COPD Bronchodilators Corticosteroids Other agents

-β2-adrenergic agonists and -may improve symptoms, lung function and -Roflumilast is an oral phosphodiesterase-4
anticholinergic agents ipratropium and quality of life in COPD patients with FEV1 of inhibitor used to reduce exacerbations in patients with severe
tiotropium are the foundation of therapy less than 60% predicted chronic bronchitis
for COPD -increased risk of pneumonia -reduce inflammation by increasing levels of intracellular
->increase airflow, alleviate symptoms, and -Although often used for acute cAMP in lung cells
decrease exacerbation rates exacerbations, oral corticosteroids are not -nausea, vomiting, diarrhea,
-LABAs and tiotropium are preferred as recommended for long-term treatment and headache
first-line treatment
Allergic Antihistamines (H1-receptor bl.) Corticosteroids α-Adrenergic agonists Other agents
rhinitis -useful for the management of -Intranasal corticosteroids, such as -nasal decongestants such -Intranasal cromolyn may be useful in allergic
symptoms of allergic rhinitis caused by beclomethasone, budesonide, as rhinitis, particularly when administered before
histamine fluticasone, ciclesonide, phenylephrine, constrict contact with an allergen
-more effective for prevention mometasone, and triamcinolone, dilated arterioles in the ->dosing should begin at least 1 to 2 weeks
of symptoms, rather than treatment are the most effective medications nasal mucosa and reduce prior to allergen
once symptoms have begun for treatment of allergic rhinitis airway resistance Exposure
-First-generation antihistamines, such as -improve sneezing, itching, -aerosol->drugs have a -Although potentially inferior to other
diphenhydramine and rhinorrhea, and nasal congestion rapid onset of action and treatments, some LT antagonists are effective
chlorpheniramine, are usually not -Systemic absorption is minimal show few systemic effects for allergic rhinitis (monotherapy
preferred due to adverse effects, such -nosebleed, sore throat, and, -no longer than 3 days due or in combination)->pat. with also asthma
as sedation, performance impairment, rarely, candidiasis to the risk of rebound -intranasal formulation of ipratropium is
and other anticholinergic effects -just for the nose, don’t inhale nasal congestion (rhinitis available to treat rhinorrhea associated with
-fexofenadine, loratadine, -chronic rhinitis->improvement medicamentosa) allergic rhinitis or common cold
desloratadine, cetirizine, and intranasal after 1 to 2 weeks
azelastine are generally better tolerated
Cough Opioids Benzonatate
-Codeine decreases the sensitivity of cough centers in the CNS to peripheral stimuli and decreases mucosal -benzonatate suppresses the cough reflex
secretion through peripheral action
-therapeutic effects occur at doses lower than those required for analgesia ->anesthetizes the stretch receptors located in
->constipation, dysphoria, and fatigue, still occur the respiratory passages, lungs, and pleura
-Dextromethorphan is a synthetic derivative of morphine that has no analgesic effects in antitussive doses -Side effects include dizziness, numbness of
-low doses-> a low addictive profile but potential drug of abuse, since it may cause dysphoria at high doses the tongue, mouth, and throat
-Dextromethorphan has a significantly safer side effect profile than codeine and is equally effective for ->may be particularly problematic if the
cough suppression capsules are broken or chewed and the
-Guaifenesin available as a single-ingredient formulation and is also a common ingredient in combination medication comes in direct contact with the
products with codeine or dextromethorphan oral mucosa