Respiratory

•Leukotriene Modifier (Anti-Inflamitory)
•Pharmacotherapeutics–Prophylaxis or treatment of chronic asthma.
•Pharmacokinetics–Administered: oral. Metabolism: liver. Excreted: urine and feces.
•Pharmacodynamics–Blocks receptors for the leukotrienes bound to the amino acid cysteine.
•Contraindications and precautions–Hypersensitivity•Adverse effects–Headache, gastritis, pharyngitis, and rhinitis •Drug interactions–Theophylline, warfarin, aspirin, erythromycin, and drugs metabolized through the P-450 CYP2C9

•Mast Cell Stabilizer (Anti-Inflamatory)
•Pharmacotherapeutics
–Prophylactic agent in treating mild-to-moderate asthma.
•Pharmacokinetics
–Administered: inhalation or oral. Distribution: lungs. * Excreted: feces.
•Pharmacodynamics
–Works at the surface of the mast cell to inhibit mast cell rupture and degranulation after contact with an antigen.
•Contraindications and precautions
–Hypersensitivity
•Adverse effects
–Bronchospasm, throat irritation, and cough
•Drug interactions
–No clinically important drug interactions are known with cromolyn sodium

•Beta-Agonist (Bronchodialator)
•Pharmacotherapeutics
–Bronchodilator in managing CAL and asthma.
•Pharmacokinetics
–Administered: inhalation. Excreted: urine and feces. Onset: 5–15 minutes.
•Pharmacodynamics
–It selectively stimulates receptors of smooth muscle in the lungs, the uterus, and the vasculature that supplies skeletal muscle.
•Contraindications and precautions
–Hypersensitivity
•Adverse effects–Tachycardia, palpitations, anxiety, tremors, headache, insomnia, muscle cramps, and gastrointestinal (GI) symptoms
•Drug interactions
–Other sympathomimetic agents, beta-adrenergic blocking agents, digoxin, antidepressants, and potassium-losing diuretics

•Methylxanthines (Brochodialator)
•Pharmacotherapeutics
–Indicated for the symptomatic relief or prevention of bronchial asthma and reversal of bronchospasm.
•Pharmacokinetics
–Administered: oral or IV. Metabolism: liver. *Excreted: kidneys. Peak: 2 hours.
•Pharmacodynamics
–It is believed that bronchodilation is caused by inhibition of phosphodiesterase.
•Contraindications and precautions
–Hypersensitivity, status asthmaticus, or peptic ulcer
•Adverse effects
–Adverse effects related to theophylline use are related directly to serum levels of the drug
•Drug interactions
–Multiple drug interactions

•Anticholinergic (Bronchodialator)
•Pharmacotherapeutics
–Used for maintenance treatment of bronchospasm.
•Pharmacokinetics
–Administered: inhalation. Onset: 15-30 minutes.
•Pharmacodynamics
–Antagonizes the action of acetylcholine by blocking muscarinic cholinergic receptors.
•Contraindications and precautions
–Sensitivity to ipratropium and atropine
•Adverse effects
–Paradoxic acute bronchospasm, cough, hoarseness, throat irritation, or dysgeusia (altered taste)
•Drug interactions
–No serious drug–drug interactions are associated with ipratropium

Antihistamine
•Pharmacotherapeutics
–Relieves symptoms associated with seasonal and perennial allergies.
•Pharmacokinetics
–Administered: oral. Metabolism: liver. Excreted: urine and feces. Peak: 2–6 hours.
•Pharmacodynamics
–Selectively blocks the effects of histamine at H1-receptor sites.
•Contraindications and precautions
–Hypersensitivity
•Adverse effects
–Nausea, vomiting, dysmenorrhea, drowsiness, dyspepsia (indigestion), and fatigue
•Drug interactions
–Only a few drug interactions are associated with fexofenadine

Decongestant/Sympathomimetics
•Pharmacotherapeutics
–Reduces the volume of nasal mucus and is recommended for the temporary relief of nasal
congestion.
•Pharmacokinetics
–Administered: oral. Metabolism: liver. Excreted: kidneys. Onset: 30 minutes.
•Pharmacodynamics
–Causes vasoconstriction in the nasal mucous membranes.
•Contraindications and precautions
–Caution with pregnancy and lactation
•Adverse effects
–Tension, anxiety, restlessness, tremor, insomnia, and weakness
•Drug interactions
–MAOIs, guanethidine, methyldopa, or furazolidone

Antitussive
•Pharmacotherapeutics
–Chronic nonproductive cough.
•Pharmacokinetics
–Administered: oral. Metabolism: liver. Excreted: kidneys.
•Pharmacodynamics
–Directly affects the cough center in the medulla.
•Contraindications and precautions
–Chronic coughs resulting from emphysema and asthma
•Adverse effects
–Nausea, vomiting, drowsiness, dizziness, irritability, and restlessness
•Drug interactions
–MAOIs, fluoxetine, quinidine, and sibutramine

Mucolytic
•Pharmacotherapeutics
–Used to liquefy the thick, tenacious secretions.
•Pharmacokinetics
–Administered: inhalation. Onset: 1 minute.
•Pharmacodynamics
–It splits disulfide bonds that are responsible for holding the mucous material together.