Drugs used for respiratory system

Dr. Karun Kumar

JR-II

Dept. of Pharmacology

Respiration physiology

Drugs for bronchial asthma

1. Bronchodilators

A. Selective β2 agonists Salbutamol, Terbutaline,

Formoterol, Bambuterol &

Salmeterol

B. Nonselective sympathomimetics Epinephrine,

Ephedrine

C. Methylxanthines Theophylline, Aminophylline

D. Anticholinergics Ipratropium br., Tiotropium br.

2. Corticosteroids

A. Oral Prednisone, Prednisolone, Methylprednisolone

B. ParenteralMethylprednisolone, Hydrocortisone

C. Inhalational Beclomethasone, Budesonide, Fluticasone

3. Leukotriene (LT) modulators

A. Cysteinyl LT receptor antag. Montelukast, Zafirlukast

B. 5-Lipoxygenase inhibitor Zileuton

4. Mast cell stabilizers Sodium cromoglycate, Ketotifen

5. Monoclonal Anti-IgE antibody Omalizumab

6. Miscellaneous Nitric oxide donors

Leukotriene antagonists

Anti-IgE antibody

T/t of Status asthmaticus

1. Hydrocortisone hemisuccinate 100 mg i.v. stat followed by 100-200 mg 4-8 hourly infusion

2. Nebulized Salbutamol (2.5-5 mg) + Ipratropium bromide (0.5 mg) intermittent inhalations

3. High flow humidified oxygen inhalation

4. Salbutamol/Terbutaline 0.4 mg i.m/s.c.

5. Intubation & mechanical ventilation

6. Chest infection t/t with intensive a.b. therapy

7. Correction of dehydration & acidosis with saline + Sodium bicarbonate/lactate infusion

Drugs for cough

1.Antitussives

a) Centrally acting Codeine, Pholcodeine, Noscapine,

Dextromethorphan, Pipazethate

b) Central & peripherally acting Benzonatate

c) Peripherally acting Prenoxdiazine

d) Miscellaneous

i) Antihistaminics Chlorpheniramine, Diphenhydramine

ii) Pharyngeal demulcents Lozenges, Cough drop

iii) Local anaesthetics Xylocaine, Bupivacaine

2.Expectorants

a) Mucokinetic e. Na/K citrate, KI, Guaiphenesin, NH4Cl

b) Mucolytic e. Bromhexine, Ambroxol, Acetylcysteine

3. Adjuvant antitussives Salbutamol, Terbutaline