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DRUGS AFFECTING DRUGS AFFECTING THE RESPIRATORY THE RESPIRATORY ORGANS FUNCTIONORGANS FUNCTION
Lector prof. Posokhova K.A.Lector prof. Posokhova K.A.
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Drugs affecting the respiratory organsDrugs affecting the respiratory organs function function
anticough drugsanticough drugs;;
expectorantsexpectorants;;
breathing stimulantsbreathing stimulants;;
drugs used for bronchial asthmadrugs used for bronchial asthma;;
drugs used for lungs edemadrugs used for lungs edema
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COUGHCOUGH
with presence of secretion inwith presence of secretion in bronchibronchi
drydry
PRODUCTIVEPRODUCTIVESputum with significant viscous-elastic properties: - muco- and proteolytic drugsmuco- and proteolytic drugsSputum with significant adhesive properties: - drugs which stimulate production of surfactantdrugs which stimulate production of surfactantDecreasing of speed of mucociliar transport with unchanged properties of sputum: - drugs which stimulate ciliar functiondrugs which stimulate ciliar functionSignificant disorders of bronchial permeability, morphological changes of bronchi (atrophy of mucous membrane, bronchial stenosis), excessive production of mucus: - alkali inhalationsalkali inhalationsSigns of allergic reaction with increased histamine activity:- antihistamine drugsantihistamine drugs
NONPRODUCTIVENONPRODUCTIVECataral inflammation (usually viral), reflector and central cough: - anticough drugsanticough drugsSigns of allergic reaction: - antihistamine drugsantihistamine drugsBronchospasm: - broncholyticsbroncholytics
REHYDRANTS IN ALL CASESREHYDRANTS IN ALL CASES
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Anticough drugsAnticough drugs
Drugs of central actionDrugs of central action ( (depress central depress central links of cough reflexlinks of cough reflex):):
а)а) narcoticnarcotic:: codeincodein, , dextromethorphandextromethorphan
б) б) nonnarcoticnonnarcotic:: glaucin hydrochlorideglaucin hydrochloride ((glauventglauvent), ), oxeladin citrate (tussuprex)oxeladin citrate (tussuprex)
Drugs of peripheral actionDrugs of peripheral action ( (block block sensitivesensitive receptors of cough receptors of cough reflexogenic zonesreflexogenic zones): ): libexinlibexin
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Oxeladin citrateOxeladin citrate, Tussuprex, Tussuprex
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Glaucin hydrochlorideGlaucin hydrochloride ( (glauventglauvent) + ) + ephedrineephedrine + + Sage oilSage oil
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LibexinLibexin
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ExpectorantsExpectorants
Secrete-motor drugsSecrete-motor drugs ( (stimulate expectorationstimulate expectoration):):а) а) drugs of reflex actiondrugs of reflex action: : drugs of medical plantsdrugs of medical plants, , sodium benzoatesodium benzoate, , bronchicum elixirbronchicum elixir, , mucaltinmucaltinб) б) drugs of resorbtive and local actiondrugs of resorbtive and local action: : bromide -bromide -sodium and potassiumsodium and potassium, , ammonium chlorideammonium chloride, , sodium sodium hydrocarbonatehydrocarbonate, , ether oilsether oilsBronchosecretolytic drugs Bronchosecretolytic drugs ((mucolyticsmucolytics))::а) а) proteolytic enzymesproteolytic enzymes: : tripsintripsin, , chimopsinchimopsin, , chimotripsinchimotripsin, , desoxyribonuclease desoxyribonuclease б) б) mucolyticsmucolytics: : acetylcysteinacetylcystein, , carbocysteincarbocysteinв) в) drugs which influence surfactant production or drugs which influence surfactant production or surfactantssurfactants: : bromhexin, ambroxol, “Alveofakt”, bromhexin, ambroxol, “Alveofakt”, “Ekzosurf”“Ekzosurf”
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Drugs of medical plantsDrugs of medical plants
Althea officinalisAlthea officinalis ThermopsisThermopsis Viola Viola
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Combined remedyCombined remedy “ “BronchicumBronchicum””
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MucaltinMucaltin (Mucaltinum) (Mucaltinum)
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Drugs of medical plantsDrugs of medical plants
Ledum palustraeLedum palustrae Origanum vulgarisOriganum vulgaris
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Crystal tripsinCrystal tripsin (Trуpsinum crystallisatum) (Trуpsinum crystallisatum) Ampoules -Ampoules - 0,005 0,005 gg andand 0,01 0,01 gg
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AcetylcysteinAcetylcystein (Acetylcysteinum) (Acetylcysteinum) Forms of production:Forms of production: tablets - tablets - 0,1, 0,2 0,1, 0,2 andand 0,6, 20 % 0,6, 20 % solution for inhalation in ampoules –solution for inhalation in ampoules –
5 5 andand 10 10 mlml; 10 % ; 10 % solution for injection in ampoules -solution for injection in ampoules - 2 2 ml andml and 5 % 5 % solution in ampoules –solution in ampoules – 10 10mlml. .
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BromhexinBromhexin (Bromhexinum) (Bromhexinum)
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АmbroxolАmbroxol (Lasolvan) (Lasolvan)Forms of productionForms of production: : tablets -tablets - 0,03 0,03 and syrupand syrup..
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COUGHCOUGHDry Dry
With presence of sputum in bronchiWith presence of sputum in bronchi
PRODUCTIVEPRODUCTIVESputum with significant viscous-elastic properties - muco- and proteolytic muco- and proteolytic
drugsdrugsSputum with significant adhesive properties - drugs which stimulate drugs which stimulate
production of surfactantproduction of surfactantDecreasing of speed of mucociliar transport with unchangedproperties of sputum - drugs which stimulate cilia functiondrugs which stimulate cilia functionSignificant disorders of bronchial permeability, morphological changes of
bronchi (atrophy of mucous membrane, bronchial stenosis), excessive production of mucus - alkali inhalations
Signs of allergic reaction with increased histamine activity - antihistamine antihistamine drugsdrugs
NONPRODUCTIVENONPRODUCTIVECataral inflammation (usually viral), reflector and central cough - anticough anticough
drugsdrugsSigns of allergic reaction - antihistamine drugsantihistamine drugsBronchospasm - broncholyticsbroncholytics
REHYDRANTS IN ALL CASES
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Stimulants of breathingStimulants of breathing ((analepticsanaleptics))
Analeptics of direct actionAnaleptics of direct action: : bemegrid, bemegrid, ethymisol, caffeineethymisol, caffeine
Analeptics of mixed actionAnaleptics of mixed action: : cordiamin, cordiamin, camphorcamphor, , carbon acidcarbon acid ( (carbogen – carbogen – mixture of Omixture of O22 and CO and CO22))
Analeptics of reflex actionAnaleptics of reflex action: :
lobelin, cytitonlobelin, cytiton
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AethimizolAethimizol (Aethimizolum) (Aethimizolum)Sodium caffeine-benzoateSodium caffeine-benzoate (Coffeinum-natrii (Coffeinum-natrii
benzoas)benzoas)BemegridBemegrid (Bemegridum) (Bemegridum)
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CordiaminCordiamin (Cordiaminum) (Cordiaminum)Camphor Camphor (Camphora)(Camphora)
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DRUGS FOR BRONCHIAL DRUGS FOR BRONCHIAL ASTHMAASTHMA
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To remove attack of bronchial To remove attack of bronchial asthma asthma
Broncholytic drugsBroncholytic drugs::AdrenomimeticsAdrenomimetics ( (αα,, ββ--adremonimeticsadremonimetics, , ββ--adrenomimeticsadrenomimetics, , ββ22--adrenomimeticsadrenomimetics))MethylxantinesMethylxantinesCholinoblockersCholinoblockers ( (MM--cholinoblockerscholinoblockers, , ganglionblockersganglionblockers))
Antiallergics and drugs that reduce Antiallergics and drugs that reduce airway hyperresponsivenessairway hyperresponsivenessExpectorants Expectorants
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Beta-adrenomimeticsBeta-adrenomimetics
SalbutamolSalbutamol, , Ventolin,Ventolin, Berotek,Berotek, AsthmopentAsthmopent
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MethylxanthinesMethylxanthinesTheophyllinTheophyllin (of prolonged action)(of prolonged action)
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M-cholinoblockersM-cholinoblockersAtropine sulfateAtropine sulfate, , Solutan, Ipratropii bromidum Solutan, Ipratropii bromidum
(Atrovent)(Atrovent)
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Inhibitors of mast cells degranulationInhibitors of mast cells degranulation
Cromolyn, KetotifenCromolyn, Ketotifen and and NNedocromiledocromil antagonize antigen-induced (IgE-mediated) antagonize antigen-induced (IgE-mediated) mast cell degranulation mast cell degranulation
they prevent the release of histamine and slow-they prevent the release of histamine and slow-reacting substance of anaphylaxis (SRS-A) - reacting substance of anaphylaxis (SRS-A) - mediators of type I allergic reactionsmediators of type I allergic reactions
their beneficial effects in the treatment of their beneficial effects in the treatment of asthma are largely asthma are largely prophylacticprophylactic
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KetotifenKetotifen
TiladeTilade ( (sodium nedocromilsodium nedocromil))
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Corticosteroid hormones in the Corticosteroid hormones in the management of asthmamanagement of asthma
In 1991- guidelines for the diagnosis and In 1991- guidelines for the diagnosis and management of asthma were published by management of asthma were published by the National Asthma Education Program the National Asthma Education Program (USA). This report described the patho-(USA). This report described the patho-physiology of asthma including airway physiology of asthma including airway obstruction, airway inflammation, and obstruction, airway inflammation, and airway hyperresponsiveness. airway hyperresponsiveness. Since then, Since then, corticosteroids have moved to corticosteroids have moved to the forefront in the treatment of asthmathe forefront in the treatment of asthma..
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Inhaled corticosteroidsInhaled corticosteroids
BeclomethasoneBeclomethasone BudesonideBudesonide
Dexamethasone Dexamethasone Flunisolide Flunisolide Fluticasone Fluticasone
TriamcinoloneTriamcinolone
Administration corticosteroids by inhalation Administration corticosteroids by inhalation limits the systemic adverse reactions limits the systemic adverse reactions
associated with oral or parenteral therapy associated with oral or parenteral therapy
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Administration of inhaled corticosteroidsAdministration of inhaled corticosteroids
by the use of chambers or spacers by the use of chambers or spacers these devices help decrease systemic these devices help decrease systemic absorption and subsequent adverse absorption and subsequent adverse reactions of the corticosteroids reactions of the corticosteroids most inhaled therapy is delivered via most inhaled therapy is delivered via metered dose inhalersmetered dose inhalersother method - the breath-actuated dry other method - the breath-actuated dry powder inhaler devices (Rotahaler, powder inhaler devices (Rotahaler, Diskhaler, Turbuhaler) Diskhaler, Turbuhaler)
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PrednisolonPrednisolon, , HydrocortizoneHydrocortizone, , DexamethazoneDexamethazone..
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Potential role in the treatment of Potential role in the treatment of asthmaasthma
ZileutonZileuton - a 5-lipoxygenase inhibitor - a 5-lipoxygenase inhibitor
ZafirlukastZafirlukast - a leukotriene-receptor antagonista leukotriene-receptor antagonist
Leukotrienes attract cellular infiltrates producing Leukotrienes attract cellular infiltrates producing epithelial injury, abnormalities in neural epithelial injury, abnormalities in neural mechanisms, increases in airway smooth muscle mechanisms, increases in airway smooth muscle responsiveness, and airway obstructionresponsiveness, and airway obstruction
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DRUGS FOR LUNGS EDEMADRUGS FOR LUNGS EDEMA
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Classification of lungs edema::
Cardiogenic Cardiogenic
Toxic Toxic
NeurogenicNeurogenic
Caused by prolonged inspire Caused by prolonged inspire resistanceresistance
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Treatment measures for lungs edemaTreatment measures for lungs edema
а) а) decreasing of hydrostatic pressure in pulmonary decreasing of hydrostatic pressure in pulmonary vessels vessels and decreasing of cardiac inputand decreasing of cardiac input bb) ) decreasing the volume of blood circulation decreasing the volume of blood circulation c) lungs dehydrationc) lungs dehydration dd) ) decreasing of permeability of alveolar-capillary decreasing of permeability of alveolar-capillary membranesmembranes ee) ) improvement of tissue oxygenationimprovement of tissue oxygenation, , renewing of renewing of respiratory ways penetrability,respiratory ways penetrability, removing the foam in removing the foam in alveolialveoli f) correction of acid-base and electrolyte balancef) correction of acid-base and electrolyte balancegg) ) removal of pain syndrome and acute disorders of removal of pain syndrome and acute disorders of heart rhythmheart rhythmg)g) strengthening of contractive ability of myocardium strengthening of contractive ability of myocardium and fighting with bronchospasmand fighting with bronchospasm
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Morphine hydrochlorideMorphine hydrochloride(Morphini hydrochloridum)(Morphini hydrochloridum)
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GANGLIONBLOCKERSGANGLIONBLOCKERSHygroniumHygronium, , PentaminPentamin
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VasodilatorsVasodilatorsNitroglycerinNitroglycerin (Nitroglycerinum) (Nitroglycerinum)
NitromintNitromint
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DiureticsDiuretics
Furosemid Furosemid ((LazixLazix), ), MannitMannit
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Modified Bobrov’s apparatusModified Bobrov’s apparatus(Alcohol 55-90 % for inhalation with oxygen – to reduce (Alcohol 55-90 % for inhalation with oxygen – to reduce
the foam in alveoli)the foam in alveoli)
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DimedrolDimedrol, , SuprastinSuprastin, , PrednisolonePrednisolone