COPD : chronic obstructive

pulmonary disease
First phase :
bronchoconstriction
 bronchodilators
Second phase : inflammation
 steroids
For moderate or severe asthma
attacks
Bronchodilator, vasodilator
Stimulates respiration and
strengthens the action of
cardiac muscles
CNS stimulant
Oral or IV form
Pharmacokinetics
 Metabolite: 3-methyl-xanthine
 Drug interactions:
Phenytoin, carbamazepine

Erythromycin
 Adult therapeutic range: 10-20ug/mL
 Newborns : 5-10ug/mL
 Toxicity :
 15-20 ug/mL
 Nausea, vomiting, headache and
anxiety
 20-40 ug/mL
 Tachycardia, arrhythmias

 >40 ug/mL
 Seizures, cardiac arrest
 Tissue damage ---arachidonic acid
1. lipo-oxygenase pathway
> leukotrienes
2. cyclo-oxygenase pathway
> thromboxanes
> prostaglandins
*** Inflammation
Block the cyclo-oxygenase
pathway
Anti-inflammatory
Fluid retention, weight gain,
osteoporosis, gastrointestinal
bleeding and mental changes
Anti-inflammatory w/o
undesirable side effects
Acetaminophen/Paracetamol
Acetylsalicylic acid/Aspirin
Naproxen, Ibuprofen,
Piroxicam
Analgesic,antipyretic and anti-
inflammatory
Lower doses: anti-thrombotic
Chronic toxicity: tinnitus, muffled
hearing
Acute toxicity : acidosis
Reye’s syndrome: hepatotoxicity
Analgesic and anti-pyretic
Metabolites : glucoronide and
sulfate conjugates
Acute toxicity : nausea,
vomiting and abdominal pain
Chronic toxicity : anemia, renal
damage, GI disturbances
Autoimmune diseases
Tissue transplant recipient
1. Ciclosporin
2. Tacrolimus
3. Rapamycin
4. Mycophenolate mofetil
5. Leflunamide
Ciclosporin
 Drug of choice for maintenance
of kidney, liver, heart and heart-
lung allografts
 Adverse effect : nephrotoxicity
 Other effects : neurologic,
dermatologic, hepatotoxic
Tacrolimus
 Currently used in transplant
surgery to prevent organ rejection
 Similar toxicity profile to
ciclosporin
Available as citrate and CO3 salts
Anti-manic agents
Prophylaxis and treatment of
bipolar disorder
Toxicity : from single toxic dose or
prolonged use
Renal toxicity and hypothyroidism
Block reuptake of adrenergic and
dopaminergic neurotransmitters
Amitriptyline, imipramine,
nortriptyline, despramine, doxepin
Toxicity: excess CNS stimulation -
seizures, coma, hypotension,
respiratory depression
Inhibits dihydrofolate reductase
(DNA synthesis)
Uses :
 Psoriasis
 Refractory rheumatoid arthritis
 Malignant neoplastic diseases
Toxicity : hematologic effects, GI
effects
Treat leukemias and lymphomas
prior to BM transplantation
Toxicity : hepatic veno-occlusive
disease