rhinitis
- Ointment- For skin and mucous membrane
Beclomethasone Dose:
- Beclate inhaler- 50,100,200 microgram
- Metered dose-1-2 puffs 3-4 times a day
Beclomethasone Adverse Effects:
- Hoarseness of voice
- Sore throat
- Oropharyngeal Candidiasis
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Question 5. Ipratropium.
Answer:
- It is a semi-synthetic anticholinergic drug
- Given by inhalation
Ipratropium Uses:
- Bronchial asthma
- COPD
- Inhaled ipratropium – used as a prophylactic agent
- Nebulized ipratropium mixed with salbutamol – used in refractory asthma
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Question 5. Name four bronchodilators.
Answer:
- Sympathomimetics – adrenaline, isoprenaline, salbutamol
- Methyl xanthine – theophylline, aminophylline
- Anticholinergic – ipratropium bromide, tiotropium bromide