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Drug Therapy for COPD
More effective in “relieving” respiratory symptoms than curing underlying disorders that cause the symptoms
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Two major drug groups used to treat respiratory symptoms:
- Bronchodilators
- Anti-inflammatory agents
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Bronchodilators
- Beta-adrenergic agonists
- Most frequently prescribed drugs for pulmonary disorders
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Beta Agonists:
- Activate SNS=relaxes bronchial smooth muscle=bronchodilation
- DOC in treatment of bronchoconstriction
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Beta-Adrenergic Agonists
- Act on either beta-1 receptors (located primarily in the heart)
- Think…one heart…beta-1
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Beta 2 receptors are located where?
- on smooth muscle of the lung
- uterus
- other organs
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Beta-2 works on
lungs…you have 2 lungs
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Beta agonists that activate both beta 1 and beta 2 receptors are called
“non-selective” agents
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What is an examples of non-selective Beta Agonist?
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What was the 1st beta agonist used for bronchospasms. “non-selective”
Isoproterenol
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Why is Isoproterenol not used much today?
numerous side effects
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A catecholamine with alpha and beta receptor properties used for COPD?
Epinephrine
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Uses of epinephrine in COPD patients?
- Given for immediate bronchodilation effects to increase patency of airway
- EMERGENCY DRUG - shock
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Selective Beta agonists
- Albuterol, aka Proventil or Ventolin
- Can get some beta 1 effects if used in excess
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Beta adrenergic agonists
Selective beta 2 agonists have largely replaced the older non- selective agonists that were often alpha, beta 1 and beta 2
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What does the Beta Adrenergic agonists do?
Prevents unwanted cardiac effects
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Beta 2 adrenergic agonists - Classified by duration of action
- Short acting agents have rapid onset of action
- Usually within several minutes
- Effective in terminating and acute asthma “episode”
- “Rescue agents”
- Typically lasts 2-6 hours in duration
- Used “prn”
- DOC for acute symptoms
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What are Short Acting Beta Agonists (SABA’s)?
- SABA’S…rapid onset…30 sec-1 minute
- short-term relief of acute reversible airway problems
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Examples of SABA’s?
- Albuterol
- Proventil
- Ventolin
- Alupent (Metaproterenol)
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How is (albuterol) Proventil & Ventolin administered?
Available in po, MDI, DPI
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What is MOA of Albuterol, proventil, & Ventolin?
Promotes bronchodilation
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How is Alupent (Metaproterenol) administered?
Nebulizer, MDI, po
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Bronchodilators
- Relax smooth muscle of the bronchi, promoting bronchodilation
- Reduces airway resistance
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Beta-adrenergic agonists bronchodilators
Most frequently prescribed drugs for pulmonary disorders
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Beta Agonists:
- Activate SNS=relaxes bronchial smooth muscle=bronchodilation
- DOC in treatment of bronchoconstriction
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Bronchodilators - Sympathomimetics
Epinephrine (adrenaline)
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Action of epinephrine
- Increases cAMP in lung tissue causing bronchodilation
- Restores circulation and increases airway patency
- First line of defense in acute asthma attack or anaphylaxis, given subQ
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Side effects of epinephrine
- Palpitations
- Dizziness
- Nervousness
- Tremors
- Tachycardia
- Dysrhythmias
- hypertension
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