KFU DAMMAM

COLLEGE OF MEDCINE


207
PHARMACOLOGY SUMMARY & REVIEW
Dr. Abdulaziz Al-Khawaja
Dr. Mohammed Akram
Dr. N. B. Biswas
Done by: Ahmed Ali Al-Ghareeb

P H R M A C O L O G Y - NOTE 1 - Treatment of Asthma

|

2

C
l
i
n
i
c
a
l

f
e
a
t
u
r
e
s

o
f

b
r
o
n
c
h
i
a
l

a
s
t
h
m
a
.
Contraction of airway smooth muscle.
leading to acute dyspnea & airway
obstruction.
Mucus hypersecretion.
leading to mucus pulgging.
Airway inflamation.
leading to bronchodema.
Role of
Leukotrines
in asthma
Broncho-
constriction
Mucosal
inflammation
Mucosal
edema
Mucus
secretion
Drugs for Asthma
Bronchodilators
2-adrenergic
agonist
Salbutamole
Terbutaline
Salmaterol
Methylxanthines
Theophylline
Aminophylline
Anti-muscarinic
Ipratropium
Anti-inflammatory
(glucorticosteroids)
Beclomethasone
Hydrocortisone
Prednisolone
Anti-leukotrienes
LT synthesis
inhibitor
Zileuton
LT receptor
antagonist
Montelukast
Mast cell stabilizers
Sodium
Cromoglycate
Uses of bronchodilator
for acute
broncho-
spasm
during acute
phase of
asthma attack
for quick
reduce airway
constriction













P H R M A C O L O G Y - NOTE 1 - Treatment of Asthma

|

3


Bronchodilaters
DRUG PHARMACOKINETIC ACTION USES SIDE EFFECT

2
-
a
d
r
e
n
e
r
g
i
c

a
g
o
n
i
s
t




Salbutamole Fast onest.
Short duration.
Given inhaler or Nebulizer.
Less side effect.
Given orally, S.C, IV or IM.
Large dose.
More side effect.
Bind to -receptor & stimulate
adenylcyclase.
Leading to cAMP.
Bronchodilatation.
Used for acute attack. Tremor.
Vascular headache.

Terbutaline
Salmaterol Slow onest.
Long duration.
Used for long term therapy.
M
e
t
h
y
l
x
a
n
t
h
i
n
e
s


Theophylline


Has narrow theraputic index.
Given orally.
Cause GI irritant.
Inhibit PDEI.
Leading to cAMP.
Ca
++
influx
Bronchodilatation
1) CNS stimulation.
2) Cardiac muscle stimulation.
3) Diuresis.
4) S.M. relaxtion of bronchial & uterus.
5) Periphral & cornory vasodilatation.
6) Cerebral vasoconstriction.
GIT: nausea, vomiting .
CNS: stimulation insomnia,
irritabillity & headach.
CVS: BP, arrhythmia.
Kidney: diuresis.
Aminophylline

Water mixture of Theophylline + Ethylenediamine.
Given orally, rectally (suppositories) or injection.
Anti-
musc
rinic
Ipratropium It is poorly absobed from the GIT.
So,it given by inhalation.
Slower onest & longer duration than salbutamol.
Blocking M receptor in bronchial
smooth muscle.
Bronchodilatation
Dry mouth.
Anti-inflammatory(Glucorticosteroid)
DRUG PHARMACOKINETIC ACTION USES SIDE EFFECT

Beclomethasone Given by inhalation, orally or IV. 1) Reduce mucosal edema.
2) Sensitize 2-agonist.
3) Reduce inflammatory cell activation
If taken by inhalation,
Dysphonia (hoarseness).
Oral candidiasis (fungal
infection).
Hydrocortisone
Prednisolone
Anti-Leukotrienes
DRUG PHARMACOKINETIC ACTION USES SIDE EFFECT

Zileuton 1) Inhibit lipoxygenase enzyme.
2) Reduce conversion of AA to LT.
So, it is
Broncodilater.
Anti-inflammatory.
To prevent asthma caused by
Aspirin.
NASID.

Montelukast 1) Blocking LT receptors.
2) Inhibit bronchoconstriction caused by LT
To prevent asthma caused by
NASID & Exercise.

Mast Cell Stabilizers
DRUG PHARMACOKINETIC ACTION USES SIDE EFFECT

Na Cromoglycate Given by inhalation. Reduce the mediators that release
from mast cell in response to allergen
that cause bronchoconstriction.
Prophylaxis aginst asthma
attack.
Cough.
Wheeze.
Ketotifen Given orally.