Drugs for

Respiratory
System
 Common Symptoms
 Coughing
 Sputum
 Hoarseness
 Wheezing
 Chest Pain
 Breathing
 Respiratory Conditions
Upper Lower
 Common Colds  Atelectasis
 Seasonal Rhinitis  Pneumonia
 Sinutis  Bronchitis
 Pharyngitis
Drugs Acting on the
Drugs Acting on the
Upper Respiratory
Lower Respiratory
Tract
Tract
1. Antitussive
1. Bronchodilators
2. Decongenstants
2. Sympathomimetics
3. Antihistamines
3. Anticholinergics
4. Expectorants
4. Inhaled Steroids
5. Mucolytics
5. Leukotriene Receptor
Antagonist
6. Lung Surfactants
 Antitussive
 Suppress the cough reflex
 MOA: acts on the medullary center of the
brain to depress the cough reflex
 Codeine, Dextromethorphan,
Acetylcysteine
 Contraindications: Patients with Asthma,
hypersentivity,
 Side Effects: nausea, constipation and
complaints of dry mouth, headache, feelings
of congestion, dizzines
 Decongenstants
 local vasoconstrictor
 MOA: decrease the flow of blood to the irritated
capillaries of the mucus membrane which lead to
shrinking of engorge nasal passages
 Topical: ephedrine, oxymethazoline,
phenylephrine,
 Oral: pseudoephedrine
 Topical Nasal Steroids : Beclomethasone,
dexamthesaone,fluticasone
 Only relieve symptoms
 Contraindications: presence of lesion
 Adverse Effects: topical: stinging and burning,dryness
of the mucosa,Rebound effect: congestion
 Antihistamines
• Treat allergies and relieve respiratory
symptoms
• MOA: block the effects of histamine 1
receptor sites, decreasing allergic response
• Fexofenadine, promethazine,
chlorpheniramine
• Cross placenta and enter breasmilk
• Side Effects: drowsiness and sedation,
antichlolinergic effects: drying of respiratory
and GI mucus membranes
 Expectorants
• Liquify the lower respiratory tract secretions,
reducing the viscousity
• MOA: reuce the adhesiveness and surface
tension of fluids, thinning of secretions
• Guaifenesin, terpin hydrate
• Adverse Effect: GI Symptoms, headache,
dizziness
 Mucolytics
 MOA: helps loosen thick secretions
 By nebulization, Oral
 acetylcysteine, ambroxol, bromhexine,
carbocisteine, erdosteine, mecysteine, and
dornase alfa
 Indicated for COPD, atelectasis
 Acetylcysteine helps slpit apart disulfide
bonds that are responsible for holding the
mucu membranes together
 Bronchodilators &
Antiasthmatics
MOA: Cause the bronchioles to relax and expand
Adverse Effects: tachycardia, nervousness, trembling of
hands, GI symptoms,
Types:
 B2 adrenergic agonists( short acting & Long Acting)
 Anticholinergic agent
 Xanthines
 Sympathomimetics
 Inhaled Steroids
 Lung Surfactants
 B2 adrenergic agonists
• Beta-2 agonists are used for both asthma and
COPD, although some types are only available
for COPD.
• Inhaled, tablets, syrup
MOA: work by stimulating receptors called beta-
2 receptors in the muscles that line the
airways, which causes them to relax and
allows the airways to widen (dilate).
Salbutamol, salmeterol, formoterol and
vilanterol
• Short-acting beta-agonists (SABAs) provide quick
relief of asthma symptoms.;
• Examples of these short-acting medications
include: albuterol (AccuNeb, Proventil HFA,
ProAir HFA, Ventolin HFA) and levalbuterol
(Xopenex, Xopenex HFA).
• Long-acting beta-agonists (LABAs) are taken on a
daily basis to relax the muscles lining the airways that
carry air to the lungs. This allows the tubes to remain
open, making breathing easier. Taken with steroids.
• Combinations of a long-acting beta2-agonist and
inhaled corticosteroid include formoterol and
budesonide (Symbicort), formoterol and
mometasone (Dulera), and salmeterol and
 Anticholinergic Agents
 Anticholinergics (antimuscarinics) are mainly
used to treat COPD, but a few can also be used
for asthma.
 MOA:antagoize the action of acetylcholine at
vagal mediated receptor sites.
 ipratropium, tiotropium, aclidinium and
glycopyrronium
 Xanthines/Theophyllines
 unclear exactly how theophylline works, but it
seems to reduce any inflammation (swelling)
in the airways, in addition to relaxing the
muscles lining them.
 Weaker and most likely to cause side effects
 Nicotine increases the metabolism in the liver
 Theophylline,Aminophyliline, caffeine,
dyphylline
 Sympathomimetics
 Are drugs that mimic the effects of the
sympathetic nervous system
 MOA: Dilates bronchi and increases rate and
depth of respirations
 Albuterol, epinephrine, isoetharine,
terbutaline
 Inhaled Steroids
 Effective in the treatment of bronchospasm
 MOA: decreases inflammatory response of the
airway
 Cross the placenta
 Adverse Effcets: sore throat, hoarsness, dry
moth, phangeal and laryngeal fungal
infections
 Beclomethasone, budesonide, fluticasone
 Not intended for acute attacts
 Leukotrine receptor Antagonists
 Useful in asthma, bronchitis and epmphysema
 MOA: blocks or antagonize receptors for the
poduction of leukotrinesD4 and E4 which contributes
to inflammation, edema and mucus secretion
 Indicated for prophylaxis and chronic treatment of
bronchial asthma
 Cross the placentA
 Adverse Effects: headache, dizzines, myalgia, GI
symptoms,
 Never combine with calcium channel blockers or
aspirin = toxicity
 Montelukast, zafirlukast
 Lung Surfactants
 Reduce surface tension within the alveoli
allowing expansion and good gas exchange
 Indicated for infants who have Respiratory
Distress Syndrome
 Instilled intratracheally
 Metabolized in the lungs
 Beractant, calfactant, colfosceril, poractant